scholarly journals Impact of the Method of Delivering Electronic Health Behavior Change Interventions in Survivors of Cancer on Engagement, Health Behaviors, and Health Outcomes: Systematic Review and Meta-Analysis

10.2196/16112 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e16112
Author(s):  
Kate Furness ◽  
Mitchell N Sarkies ◽  
Catherine E Huggins ◽  
Daniel Croagh ◽  
Terry P Haines
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Patients With Cancer ◽  
Behavior Change Interventions

Background Increased accessibility to the internet and mobile devices has seen a rapid expansion in electronic health (eHealth) behavior change interventions delivered to patients with cancer and survivors using synchronous, asynchronous, and combined delivery methods. Characterizing effective delivery methods of eHealth interventions is required to enable improved design and implementation of evidence-based health behavior change interventions. Objective This study aims to systematically review the literature and synthesize evidence on the success of eHealth behavior change interventions in patients with cancer and survivors delivered by synchronous, asynchronous, or combined methods compared with a control group. Engagement with the intervention, behavior change, and health outcomes, including quality of life, fatigue, depression, and anxiety, were examined. Methods A search of Scopus, Ovid MEDLINE, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature Plus, PsycINFO, Cochrane CENTRAL, and PubMed was conducted for studies published between March 2007 and March 2019. We looked for randomized controlled trials (RCTs) examining interventions delivered to adult cancer survivors via eHealth methods with a measure of health behavior change. Random-effects meta-analysis was performed to examine whether the method of eHealth delivery impacted the level of engagement, behavior change, and health outcomes. Results A total of 24 RCTs were included predominantly examining dietary and physical activity behavior change interventions. There were 11 studies that used a synchronous approach and 11 studies that used an asynchronous approach, whereas 2 studies used a combined delivery method. Use of eHealth interventions improved exercise behavior (standardized mean difference [SMD] 0.34, 95% CI 0.21-0.48), diet behavior (SMD 0.44, 95% CI 0.18-0.70), fatigue (SMD 0.21, 95% CI −0.08 to 0.50; SMD change 0.22, 95% CI 0.09-0.35), anxiety (SMD 1.21, 95% CI: 0.36-2.07; SMD change 0.15, 95% CI −0.09 to 0.40), depression (SMD 0.15, 95% CI 0.00-0.30), and quality of life (SMD 0.12, 95% CI −0.10 to 0.34; SMD change 0.14, 95% CI 0.04-0.24). The mode of delivery did not influence the amount of dietary and physical activity behavior change observed. Conclusions Physical activity and dietary behavior change eHealth interventions delivered to patients with cancer or survivors have a small to moderate impact on behavior change and a small to very small benefit to quality of life, fatigue, depression, and anxiety. There is insufficient evidence to determine whether asynchronous or synchronous delivery modes yield superior results. Three-arm RCTs comparing delivery modes with a control with robust engagement reporting are required to determine the most successful delivery method for promoting behavior change and ultimately favorable health outcomes.

scholarly journals Impact of the Method of Delivering Electronic Health Behavior Change Interventions in Survivors of Cancer on Engagement, Health Behaviors, and Health Outcomes: Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Kate Furness ◽  
Mitchell N Sarkies ◽  
Catherine E Huggins ◽  
Daniel Croagh ◽  
Terry P Haines
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Patients With Cancer ◽  
Behavior Change Interventions

BACKGROUND Increased accessibility to the internet and mobile devices has seen a rapid expansion in electronic health (eHealth) behavior change interventions delivered to patients with cancer and survivors using synchronous, asynchronous, and combined delivery methods. Characterizing effective delivery methods of eHealth interventions is required to enable improved design and implementation of evidence-based health behavior change interventions. OBJECTIVE This study aims to systematically review the literature and synthesize evidence on the success of eHealth behavior change interventions in patients with cancer and survivors delivered by synchronous, asynchronous, or combined methods compared with a control group. Engagement with the intervention, behavior change, and health outcomes, including quality of life, fatigue, depression, and anxiety, were examined. METHODS A search of Scopus, Ovid MEDLINE, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature Plus, PsycINFO, Cochrane CENTRAL, and PubMed was conducted for studies published between March 2007 and March 2019. We looked for randomized controlled trials (RCTs) examining interventions delivered to adult cancer survivors via eHealth methods with a measure of health behavior change. Random-effects meta-analysis was performed to examine whether the method of eHealth delivery impacted the level of engagement, behavior change, and health outcomes. RESULTS A total of 24 RCTs were included predominantly examining dietary and physical activity behavior change interventions. There were 11 studies that used a synchronous approach and 11 studies that used an asynchronous approach, whereas 2 studies used a combined delivery method. Use of eHealth interventions improved exercise behavior (standardized mean difference [SMD] 0.34, 95% CI 0.21-0.48), diet behavior (SMD 0.44, 95% CI 0.18-0.70), fatigue (SMD 0.21, 95% CI −0.08 to 0.50; SMD change 0.22, 95% CI 0.09-0.35), anxiety (SMD 1.21, 95% CI: 0.36-2.07; SMD change 0.15, 95% CI −0.09 to 0.40), depression (SMD 0.15, 95% CI 0.00-0.30), and quality of life (SMD 0.12, 95% CI −0.10 to 0.34; SMD change 0.14, 95% CI 0.04-0.24). The mode of delivery did not influence the amount of dietary and physical activity behavior change observed. CONCLUSIONS Physical activity and dietary behavior change eHealth interventions delivered to patients with cancer or survivors have a small to moderate impact on behavior change and a small to very small benefit to quality of life, fatigue, depression, and anxiety. There is insufficient evidence to determine whether asynchronous or synchronous delivery modes yield superior results. Three-arm RCTs comparing delivery modes with a control with robust engagement reporting are required to determine the most successful delivery method for promoting behavior change and ultimately favorable health outcomes.

