Factors that contribute to effective online nutrition education interventions: a systematic review

Abstract Context The use of the internet and technology as a medium for delivering online nutrition education (ONE) has increased; however, evidence-based studies exploring factors that contribute to best practices in online interventions have not emerged. Objective The purpose of this systematic review was to identify factors that contributed to successful ONE interventions in relation to research studies published between 2009 and 2018. Data sources Following the PRISMA guidelines, relevant studies were identified through PubMed, Medline, Web of Science, Science Direct, and Education Resources Information Center (ERIC) databases. Data extraction Five authors screened and determined the quality of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and extracted the data from the articles. Data analysis Twenty-seven studies were included: 21 studies were website-based, 3 were delivered through smartphone application, 2 were delivered as online courses, and 1 used text messages. Tailored messages/feedback, interaction between participants and investigators, identification of specific behaviors, use theory, adequate duration, and alignment between stated objectives and activities were factors that contributed to successful online interventions, while comparison bias and the lack of specific details on duration and dosage, tracking system, objective outcome measurements, and follow-up were factors that may have interfered with successful ONE interventions. Conclusions The findings underscore the importance of developing ONE intervention designs that utilize factors unique to online platforms for effective interventions aimed at behavior change.

Download Full-text

Private Rooms in Low Acuity Settings: A Systematic Review of the Literature

HERD Health Environments Research & Design Journal ◽

10.1177/1937586717702597 ◽

2017 ◽

Vol 11 (1) ◽

pp. 57-74 ◽

Cited By ~ 4

Author(s):

Jeffrey Voigt ◽

Michael Mosier ◽

Rabih Darouiche

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Quality Data ◽

Review Of The Literature ◽

Single Patient ◽

Patient Falls ◽

Assessment Development ◽

High Acuity ◽

Data Extraction Form ◽

Quality Evidence

Objectives: Determine if the peer-reviewed evidence supports single-patient ward bedrooms in low-acuity care settings within a hospital. Background: New evidence exists since the 2006 Facility Guideline Institute guideline recommended single-bedded rooms (SBRs) in low-acuity care settings. Additionally, prior studies evaluated high-acuity care settings (e.g., critical care) in their recommendations on SBRs. There is a need to reevaluate the evidence. Methods: A systematic review of the literature was completed including electronic and hand searches of references. A data extraction form was utilized. Two reviewers evaluated the studies independently. Studies that were included examined the effect of single-patient rooms on medical surgical ward beds only. Each study was graded using accepted clinical evidence grading instruments. Results: Over 1,400 records were identified. After excluding studies, a total of 49 records were graded. The highest quality evidence identified (Center for Evidence-Based Medicine [CEBM]: 2a, 2b, and Grading of Recommendations, Assessment, Development, and Evaluation [GRADE] C) did not support the use of single-patient rooms for reducing infections, for minimizing patient falls, for reducing medication errors, or for patient satisfaction. Operational efficiencies were improved with SBRs but only addressed the maternity ward. The lowest quality evidence (CEBM: 4/5 and GRADE D) supported the use of single-patient rooms. Conclusions: Based on CEBM and GRADE assessments, there is a lack of high-quality data supporting the use of low-acuity SBRs throughout the entire hospital. Furthermore, it is recommended that more research be conducted on the effect of SBRs, so higher quality evidence is developed.

Download Full-text

Interventions to Reduce Aerosolized Microbes in Dental Practice: A Systematic Review with Network Meta-analysis of Randomized Controlled Trials

Journal of Dental Research ◽

10.1177/0022034520943574 ◽

2020 ◽

Vol 99 (11) ◽

pp. 1228-1238 ◽

Cited By ~ 5

Author(s):

