scholarly journals The effectiveness of digital interventions for increasing physical activity in individuals of low socioeconomic status: a systematic review and meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Max J. Western ◽  
Miranda E. G. Armstrong ◽  
Ishrat Islam ◽  
Kelly Morgan ◽  
Una F. Jones ◽  
...  
Keyword(s):  
Physical Activity ◽  
Low Socioeconomic Status ◽  
Digital Technology ◽  
Meta Analysis ◽  
Digital Technologies ◽  
Risk Of Bias ◽  
Behaviour Change Techniques ◽  
Low Ses ◽  
Low Socioeconomic ◽  
Digital Interventions

Abstract Background Digital technologies such as wearables, websites and mobile applications are increasingly used in interventions targeting physical activity (PA). Increasing access to such technologies makes an attractive prospect for helping individuals of low socioeconomic status (SES) in becoming more active and healthier. However, little is known about their effectiveness in such populations. The aim of this systematic review was to explore whether digital interventions were effective in promoting PA in low SES populations, whether interventions are of equal benefit to higher SES individuals and whether the number or type of behaviour change techniques (BCTs) used in digital PA interventions was associated with intervention effects. Methods A systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Library, published between January 1990 and March 2020. Randomised controlled trials, using digital technology as the primary intervention tool, and a control group that did not receive any digital technology-based intervention were included, provided they had a measure of PA as an outcome. Lastly, studies that did not have any measure of SES were excluded from the review. Risk of Bias was assessed using the Cochrane Risk of Bias tool version 2. Results Of the 14,589 records initially identified, 19 studies were included in the final meta-analysis. Using random-effects models, in low SES there was a standardised mean difference (SMD (95%CI)) in PA between intervention and control groups of 0.06 (− 0.08,0.20). In high SES the SMD was 0.34 (0.22,0.45). Heterogeneity was modest in both low (I2 = 0.18) and high (I2 = 0) SES groups. The studies used a range of digital technologies and BCTs in their interventions, but the main findings were consistent across all of the sub-group analyses (digital interventions with a PA only focus, country, chronic disease, and duration of intervention) and there was no association with the number or type of BCTs. Discussion Digital interventions targeting PA do not show equivalent efficacy for people of low and high SES. For people of low SES, there is no evidence that digital PA interventions are effective, irrespective of the behaviour change techniques used. In contrast, the same interventions in high SES participants do indicate effectiveness. To reduce inequalities and improve effectiveness, future development of digital interventions aimed at improving PA must make more effort to meet the needs of low SES people within the target population.

scholarly journals Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Alexandra Rhodes ◽  
Andrea D. Smith ◽  
Paul Chadwick ◽  
Helen Croker ◽  
Clare H. Llewellyn
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Gain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Dietary Behaviors ◽  
User Engagement ◽  
Digital Interventions ◽  
Effective Interventions ◽  
Meta Analyses

BACKGROUND Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. OBJECTIVE This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. METHODS A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. RESULTS In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (−0.28 kg; 95% CI −1.43 to 0.87) or per-protocol data (−0.65 kg; 95% CI −1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the <i>goals and planning</i>, and <i>feedback and monitoring</i> domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. CONCLUSIONS In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.

scholarly journals Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis

10.2196/18255 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e18255
Author(s):  
Alexandra Rhodes ◽  
Andrea D Smith ◽  
Paul Chadwick ◽  
Helen Croker ◽  
Clare H Llewellyn
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Gain ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Dietary Behaviors ◽  
User Engagement ◽  
Digital Interventions ◽  
Effective Interventions ◽  
Meta Analyses

Background Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. Objective This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. Methods A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. Results In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (−0.28 kg; 95% CI −1.43 to 0.87) or per-protocol data (−0.65 kg; 95% CI −1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the goals and planning, and feedback and monitoring domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. Conclusions In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.

scholarly journals Effective elements of Dutch care-physical activity initiatives for low socioeconomic status adults

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L S Mulderij ◽  
F Wolters ◽  
M A E Wagemakers ◽  
K T Verkooijen
Keyword(s):  
Physical Activity ◽  
At Risk ◽  
Health Promotion ◽  
Socioeconomic Status ◽  
Concept Mapping ◽  
Low Socioeconomic Status ◽  
Intersectoral Collaboration ◽  
Low Ses ◽  
Low Socioeconomic ◽  
Lifestyle Related Diseases

