BACKGROUND
Background: Noncommunicable diseases (NCDs) are the leading cause of death globally. Promoting physical activity and healthy eating is essential to help manage the NCD burden and reduce mortality. Social media may be a potential platform for delivering and scaling health promotion initiatives.
OBJECTIVE
Objective: In this systematic review, we aimed to examine i) the feasibility and acceptability of social media interventions targeting physical activity and/or diet for people with NCDs, ii) the effectiveness of these interventions on exercise and diet behaviours, iii) specific design components used to promote user engagement and iv) the effectiveness on other health outcomes.
METHODS
Methods: We searched MEDLINE, Google Scholar, CINAHL, EMBASE, and SPORTDiscus from inception until June 2021. Social media interventions targeting physical activity and/or diet were included. Participants were any age, with a diagnosis of one of the following categories of NCDs; cardiovascular disease, cancer, chronic respiratory disease, diabetes or mental illness. Interventions using social media alone or as part of an intervention with other modes of delivery were included. Eligible study designs were randomised controlled trials (RCTs), non-randomised controlled trials, feasibility or pilot studies, or quasi-experimental studies.
RESULTS
Results: A total of 2,358 publications were identified. After removal of duplicates, 2,233 publication titles and abstracts were screened, and 10 publications were eligible, describing 8 individual studies. The study designs included n=5 RCTs and n=3 pilot or feasibility studies, all published between 2016 and 2020. Sample sizes ranged from n=11 to n=312. Half of the studies were conducted in the United States of America. Clinical populations included severe mental illness (n=2), cardiovascular disease (n=2), chronic obstructive pulmonary disease (n=2), cancer (n=1) and Type 2 diabetes (n=1). Facebook (n=3) and WeChat (n=3) were the most used social media platforms. The majority utilised social media to deliver health education and facilitate social support and all studies reported >70% retention. Four of the five included RCTS reported significant improvements in exercise behaviours (e.g., step count, exercise capacity) while diet was only assessed in two studies and results were non-significant. Of the 6 included RCTs (including 1 pilot RCT), study quality ranged from fair to good according to the PEDRo quality checklist.
CONCLUSIONS
Conclusions: Social media interventions appear to be feasible and acceptable among specific ND populations and preliminary evidence suggests interventions delivered solely via social media or in addition to other modalities may be effective for improving exercise behaviours. The evidence for diet behaviours remains unclear. While overall there is an emerging evidence base, more rigorous evaluation including replication studies are needed to determine the efficacy of social media interventions.
CLINICALTRIAL
CRD42021251838
Social media interventions for diet and exercise behaviours: a systematic review and meta-analysis of randomised controlled trials
