Interventions improving health professionals’ practice for addressing patients’ weight management behaviours: systematic review of reviews

2020 ◽  
Author(s):  
Bahareh Yazdizadeh ◽  
Ruth Walker ◽  
Helen Skouteris ◽  
Ellinor K Olander ◽  
Briony Hill
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Data Extraction ◽  
System Level ◽  
Training Interventions ◽  
Cochrane Database ◽  
Physical Activity Advice ◽  
Diet And Physical Activity

Abstract Health professionals require education and training to implement obesity management guidelines and ultimately impact on the health outcomes experienced by their patients. Therefore, a systematic review of systematic reviews that evaluated interventions designed to change the practice of health professionals when addressing diet and physical activity with their patients was conducted. MEDLINE Complete; Cochrane database of systematic reviews; PsycINFO; CINAHL Complete; Global Health; Embase; INFORMIT: Health Subset; Health System Evidence and RX for change were searched in March 2019, with no date or language limits. Identified references underwent screening, full-text analyses and data extraction in duplicate. The search identified 15 230 references. Five systematic reviews that provided a narrative syntheses of a combined 38 studies were included. Health professional participants generally reported being satisfied with the training interventions. Heterogeneity between and within included reviews, non-controlled designs of individual studies and low quality of evidence at an individual study level and review level made it difficult to draw firm conclusions regarding what interventions are most effective in changing health professionals’ knowledge, skills, self-efficacy, attitudes and practice. However, similar gaps in the literature were identified across included reviews. Key areas that could be addressed in future interventions including organization and system-level barriers to providing advice, health professionals’ attitudes and motivation and weight stigma have been highlighted. Health professionals and patients could be more involved in the planning and development of interventions that work towards improving diet and physical activity advice and support provided in healthcare.

scholarly journals Development of the ACTIVE framework to describe stakeholder involvement in systematic reviews

2019 ◽  
Vol 24 (4) ◽  
pp. 245-255 ◽  
Author(s):  
Alex Pollock ◽  
Pauline Campbell ◽  
Caroline Struthers ◽  
Anneliese Synnot ◽  
Jack Nunn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Public Involvement ◽  
Review Process ◽  
Data Extraction ◽  
Stakeholder Involvement ◽  
Decision Makers ◽  
Literature Searching ◽  
Health Decision

Objectives Involvement of patients, health professionals, and the wider public (‘stakeholders’) is seen to be beneficial to the quality, relevance and impact of research and may enhance the usefulness and uptake of systematic reviews. However, there is a lack of evidence and resources to guide researchers in how to actively involve stakeholders in systematic reviews. In this paper, we report the development of the ACTIVE framework to describe how stakeholders are involved in systematic reviews. Methods We developed a framework using methods previously described in the development of conceptual frameworks relating to other areas of public involvement, including: literature searching, data extraction, analysis, and categorization. A draft ACTIVE framework was developed and then refined after presentation at a conference workshop, before being applied to a subset of 32 systematic reviews. Data extracted from these systematic reviews, identified in a systematic scoping review, were categorized against pre-defined constructs, including: who was involved, how stakeholders were recruited, the mode of involvement, at what stage there was involvement and the level of control or influence. Results The final ACTIVE framework described whether patients, carers and/or families, and/or other stakeholders (including health professionals, health decision makers and funders) were involved. We defined: recruitment as either open or closed; the approach to involvement as either one-time, continuous or combined; and the method of involvement as either direct or indirect. The stage of involvement in reviews was defined using the Cochrane Ecosystem stages of a review. The level of control or influence was defined according to the roles and activities of stakeholders in the review process, and described as the ACTIVE continuum of involvement. Conclusions The ACTIVE framework provides a structure with which to describe key components of stakeholder involvement within a systematic review, and we have used this to summarize how stakeholders have been involved in a subset of varied systematic reviews. The ACTIVE continuum of involvement provides a new model that uses tasks and roles to detail the level of stakeholder involvement. This work has contributed to the development of learning resources aimed at supporting systematic review authors and editors to involve stakeholders in their systematic reviews. The ACTIVE framework may support the decision-making of systematic review authors in planning how to involve stakeholders in future reviews.

scholarly journals Diet and physical activity in pregnancy and offspring’s cardiovascular health: a systematic review

2018 ◽  
Vol 10 (3) ◽  
pp. 286-298 ◽  
Author(s):  
T. M. van Elten ◽  
M. D. A. Karsten ◽  
M. N. M. van Poppel ◽  
A. Geelen ◽  
J. Limpens ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Health ◽  
Data Extraction ◽  
Maternal Diet ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Core Outcome Sets ◽  
Diet And Physical Activity