scholarly journals Effects of eHealth-Based Multiple Health Behavior Change Interventions on Physical Activity, Healthy Diet, and Weight in People With Noncommunicable Diseases: Systematic Review and Meta-analysis

10.2196/23786 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e23786
Author(s):  
Yanping Duan ◽  
Borui Shang ◽  
Wei Liang ◽  
Gaohui Du ◽  
Min Yang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Healthy Diet ◽  
Noncommunicable Diseases ◽  
Healthy Weight ◽  
Multiple Health Behavior Change ◽  
Multiple Health

Background Noncommunicable diseases (NCDs) are associated with the burden of premature deaths and huge medical costs globally. There is an increasing number of studies combining a multiple health behavior change (MHBC) intervention paradigm with eHealth approaches to jointly promote weight-related health behaviors among people with NCD; yet, a comprehensive summary of these studies is lacking. Objective This review aims to meta-analyze the effectiveness and systematically summarize the characteristics of the relevant intervention studies for improving the outcomes of physical activity, healthy diet, and weight among people with NCD. Methods Following PRISMA guidelines, 4 electronic databases (PsycINFO, PubMed, Scopus, SPORTDiscus) were systematically searched to identify eligible articles based on a series of inclusion and exclusion criteria. Article selection, quality assessment, and data extraction were independently performed by 2 authors. The standardized mean difference (SMD) was calculated to evaluate the effectiveness of interventions for 3 intervention outcomes (physical activity, healthy diet, and weight), and subsequent subgroup analyses were performed for gender, age, intervention duration, channel, and theory. Calculations were conducted, and figures were produced in SPSS 22 and Review Manager 5.3. Results Of the 664 original hits generated by the systematic searches, 15 eligible studies with moderate to high quality were included. No potential publication bias was detected using statistical analyses. Studies varied in intervention channel, intensity, and content. The meta-analysis revealed that the eHealth MHBC interventions significantly promoted physical activity (SMD 0.85, 95% CI 0.23 to 1.47, P=.008) and healthy diet (SMD 0.78, 95% CI 0.13 to 1.43, P=.02), but did not contribute to a healthy weight status (SMD –0.13, 95% CI= –0.47 to 0.20, P=.43) among people with NCDs, compared to the control conditions. Results from subgroup analysis indicated that theory-based interventions achieved greater effect than nontheory-based interventions in promoting physical activity, and interventions with traditional approaches (SMS, telephone) were more effective than those with modern internet-based approaches in promoting healthy diet. Conclusions The results of this review indicates that eHealth MHBC interventions achieve preliminary success in promoting physical activity and healthy diet behaviors among people with NCD. Future studies could improve the intervention design to achieve better intervention effectiveness. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42019118629; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=118629

A Meta-Analysis of Web-Delivered Tailored Health Behavior Change Interventions

2013 ◽  
Vol 18 (9) ◽  
pp. 1039-1069 ◽  
Author(s):  
Mia Liza A. Lustria ◽  
Seth M. Noar ◽  
Juliann Cortese ◽  
Stephanie K. Van Stee ◽  
Robert L. Glueckauf ◽  
...  
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Behavior Change Interventions

scholarly journals Effects of eHealth-Based Multiple Health Behavior Change Interventions on Physical Activity, Healthy Diet, and Weight in People With Noncommunicable Diseases: Systematic Review and Meta-analysis (Preprint)