D. Koletsi ◽

G.N. Belibasakis ◽

T. Eliades

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Data Extraction ◽

Meta Analysis ◽

Bacterial Load ◽

Controlled Trials ◽

Dental Practice ◽

Assessment Development ◽

Randomized Controlled ◽

State Of Research

The aim of this systematic review and network meta-analysis was to identify and rank the effectiveness of different interventions used in dental practice to reduce microbial load in aerosolized compounds. Seven electronic databases were searched to April 6, 2020, for randomized controlled trials (RCTs) or nonrandomized prospective studies in the field. Study selection, data extraction, and risk-of-bias assessment were performed for all included studies, while the outcome of interest pertained to differences in bacterial load quantification through the use of different interventions prior to aerosol-generating procedures in dental practices. Random effects frequentist network meta-analysis was performed, with mean difference (MD) and 95% CI as the effect measure. Confidence in the documented evidence was assessed through the newly fueled CINeMA framework (Confidence in Network Meta-analysis) based on the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation). Twenty-nine clinical trials were deemed eligible, 21 RCTs and 8 nonrandomized studies, while 11 RCTs contributed to the network meta-analysis, comprising 10 competing interventions. Tempered chlorhexidine (CHX) 0.2% as compared with nonactive control mouth rinse, prior to routine ultrasonic scaling, was most effective toward reduced postprocedural bacterial load with an MD of −0.92 (95% CI, −1.54 to −0.29) in log10 bacterial CFUs (colony-forming units). For CHX 0.2%, an MD of −0.74 (95% CI, −1.07 to −0.40) was observed as compared with control. Tempered CHX 0.2% presented the highest probabilities of being ranked the most effective treatment (31.2%). Level of confidence varied from very low to moderate across all formulated comparisons. These findings summarize the current state of research evidence in the field of aerosolized bacteria in dentistry. Instigated by the era of SARS-CoV-2 pandemic, the stipulation of a broader evaluation of the aerosolized microbes, including viruses, potentially coupled with disinfectant-based prevention schemes should be prioritized.

Download Full-text

A Systematic Review of Interventions to Increase Awareness, Knowledge, and Folic Acid Consumption before and during Pregnancy

American Journal of Health Promotion ◽

10.4278/06051566r2.1 ◽

2008 ◽

Vol 22 (4) ◽

pp. 237-245 ◽

Cited By ~ 21

Author(s):

Corina Mihaela Chivu ◽

Theodore H. Tulchinsky ◽

Karla Soares-Weiser ◽

Rony Braunstein ◽

Mayer Brezis

Keyword(s):

Systematic Review ◽

Folic Acid ◽

Data Extraction ◽

Interrupted Time Series ◽

Cochrane Library ◽

Case Control Studies ◽

Effective Interventions ◽

Before And After ◽

Quasi Experimental ◽

Time Series Studies

Objective. We conducted a systematic review of studies designed to increase awareness of, knowledge about, and consumption of folic acid before and during pregnancy. Data sources. Studies were identified from Cochrane Library, Medline, and the references of primary studies and reviews. Study inclusion and exclusion criteria. Studies included randomized controlled trials, quasi-experimental interrupted time series studies, follow-up studies, case-control studies, and before-and-after studies, all of which were conducted between 1992 and 2005 on women ages 15 to 49 years and/or health professionals, evaluating awareness and/or knowledge and/or consumption of folic acid both before and after intervention. Studies were excluded if data were not presented both before and after intervention or were other outcomes than those mentioned here. Data extraction. Data were extracted in relation to characteristics of studies, participants, interventions, and outcomes. Data synthesis. Because of heterogeneity, we performed a narrative synthesis describing the direction and the size of effects. Results. On average, women's awareness increased from 60% to 72%, knowledge from 21% to 45%, and consumption from 14% to 23%. Conclusions. Interventions had a positive effect on folic acid intakes before and during pregnancy, although the average usage reached less than 25%. So what? Further research is needed to design more effective interventions to increase periconceptional use of folic acid.

Download Full-text

Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2016-014611 ◽

2017 ◽

Vol 7 (11) ◽

pp. e014611 ◽

Cited By ~ 1

Author(s):

Caio Chaves Guimaraes ◽

Rogério Heládio Lopes Motta ◽

Cristiane de Cássia Bergamaschi ◽

Jimmy de Oliveira Araújo ◽

Natalia Karol de Andrade ◽

...