AbstractThere is increasing evidence linking maternal diet and physical activity before and during pregnancy with offspring’s cardiovascular health. Although many studies examined this association, the evidence has not been reviewed systematically. We therefore undertook a systematic review to synthesize evidence examining the association of maternal diet and physical activity before and during pregnancy with offspring’s blood pressure and vascular health. We systematically searched the databases MEDLINE and EMBASE from inception to June 30, 2017. Eligibility screening, data extraction and quality assessment were performed by two independent reviewers. A total of 19 articles were included comprising three randomized controlled trials and 16 observational studies. Of the studies that examined the association of interest, 60% (three out of five studies) showed that high maternal carbohydrate intake was associated with higher offspring’s blood pressure. Maternal protein intake during pregnancy was negatively associated with offspring carotid intima-media thickness in two out of two studies. No consistent findings for maternal fatty acid intake were found. There were too few studies to draw conclusions on energy intake, fibre intake, protein/carbohydrate ratio, specific foods, dietary patterns and maternal physical activity. Heterogeneity in exposure and outcome assessment hampered pooling. Also, owing to the observational nature of most studies, causality cannot be established. Harmonization of valid exposure and outcome measurements, and the development of core outcome sets are needed to enable more robust conclusions.

scholarly journals Individual interventions to improve adherence to pharmaceutical treatment, diet and physical activity among adults with primary hypertension. A systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e037920
Author(s):  
Dora Inés Parra ◽  
Isabel Trapero Gimeno ◽  
Javier Mauricio Sánchez Rodríguez ◽  
Lizeth Catherine Rodríguez Corredor ◽  
Juliana Alexandra Hernández Vargas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Pharmacological Treatment ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Primary Hypertension ◽  
Human Beings ◽  
Therapeutic Regime ◽  
Diet And Physical Activity

IntroductionHypertension is a chronic disease with 31% worldwide prevalence in adults. It has been associated with non-adherence to therapeutic regime with a negative impact on the prognosis of the disease and healthcare-associated costs. So, it is necessary to identify effective interventions to improve adherence among the afflicted population. The objective of this protocol is to describe the methods for a systematic review that will evaluate the effect of individual interventions so as to improve adherence to the prescribed pharmacological treatment, as well as to prescribed diet and physical activity in adults with primary hypertension.Methods and analysisA systematic search of studies will be conducted in PubMed/MEDLINE, BVS, CINAHL, Embase, Cochrane and Scopus databases. Randomised and non-randomised clinical studies conducted in human beings, published from 1 January 2009 to 13 December 2019, are to be included, in any language. Adherence to pharmacological treatment, diet and physical activity, measured by direct and indirect methods, will be the primary outcome. Two independent reviewers will select relevant studies and will extract the data following the Cochrane’s Handbook for Systematic Reviews of Approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Methodological quality will be evaluated using the risk-of-bias (RoB) 2 and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tools. Risk of bias will also be evaluated, and if the criteria are met, a meta-analysis will be finally performed.Ethics and disseminationInformation to be analysed is of a grouped nature, and given that its sources are published studies, no ethics committee approval is required. Results will be published in scientific journals, and in conferences, seminars and symposiums. Copyrights will be addressed by giving due credit through bibliographic references.PROSPERO registration numberCRD42020147655

scholarly journals Diet and physical activity in pregnancy to prevent gestational diabetes: a protocol for an individual participant data (IPD) meta-analysis on the differential effects of interventions with economic evaluation

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048119
Author(s):  
Dyuti Coomar ◽  
Jonathan M Hazlehurst ◽  
Frances Austin ◽  
Charlie Foster ◽  
Graham A Hitman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Gestational Diabetes ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Randomised Trials ◽  
Diet And Physical Activity ◽  
Individual Participant ◽  
In Pregnancy

IntroductionMothers with gestational diabetes mellitus (GDM) are at increased risk of pregnancy-related complications and developing type 2 diabetes after delivery. Diet and physical activity-based interventions may prevent GDM, but variations in populations, interventions and outcomes in primary trials have limited the translation of available evidence into practice. We plan to undertake an individual participant data (IPD) meta-analysis of randomised trials to assess the differential effects and cost-effectiveness of diet and physical activity-based interventions in preventing GDM and its complications.MethodsThe International Weight Management in Pregnancy Collaborative Network database is a living repository of IPD from randomised trials on diet and physical activity in pregnancy identified through a systematic literature search. We shall update our existing search on MEDLINE, Embase, BIOSIS, LILACS, Pascal, Science Citation Index, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and Health Technology Assessment Database without language restriction to identify relevant trials until March 2021. Primary researchers will be invited to join the Network and share their IPD. Trials including women with GDM at baseline will be excluded. We shall perform a one and two stage random-effect meta-analysis for each intervention type (all interventions, diet-based, physical activity-based and mixed approach) to obtain summary intervention effects on GDM with 95% CIs and summary treatment–covariate interactions. Heterogeneity will be summarised using I2 and tau2 statistics with 95% prediction intervals. Publication and availability bias will be assessed by examining small study effects. Study quality of included trials will be assessed by the Cochrane Risk of Bias tool, and the Grading of Recommendations, Assessment, Development and Evaluations approach will be used to grade the evidence in the results. A model-based economic analysis will be carried out to assess the cost-effectiveness of interventions to prevent GDM and its complications compared with usual care.Ethics and disseminationEthics approval is not required. The study is registered on the International Prospective Register of Systematic Reviews (CRD42020212884). Results will be submitted for publication in peer-reviewed journals.