2020 ◽  
Author(s):  
Yanping Duan ◽  
Borui Shang ◽  
Wei Liang ◽  
Gaohui Du ◽  
Min Yang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Healthy Diet ◽  
Noncommunicable Diseases ◽  
Healthy Weight ◽  
Multiple Health Behavior Change ◽  
Multiple Health

BACKGROUND Noncommunicable diseases (NCDs) are associated with the burden of premature deaths and huge medical costs globally. There is an increasing number of studies combining a multiple health behavior change (MHBC) intervention paradigm with eHealth approaches to jointly promote weight-related health behaviors among people with NCD; yet, a comprehensive summary of these studies is lacking. OBJECTIVE This review aims to meta-analyze the effectiveness and systematically summarize the characteristics of the relevant intervention studies for improving the outcomes of physical activity, healthy diet, and weight among people with NCD. METHODS Following PRISMA guidelines, 4 electronic databases (PsycINFO, PubMed, Scopus, SPORTDiscus) were systematically searched to identify eligible articles based on a series of inclusion and exclusion criteria. Article selection, quality assessment, and data extraction were independently performed by 2 authors. The standardized mean difference (SMD) was calculated to evaluate the effectiveness of interventions for 3 intervention outcomes (physical activity, healthy diet, and weight), and subsequent subgroup analyses were performed for gender, age, intervention duration, channel, and theory. Calculations were conducted, and figures were produced in SPSS 22 and Review Manager 5.3. RESULTS Of the 664 original hits generated by the systematic searches, 15 eligible studies with moderate to high quality were included. No potential publication bias was detected using statistical analyses. Studies varied in intervention channel, intensity, and content. The meta-analysis revealed that the eHealth MHBC interventions significantly promoted physical activity (SMD 0.85, 95% CI 0.23 to 1.47, <i>P</i>=.008) and healthy diet (SMD 0.78, 95% CI 0.13 to 1.43, <i>P</i>=.02), but did not contribute to a healthy weight status (SMD –0.13, 95% CI= –0.47 to 0.20, <i>P</i>=.43) among people with NCDs, compared to the control conditions. Results from subgroup analysis indicated that theory-based interventions achieved greater effect than nontheory-based interventions in promoting physical activity, and interventions with traditional approaches (SMS, telephone) were more effective than those with modern internet-based approaches in promoting healthy diet. CONCLUSIONS The results of this review indicates that eHealth MHBC interventions achieve preliminary success in promoting physical activity and healthy diet behaviors among people with NCD. Future studies could improve the intervention design to achieve better intervention effectiveness. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42019118629; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=118629

scholarly journals On the Usefulness of Narratives: An Interdisciplinary Review and Theoretical Model

2018 ◽  
Vol 52 (5) ◽  
pp. 429-442 ◽  
Author(s):  
Victoria A Shaffer ◽  
Elizabeth S Focella ◽  
Andrew Hathaway ◽  
Laura D Scherer ◽  
Brian J Zikmund-Fisher
Keyword(s):  
Health Behavior ◽  
Behavior Change ◽  
Health Behavior Change ◽  
Theoretical Understanding ◽  
Narrative Processing ◽  
Behavior Change Interventions ◽  
Narrative Intervention ◽  
And Behavior ◽  
Attitudes And Behavior

Abstract Background How can we use stories from other people to promote better health experiences, improve judgments about health, and increase the quality of medical decisions without introducing bias, systematically persuading the listeners to change their attitudes, or altering behaviors in nonoptimal ways? More practically, should narratives be used in health education, promotion, or behavior change interventions? Method In this article, we address these questions by conducting a narrative review of a diverse body of literature on narratives from several disciplines to gain a better understanding about what narratives do, including their role in communication, engagement, recall, persuasion, and health behavior change. We also review broad theories about information processing and persuasion from psychology and more specific models about narrative messaging found in the health communication and marketing literatures to provide insight into the processes by which narratives have their effect on health behavior. Results To address major gaps in our theoretical understanding about how narratives work and what effects they will have on health behavior, we propose the Narrative Immersion Model, whose goal is to identify the parameters that predict the specific impact of a particular narrative (e.g. persuade, inform, comfort, etc.) based on the type of narrative message (e.g. process, experience, or outcome narrative). Further, the Narrative Immersion Model describes the magnitude of the effect as increasing through successive layers of engagement with the narrative: interest, identification, and immersion. Finally, the Narrative Immersion Model identifies characteristics of the narrative intervention that encourage greater immersion within a given narrative. Conclusions We believe there are important communication gaps in areas areas of behavioral medicine that could be addressed with narratives; however, more work is needed in order to employ narrative messaging systematically. The Narrative Immersion Model advances our theoretical understanding about narrative processing and its subsequent effects on knowledge, attitudes, and behavior.

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