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Data Extraction ◽

Meta Analysis ◽

Local Anaesthetics ◽

Cochrane Central Register ◽

Assessment Development ◽

Dental Procedures ◽

Central Register ◽

Registration Number

IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes.Method/designTrials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors. The research will be conducted in the electronic databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Healthstar (via Ovid), Cumulative Index to Nursing and Allied Health Literature and Web of Science, from their inception to December 2017, without any restrictions in terms of language and status of publication. A team of reviewers will independently assess titles, abstracts and complete text to determine eligibility. For eligible studies, the same reviewers will perform data extraction and evaluate the risk of bias in the selected articles. The selected outcomes comprise death, mortality by a specific cause, stroke, acute myocardial infarction, hospitalisation, pain, bleeding, arrhythmias, ischaemic episodes, anxiety, adverse effects, changes in blood pressure, changes in heart rate, anxiety and results obtained via oximetry. Whenever possible, we will conduct a meta-analysis to establish the effects of LAs with and without vasoconstrictors in the patients with CVD, and the overall quality of evidence for each outcome will be determined using the Grading of Recommendations Assessment, Development and Evaluation classification system.Ethics and disseminationEthics committee approval was not necessary because this is a protocol of systematic review. This systematic review will be submitted for presentation at conferences and for publication in a peer-reviewed journal. Our review will assess the risks of cardiovascular events when using LAs with and without vasoconstrictors in patients with CVD, focusing on important clinical outcomes.PROSPERO registration numberCRD42016045421.

Download Full-text

A Systematic Review and Meta-analysis of the Effect of Oral Exercises on Masticatory Function

Journal of Dental Research ◽

10.1177/00220345211050326 ◽

2021 ◽

pp. 002203452110503

Author(s):

X. Shu ◽

S. He ◽

E.C.M. Lo ◽

K.C.M. Leung

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Bite Force ◽

Mean Difference ◽

Masticatory Performance ◽

Masticatory Function ◽

Assessment Development ◽

Study Selection ◽

Longitudinal Comparison

The aim of the current systematic review was to summarize and to evaluate the available information on the effectiveness of oral exercise in improving the masticatory function of people ≥18 y. Electronic databases (Medline, Embase, CENTRAL) and gray literatures were searched (up to December 2020) for relevant randomized and nonrandomized controlled clinical trials. Two reviewers independently conducted the study selection, data extraction, and quality assessments. Meta-analysis was conducted for the comparison of bite force and masticatory performance using mean difference (MD) and standardized mean difference (SMD), respectively. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment was adopted for collective grading of the overall body of evidence. Of the 1,576 records identified, 18 studies (21 articles) were included in the analysis. Results of meta-analysis indicated that oral exercise could significantly improve the mean bite force of the participants (parallel comparison: MD, 41.2; 95% CI, 11.6–70.7, P = 0.006; longitudinal comparison: MD, 126.5; 95% CI, 105.2–144.9, P < 0.001). However, the improvement in masticatory performance was not significant (parallel comparison: SMD, 0.11; 95% CI, –0.20 to 0.42, P = 0.48; longitudinal comparison: SMD, 0.4; 95% CI, –0.11 to 0.91, P = 0.13). Results of meta-regression showed that greater improvements in bite force can be achieved among younger adults and with more intensive exercise. Chewing exercise is the most effective oral exercise, followed by clenching exercise, while simple oral exercise may not have a significant effect. Based on the results of the meta-analysis and GRADE assessment, a weak recommendation for people with declined masticatory function to practice oral exercise is made.

Download Full-text

Association between vision impairment and mortality: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-037556 ◽

2020 ◽

Vol 10 (6) ◽

pp. e037556

Author(s):

Joshua R Ehrlich ◽

Jacqueline Ramke ◽

David Macleod ◽

Bonnielin K Swenor ◽

Helen Burn ◽

...

Keyword(s):

Systematic Review ◽

Global Health ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Vision Impairment ◽

Published Data ◽

Assessment Development ◽

Evaluation Approach ◽

Meta Analyses

IntroductionDue to growth and ageing of the world’s population, the number of individuals worldwide with vision impairment (VI) and blindness is projected to increase rapidly over the coming decades. VI and blindness are an important cause of years lived with disability. However, the association of VI and blindness with mortality, including the risk of bias in published studies and certainty of the evidence, has not been adequately studied in an up-to-date systematic review and meta-analysis.Methods and analysisThe planned systematic review and meta-analysis will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases, including MEDLINE Ovid, Embase Ovid and Global Health, will be searched for relevant studies. Two reviewers will then screen studies and review full texts to identify studies for inclusion. Data extraction will be performed, and for included studies, the risk of bias and certainty of the evidence will be assessed using the Grades of Recommendation, Assessment, Development and Evaluation approach. The prognostic factor in this study is visual function, which must have been measured using a standard objective ophthalmic clinical or research instrument. We will use standard criteria from WHO to categorise VI and blindness. All-cause mortality may be assessed by any method one or more years after baseline assessment of vision. Results from included studies will be meta-analysed according to relevant sections of the Meta-analysis Of Observational Studies in Epidemiology checklist.Ethics and disseminationThis review will only include published data; therefore, ethics approval will not be sought. The findings of this review and meta-analysis will be published in an open-access, peer-reviewed journal and will be included in the ongoing Lancet Global Health Commission on Global Eye Health.