Abstract Background In care-physical activity (care-PA) initiatives, primary care and sports collaborate to stimulate PA among adults at risk of lifestyle related diseases. Preliminary results of Dutch care-PA initiatives for low socioeconomic status (SES) adults indicate that these initiatives successfully lower participants’ body weight and improve quality of life. However, insight into elements that make these initiatives work is lacking. Therefore, this research aims to unravel the effective elements of care-PA initiatives for low SES adults. Methods Concept Mapping (CM) was used as tool to identify and cluster the effective elements. Nineteen Dutch health promotion experts individually listed as many elements as they felt were of importance to the effectiveness of care-PA initiatives. Next, each expert was asked to cluster the elements and to score them on importance. Then, CS Global MAX software was used for multidimensional scaling and a hierarchical cluster analysis to develop a cluster map. Finally, the cluster map was presented, discussed, and refined in a group meeting with 11 of the experts. Results The experts came up with 113 unique effective elements of care-PA initiatives for low SES adults, clustered into 11 clusters: 1) approach of professionals, 2) barriers experienced during the programme, 3) local embedding, 4) customisation of the programme to target population, 5) social support, 6) methods within the programme, 7) competencies of professionals, 8) accessibility of the programme, 9) actions within the programme, 10) recruitment of participants, and 11) intersectoral collaboration. Conclusions A valuable overview of the effective elements of care-PA initiatives for low SES adults was created. The results can be used to improve existing care-PA initiatives and to develop new ones targeted at low SES adults at risk of lifestyle related diseases. This may eventually help to reduce health inequalities between low and high SES adults. Key messages Concept mapping has been a useful group-based tool to obtain information on the effective elements of care-PA initiatives, in which individual input from health promotion experts has been collected. The overview of effective elements of care-PA initiatives for low SES adults as presented in this study is valuable for the development of care-PA initiatives specifically targeted at low SES adults.

scholarly journals Effects of an Empowerment-Based Health-Promotion School Intervention on Physical Activity and Sedentary Time among Adolescents in a Multicultural Area

2018 ◽  
Vol 15 (11) ◽  
pp. 2542 ◽  
Author(s):  
Andreas Fröberg ◽  
Linus Jonsson ◽  
Christina Berg ◽  
Eva-Carin Lindgren ◽  
Peter Korp ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Low Socioeconomic Status ◽  
Sedentary Time ◽  
School Intervention ◽  
The Self ◽  
Low Ses ◽  
Shared Decision ◽  
Intervention School ◽  
Low Socioeconomic

Physical activity (PA) decreases with age, and interventions are needed to promote PA during adolescence, especially, among those in low-socioeconomic status (SES) areas. The aim of this study was to investigate whether a two-year, empowerment-based health-promotion school intervention had any effects on changes in (a) moderate-to-vigorous PA (MVPA), (b) sedentary time (SED), (c) exercise training (ET) frequency, and (d) ET duration, among adolescents. Participants (aged 12–13 years at baseline) from one intervention school and two control schools, were recruited from a multicultural area of Sweden, characterized by low-SES. During the course of the two-year intervention, a total of 135 participants (43% boys) were included in the study. The intervention was developed and implemented as a result of cooperation and shared decision-making among the researchers and the participants. MVPA and SED were measured with accelerometers, and ET frequency and duration was self-reported at the beginning of the seventh, eighth, and ninth grade, respectively. There were no significant effects of the two-year, empowerment-based health-promotion school intervention on changes in the accelerometer-measured MVPA and SED, or the self-reported ET frequency and duration, among the adolescents. Overall, the intervention was unsuccessful at promoting PA and reducing SED. Several possible explanations for the intervention’s lack of effects are discussed.

scholarly journals Effectiveness of web-based and mobile health interventions designed to enhance adherence to physical activity for people with inflammatory arthritis: a systematic review

2021 ◽  
Author(s):  
Mandeep Sekhon ◽  
Claire White ◽  
Emma Godfrey ◽  
Aliya Amirova ◽  
Åsa Revenäs ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Inflammatory Arthritis ◽  
Risk Of Bias ◽  
Health Interventions ◽  
Behaviour Change Techniques ◽  
Post Intervention ◽  
Web Based ◽  
Intervention Content ◽  
Secondary Outcomes

Abstract Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.

