Digital therapeutics and gamified mobile applications for behavioral modification in pediatric hypertension

Hypertension in children is a growing global health concern, particularly in regions undergoing lifestyle transitions. This pilot study evaluated the effectiveness of "PressPlay Kids," a culturally-adapted, gamified mobile health application, for behavioral modification in children and adolescents with hypertension in Uzbekistan. We conducted a 12-week randomized controlled trial involving 80 participants aged 10-16, comparing the app combined with standard counseling to standard counseling alone. Participants in the intervention group showed a significantly greater reduction in systolic blood pressure compared to controls (-8.2 mmHg vs. -2.1 mmHg, p < 0.001). Significant improvements were also observed in key behavioral outcomes: daily sodium intake decreased by a median of 500 mg in the intervention group (p < 0.001), daily step count increased by over 2,000 steps (p < 0.001), and medication adherence was 22% higher among those prescribed pharmacotherapy (p = 0.009). App engagement was high, with participants logging in an average of 5.8 times per week, and 86.8% reported the app as "fun" or "very fun" to use.