Download Full-text

Overview and Strategy Analysis of Technology-based Non-pharmacological Interventions for Delirium Prevention: Systematic Review (Preprint)

10.2196/preprints.26079 ◽

2020 ◽

Author(s):

Chanmi Kim ◽

Esther M. van der Heide ◽

Thomas J. L. van Rompay ◽

Gijsbertus J. Verkerke ◽

Geke. D. S. Ludden

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Hospital Setting ◽

Psychological Needs ◽

The Body ◽

Strategy Analysis ◽

Positive Effects ◽

Effective Interventions ◽

Systematic Effort ◽

Delirium Prevention

BACKGROUND Delirium prevention is crucial, especially in critically ill patients. Increasingly, non-pharmacological multicomponent interventions for preventing delirium are recommended and technology-based interventions have developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview. OBJECTIVE The systematic review was carried out to answer the following questions: (1) What are technologies currently used in non-pharmacological technology-based interventions for preventing and reducing delirium?, (2) What are the strategies underlying these currently used technologies? METHODS A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made following the PRISMA guideline. Studies were eligible if they contained any types of technology-based interventions and assessed delirium-/risk factor-related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form. RESULTS A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. The review revealed eight different technology types and 14 strategies that were categorized into seven pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, provide (5) a sense of security, (6) a sense of control, and (7) a sense of being connected. For all technology types, significant positive effects were found on direct and/or indirect delirium outcome. Several similarities were found across effective interventions: using a multicomponent approach and/or including components comforting psychological needs of patients (e.g., familiarity, distraction and soothing elements). CONCLUSIONS Technology-based interventions have a high potential when multidimensional needs of patients (e.g., physical, cognitive and emotional) are incorporated. The seven pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the Intensive Care Unit (ICU) into a healing environment as a powerful tool to prevent delirium.

Download Full-text

Effectiveness of Text Message Interventions for Weight Management in Adolescents: Systematic Review (Preprint)

10.2196/preprints.15849 ◽

2019 ◽

Author(s):

Stephanie Ruth Partridge ◽

Rebecca Raeside ◽

Anna Singleton ◽

Karice Hyun ◽

Julie Redfern

Keyword(s):

Systematic Review ◽

Intervention Group ◽

Text Message ◽

Text Messages ◽

Self Report ◽

Z Score ◽

Contact Points ◽

Effective Interventions

BACKGROUND The incidence of obesity among adolescents is increasing. Text messages are a primary communication form for adolescents and potentially a scalable strategy for delivering population health interventions. OBJECTIVE This study aimed to determine the effectiveness of text message interventions in reducing BMI in adolescents and describe characteristics that are common to effective interventions. METHODS This systematic review included randomized controlled trials of text message lifestyle interventions involving adolescents aged 10 to 19 years with outcomes focused on obesity prevention or management. Primary outcome was objective or self-report change in BMI. RESULTS In total, 4362 records were identified, and 215 full-text articles were assessed for eligibility. A total of 8 unique studies were identified, including 767 participants, mean age 14.3 (SD 0.9) years, BMI 29.7 (SD 1.6) kg/m2 and 53.1% (407/767) female (31/101, 30.7%-172/172, 100.0%). All interventions were multicomponent. The median active intervention period was 4.5 months. During the active and extended intervention phases, text messages accounted for >50% (8 studies) and >85% (3 studies) of contact points, respectively. Text messages were heterogeneous, with a median of 1.5 text messages sent per week (range: 1-21). A total of 4 studies utilized two-way text message communication with health professionals Of the 8 studies, 7 demonstrated reductions in BMI or BMI z-score in the intervention group compared with the control at the end of the final follow-up. The effect was only statistically significant in 1 study at 6 months. Over 6 months, reductions in BMI (kg/m2) ranged from 1.3% to 4.5% and BMI z-score ranged from 4.2% to 28.1%. Overall quality of the studies was low. CONCLUSIONS Further research is required to elucidate the effectiveness and potential impact of text message interventions on weight and weight-related behaviors in adolescents.