Intertemporal impulsivity can also arise from persistent failure of long-term plans

2017 ◽  
Vol 40 ◽  
Author(s):  
Nisheeth Srivastava ◽  
Narayanan Srinivasan
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Social Utility ◽  
Low Ses ◽  
Low Socioeconomic ◽  
Planning And Control ◽  
Intertemporal Discounting ◽  
And Control ◽  
Control Failures

AbstractWe suggest that steep intertemporal discounting in individuals of low socioeconomic status (SES) may arise as a rational metacognitive adaptation to experiencing planning and control failures in long-term plans. Low SES individuals' plans fail more frequently because they operate close to budgetary boundaries, in turn because they consistently operate with limited budgets of money, status, trust, or other forms of social utility.

scholarly journals COVID-19 infections in day care centres in Germany: social and organisational determinants of infections in children and staff in the second and third wave of the pandemic

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Franz Neuberger ◽  
Mariana Grgic ◽  
Svenja Diefenbacher ◽  
Florian Spensberger ◽  
Ann-Sophie Lehfeld ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Online Survey ◽  
Random Effect ◽  
Low Ses ◽  
Third Wave ◽  
Low Socioeconomic ◽  
Long Run ◽  
Hygiene Measures ◽  
Education And Care

Abstract Background During the SARS-CoV-2 pandemic, German early childhood education and care (ECEC) centres organised children’s attendance in different ways, they reduced opening hours, provided emergency support for a few children, or closed completely. Further, protection and hygiene measures like fixed children-staff groups, ventilation and surface disinfection were introduced in ECEC centres. To inform or modify public health measures in ECEC, we investigate the occurrence of SARS-CoV-2 infections among children and staff in ECEC centres in light of social determinants (i.e. the socioeconomic status of the children) and recommended structural and hygiene measures. We focus on the question if the relevant factors differ between the 2nd (when no variant of concern (VOC) circulated) and the 3rd wave (when VOC B.1.1.7 (Alpha) predominated). Methods Based on panel data from a weekly online survey of ECEC centre managers (calendar week 36/2020 to 22/2021, ongoing) including approx. 8500 centres, we estimate the number of SARS-CoV-2 infections in children and staff using random-effect-within-between (REWB) panel models for count data in the 2nd and 3rd wave. Results ECEC centres with a high proportion of children with low socioeconomic status (SES) have a higher risk of infections in staff and children. Strict contact restrictions between groups like fixed group assignments for children and fixed staff assignments to groups prevent infections. Both effects tend to be stronger in the 3rd wave. Conclusion ECEC centres with a large proportion of children with a low SES background and lack of using fixed child/staff cohorts experience higher COVID-19 rates. Over the long run, centres should be supported in maintaining recommended measures. Preventive measures such as the vaccination of staff should be prioritised in centres with large proportions of low SES children.

scholarly journals Cyber space – risks to children and young people - research results

2018 ◽  
Vol 189 (4) ◽  
pp. 46-59
Author(s):  
Marian Kopczewski ◽  
Agnieszka Napieralska
Keyword(s):  
Physical Activity ◽  
Digital Technology ◽  
Virtual World ◽  
Digital Technologies ◽  
Free Time ◽  
The Internet ◽  
Social Psychological ◽  
Children And Young People ◽  
Cyber Space ◽  
Almost All

The 21<sup>st</sup> century is undoubtedly a period of enormous progress in the field of digital technology, a period in which the boundary between the real world and the virtual world becomes less and less visible. The Internet has undeniably become a facilitation of everyday life, since it is a tool of work, communication or a way to spend free time for many users. The virtual world is present in almost all areas of our lives, and people spend more and more time in front of the computer screens, operating websites, e-mails or social networks. Highly developed digital technology is a boon of the 21st century, but despite its numerous advantages, negative aspects are also visible. Virtual knowledge displaces physical interpersonal contacts; physical activity is replaced by spending free time in front of a computer monitor. Various threats (social, psychological, psychological, ethical and moral) resulting from modern digital technologies and the increasing degree of dependence on them are extremely significant. The authors of this article present the results of own research, aiming at making the reader aware that there are both positive and negative aspects of the virtual world.

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