scholarly journals Evaluation of the effectiveness of behavioural economic incentive programmes for the promotion of a healthy diet and physical activity: a protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e046035
Author(s):  
Suparee Boonmanunt ◽  
Oraluck Pattanaprateep ◽  
Boonsong Ongphiphadhanakul ◽  
Gareth McKay ◽  
John Attia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Financial Incentives ◽  
Meta Analysis ◽  
Economic Incentive ◽  
Healthy Diet ◽  
Current Evidence ◽  
Diet And Physical Activity ◽  
Behavioural Economic ◽  
Meta Analyses

IntroductionObesity and being overweight are major risk factors for metabolic syndrome and non-communicable diseases. Despite the recommendation that a healthy diet and physical activity can reduce the severity of these diseases, many fail to adhere to these measures. From a behavioural economic perspective, adherence to such measures can be encouraged through financial incentives. However, additional related behavioural economic approaches may improve the effectiveness of an incentive programme. As such, we have developed a protocol for a systematic review and network meta-analysis to summarise the current evidence from financial incentive programmes with and without behavioural economic insights for promoting healthy diet and physical activity.Methods and analysisPrevious systematic reviews, meta-analyses and individual studies were identified from Medline and Scopus in June 2020 and will be updated until December 2020. Individual studies will be selected and data extracted by two reviewers. Disagreement will be resolved by consensus or adjudicated by a third reviewer. A descriptive analysis will summarise the effectiveness of behavioural economic incentive programmes for promoting healthy diet and physical activity. Moreover, individual studies will be pooled using network meta-analyses where possible. I2 statistics and Cochran’s Q test will be used to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as the overall strength of the evidence.Ethics and disseminationEthics approval for a systematic review and meta-analysis is not required. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020198024.

scholarly journals Promoting Diet and Physical Activity in Nurses

2016 ◽  
Vol 31 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Luciana Torquati ◽  
Toby Pavey ◽  
Tracy Kolbe-Alexander ◽  
Michael Leveritt
Keyword(s):  
Physical Activity ◽  
English Language ◽  
Data Extraction ◽  
Student Nurses ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Data Synthesis ◽  
Diet And Physical Activity ◽  
Data Source

Objective. To systematically review the effectiveness of intervention studies promoting diet and physical activity (PA) in nurses. Data Source. English language manuscripts published between 1970 and 2014 in PubMed, Scopus, CINAHL, and EMBASE, as well as those accessed with the PICO tool, were reviewed. Study Inclusion and Exclusion Criteria. Inclusion criteria comprised (1) nurses/student nurses working in a health care setting and (2) interventions where PA and/or diet behaviors were the primary outcome. Exclusion criteria were (1) non–peer-reviewed articles or conference abstracts and (2) interventions focused on treatment of chronic conditions or lifestyle factors other than PA or diet in nurses. Data Extraction. Seventy-one full texts were retrieved and assessed for inclusion by two reviewers. Data were extracted by one reviewer and checked for accuracy by a second reviewer. Data Synthesis. Extracted data were synthesized in a tabular format and narrative summary. Results. Nine (n = 737 nurses) studies met the inclusion criteria. Quality of the studies was low to moderate. Four studies reported an increase in self-reported PA through structured exercise and goal setting. Dietary outcomes were generally positive, but were only measured in three studies with some limitations in the assessment methods. Two studies reported improved body composition without significant changes in diet or PA. Conclusions. Outcomes of interventions to change nurses’ PA and diet behavior are promising, but inconsistent. Additional and higher quality interventions that include objective and validated outcome measures and appropriate process evaluation are required.

scholarly journals How to do a systematic literature review

2000 ◽  
Vol 56 (1) ◽  
pp. 3-6 ◽  
Author(s):  
M. Papadopoulos ◽  
P. Rheeder
Keyword(s):  
Systematic Review ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Making Choices