Download Full-text

Effect of Probiotic, Prebiotic, or Synbiotic Supplement on Children, Adolescents, or Infants: A Protocol of an Umbrella Review

10.21203/rs.3.rs-656995/v1 ◽

2021 ◽

Author(s):

Shunlian 付顺链 Fu ◽

Qian Zhou ◽

Lijun Yuan ◽

Zi-nan Li ◽

Qiu Chen

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Data Extraction ◽

Random Effect ◽

Control Group ◽

Measurement Tool ◽

Umbrella Review ◽

Qualitative Comparison ◽

Assessment Development ◽

Meta Analyses

Abstract Background: Many systematic reviews and meta-analyses have studied the association between probiotics, prebiotics, or synbiotics and children, adolescents, or Infants. With the promotion of probiotics, prebiotics, or synbiotics in our life and medical practice, more and more attention has been paid to them. Therefore, it is necessary to make a systematic summary of them. When the information was obtained in the identified systematic review, it will be compared with a control group that do not use probiotics, prebiotics, or synbiotics. In addition, our aim is to assess the quality of the included systematic reviews.Methods: We will conduct a comprehensive systematic search by summarizing systematic reviews of randomized controlled trials which have studied effect of probiotic, prebiotic, or synbiotic supplement on children, adolescents, or Infants. Four electronic databases (Embase, PubMed, Medline, and Cochrane Database of Systematic Reviews) will be searched. Two reviewers will independently screen the retrieved papers. Two reviewers will independently extract the data by reference to the JBI Data Extraction Form for Review for Systematic Reviews and Research Syntheses. We will also assess methodological quality and assessment of certainty in the findings by A Measurement Tool to Assess Systematic Review version 2 (AMSTAR-2) and the GRADE (Grading of Recommendations Assessment, Development and Evaluation). We will calculate the corrected covered area (CCA). We will recalculate the summary effect and 95% CIs by using fixed-effect or random-effect models.Discussion: Through quantitative and qualitative comparison by conducting an umbrella review, we hope our results will service better for future clinical practice.Systematic review registration: This protocol have finished the registration in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42021244923).

Download Full-text

Effectiveness of Text Message Interventions for Weight Management in Adolescents: Systematic Review

JMIR mhealth and uhealth ◽

10.2196/15849 ◽

2020 ◽

Vol 8 (5) ◽

pp. e15849 ◽

Cited By ~ 2

Author(s):

Stephanie Ruth Partridge ◽

Rebecca Raeside ◽

Anna Singleton ◽

Karice Hyun ◽

Julie Redfern

Keyword(s):

Systematic Review ◽

Intervention Group ◽

Text Message ◽

Text Messages ◽

Self Report ◽

Z Score ◽

Contact Points ◽

Effective Interventions

Background The incidence of obesity among adolescents is increasing. Text messages are a primary communication form for adolescents and potentially a scalable strategy for delivering population health interventions. Objective This study aimed to determine the effectiveness of text message interventions in reducing BMI in adolescents and describe characteristics that are common to effective interventions. Methods This systematic review included randomized controlled trials of text message lifestyle interventions involving adolescents aged 10 to 19 years with outcomes focused on obesity prevention or management. Primary outcome was objective or self-report change in BMI. Results In total, 4362 records were identified, and 215 full-text articles were assessed for eligibility. A total of 8 unique studies were identified, including 767 participants, mean age 14.3 (SD 0.9) years, BMI 29.7 (SD 1.6) kg/m2 and 53.1% (407/767) female (31/101, 30.7%-172/172, 100.0%). All interventions were multicomponent. The median active intervention period was 4.5 months. During the active and extended intervention phases, text messages accounted for >50% (8 studies) and >85% (3 studies) of contact points, respectively. Text messages were heterogeneous, with a median of 1.5 text messages sent per week (range: 1-21). A total of 4 studies utilized two-way text message communication with health professionals Of the 8 studies, 7 demonstrated reductions in BMI or BMI z-score in the intervention group compared with the control at the end of the final follow-up. The effect was only statistically significant in 1 study at 6 months. Over 6 months, reductions in BMI (kg/m2) ranged from 1.3% to 4.5% and BMI z-score ranged from 4.2% to 28.1%. Overall quality of the studies was low. Conclusions Further research is required to elucidate the effectiveness and potential impact of text message interventions on weight and weight-related behaviors in adolescents.

Download Full-text