Evaluating a Mobile Health–Supported Regular Physical Measurement Program for Weight Change in Urban Zambia: A Quasi-Experimental Study
1
Department of Environmental Health and Global Health, Teikyo University Faculty of Pharmaceutical Sciences, Tokyo, Japan
2
Department of Preventive Services, School of Public Health, Kyoto University, Kyoto, Japan
3
Department of Social Epidemiology, School of Public Health, Kyoto University, Kyoto, Japan
4
Center For Primary Care Research, Lusaka, Zambia
5
Lusaka Apex Medical University, Lusaka, Zambia
Popul. Med. 2026;8(Supplement Supplement 1):A3051
ABSTRACT
BACKGROUND:
Overweight/obesity are growing public health concerns in sub-Saharan Africa 1. In Zambia, the prevalence of overweight/obesity among adults reached 24.2% in 2017, yet opportunities for regular weight measurement remain limited, and effective, scalable strategies for non-communicable disease prevention are still lacking 2,3. This study examined the effectiveness of a regular physical measurement program supported by mobile health (mHealth) tools in promoting weight loss and lifestyle change among urban adults in Zambia.
METHODS:
This quasi-experimental study was conducted from October 2024 to March 2025 in Lusaka, Zambia. Participants from three medical universities were assigned to one of three groups for 3–4 months: (1) control (health education only), (2) intervention 1 (health education plus monthly weight monitoring), and (3) intervention 2 (health education, monthly weight monitoring, and daily step tracking). A total of 180 adults aged ≥20 years with body mass index ≥25 and smartphone access were enrolled using quota sampling by age and sex. Adjusted mean changes and between-group differences were assessed using difference-in-differences mixed-effects models, adjusting for age, sex, and follow-up duration.
RESULTS:
Data from 170 participants were analyzed, with similar age and sex distributions across groups. In the mixed-effects model with a random intercept for individuals, body weight decreased slightly over time by approximately 0.7 kg (p = 0.005). The magnitude of weight change was similar across groups (control: −0.36 kg; intervention 1: −0.73 kg; intervention 2: −0.69 kg), with no significant time-by-group interaction (p = 0.731).
CONCLUSIONS:
Regular weight monitoring supported by mHealth tools may facilitate modest short-term weight reduction among urban adults in Zambia. Adding step count tracking provided no additional benefit beyond weight monitoring and health education. The high within-individual stability of body weight and the short intervention period may have limited detection of between-group differences. Longer-term follow-up and refinement of intervention components are warranted.
Overweight/obesity are growing public health concerns in sub-Saharan Africa 1. In Zambia, the prevalence of overweight/obesity among adults reached 24.2% in 2017, yet opportunities for regular weight measurement remain limited, and effective, scalable strategies for non-communicable disease prevention are still lacking 2,3. This study examined the effectiveness of a regular physical measurement program supported by mobile health (mHealth) tools in promoting weight loss and lifestyle change among urban adults in Zambia.
METHODS:
This quasi-experimental study was conducted from October 2024 to March 2025 in Lusaka, Zambia. Participants from three medical universities were assigned to one of three groups for 3–4 months: (1) control (health education only), (2) intervention 1 (health education plus monthly weight monitoring), and (3) intervention 2 (health education, monthly weight monitoring, and daily step tracking). A total of 180 adults aged ≥20 years with body mass index ≥25 and smartphone access were enrolled using quota sampling by age and sex. Adjusted mean changes and between-group differences were assessed using difference-in-differences mixed-effects models, adjusting for age, sex, and follow-up duration.
RESULTS:
Data from 170 participants were analyzed, with similar age and sex distributions across groups. In the mixed-effects model with a random intercept for individuals, body weight decreased slightly over time by approximately 0.7 kg (p = 0.005). The magnitude of weight change was similar across groups (control: −0.36 kg; intervention 1: −0.73 kg; intervention 2: −0.69 kg), with no significant time-by-group interaction (p = 0.731).
CONCLUSIONS:
Regular weight monitoring supported by mHealth tools may facilitate modest short-term weight reduction among urban adults in Zambia. Adding step count tracking provided no additional benefit beyond weight monitoring and health education. The high within-individual stability of body weight and the short intervention period may have limited detection of between-group differences. Longer-term follow-up and refinement of intervention components are warranted.
| eISSN: | 2654-1459 |
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