Physiotherapists, whether serving individual patients or populations, always have to sought to base their decisions and actions on the best possible evidence. In making choices, health professionals may benefit from structured summaries of the options and outcomes, systematic reviews of the evidence and recommendations regarding the best choices. The aim of this paper is to present guidelines on how to conduct a systematic review. The structure and content of a systematic review are being discussed, following a step-by-step approach.

scholarly journals Effectiveness of Digital Interventions for Reducing Behavioral Risks of Cardiovascular Disease in Nonclinical Adult Populations: Systematic Review of Reviews

10.2196/19688 ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. e19688
Author(s):  
Natalie Gold ◽  
Amy Yau ◽  
Benjamin Rigby ◽  
Chris Dyke ◽  
Elizabeth Alice Remfry ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Meta Analysis ◽  
Face To Face ◽  
Positive Effects ◽  
Digital Interventions ◽  
Diet And Physical Activity ◽  
Intent To Treat

Background Digital health interventions are increasingly being used as a supplement or replacement for face-to-face services as a part of predictive prevention. They may be offered to those who are at high risk of cardiovascular disease and need to improve their diet, increase physical activity, stop smoking, or reduce alcohol consumption. Despite the popularity of these interventions, there is no overall summary and comparison of the effectiveness of different modes of delivery of a digital intervention to inform policy. Objective This review aims to summarize the effectiveness of digital interventions in improving behavioral and health outcomes related to physical activity, smoking, alcohol consumption, or diet in nonclinical adult populations and to identify the effectiveness of different modes of delivery of digital interventions. Methods We reviewed articles published in the English language between January 1, 2009, and February 25, 2019, that presented a systematic review with a narrative synthesis or meta-analysis of any study design examining digital intervention effectiveness; data related to adults (≥18 years) in high-income countries; and data on behavioral or health outcomes related to diet, physical activity, smoking, or alcohol, alone or in any combination. Any time frame or comparator was considered eligible. We searched MEDLINE, Embase, PsycINFO, Cochrane Reviews, and gray literature. The AMSTAR-2 tool was used to assess review confidence ratings. Results We found 92 reviews from the academic literature (47 with meta-analyses) and 2 gray literature items (1 with a meta-analysis). Digital interventions were typically more effective than no intervention, but the effect sizes were small. Evidence on the effectiveness of digital interventions compared with face-to-face interventions was mixed. Most trials reported that intent-to-treat analysis and attrition rates were often high. Studies with long follow-up periods were scarce. However, we found that digital interventions may be effective for up to 6 months after the end of the intervention but that the effects dissipated by 12 months. There were small positive effects of digital interventions on smoking cessation and alcohol reduction; possible effectiveness in combined diet and physical activity interventions; no effectiveness for interventions targeting physical activity alone, except for when interventions were delivered by mobile phone, which had medium-sized effects; and no effectiveness observed for interventions targeting diet alone. Mobile interventions were particularly effective. Internet-based interventions were generally effective. Conclusions Digital interventions have small positive effects on smoking, alcohol consumption, and in interventions that target a combination of diet and physical activity. Small effects may have been due to the low efficacy of treatment or due to nonadherence. In addition, our ability to make inferences from the literature we reviewed was limited as those interventions were heterogeneous, many reviews had critically low AMSTAR-2 ratings, analysis was typically intent-to-treat, and follow-up times were relatively short. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019126074; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=126074.

scholarly journals Development of an efficient search filter to retrieve systematic reviews from PubMed

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
José Antonio Salvador-Oliván ◽  
Gonzalo Marco-Cuenca ◽  
Rosario Arquero-Avilés
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Systematic Reviews ◽  
Search Strategy ◽  
Average Precision ◽  
Search Filter ◽  
Search Terms ◽  
Mesh Terms ◽  
Cochrane Database ◽  
Relevant Publication

Objective: Locating systematic reviews is essential for clinicians and researchers when creating or updating reviews and for decision-making in health care. This study aimed to develop a search filter for retrieving systematic reviews that improves upon the performance of the PubMed systematic review search filter.Methods: Search terms were identified from abstracts of reviews published in Cochrane Database of Systematic Reviews and the titles of articles indexed as systematic reviews in PubMed. Both the precision of the candidate terms and the number of systematic reviews retrieved from PubMed were evaluated after excluding the subset of articles retrieved by the PubMed systematic review filter. Terms that achieved a precision greater than 70% and relevant publication types indexed with MeSH terms were included in the filter search strategy.Results: The search strategy used in our filter added specific terms not included in PubMed’s systematic review filter and achieved a 61.3% increase in the number of retrieved articles that are potential systematic reviews. Moreover, it achieved an average precision that is likely greater than 80%.Conclusions: The developed search filter will enable users to identify more systematic reviews from PubMed than the PubMed systematic review filter with high precision.

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