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

2020 ◽  
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. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42019126074; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=126074.

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 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 Long-term follow-up and objective physical activity measurements of community-based physical interventions in adults: a systematic review and meta-analysis

The Lancet ◽  
2019 ◽  
Vol 394 ◽  
pp. S96
Author(s):  
Charlotte Wahlich ◽  
Umar A R Chaudhry ◽  
Rebecca Fortescue ◽  
Derek G Cook ◽  
Shashi Hirani ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Community Based ◽  
Activity Measurements ◽  
Long Term Follow Up

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 The impact of paternal alcohol, tobacco, caffeine use and physical activity on offspring mental health: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Kayleigh E Easey ◽  
Gemma C Sharp
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Systematic Review ◽  
Alcohol Consumption ◽  
Tobacco Smoking ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Health Behaviours ◽  
Prenatal Period ◽  
The Impact

AbstractBackgroundThere is some evidence that paternal health behaviours during and around pregnancy could be associated with offspring health outcomes. However, the impact that paternal health behaviours during pregnancy can have on offspring mental health is understudied and remains unclear.MethodsWe conducted a systematic review and meta-analysis of articles in PubMed describing studies of potentially modifiable paternal health behaviours (tobacco smoking, alcohol consumption, caffeine consumption and physical activity) in the prenatal period in relation to offspring mental health.ResultsTen studies were included and categorized by paternal health behaviour and offspring mental health outcome investigated. The narrative synthesis provided evidence of association between paternal health behaviours around pregnancy and offspring mental health problems, with the strongest evidence shown for tobacco use. Grouped by analysis type, two separate meta-analyses showed evidence of paternal smoking during pregnancy being associated with greater odds of ADHD in offspring (OR 1.42, 95% CI 1.02 to 1.99; HR 1.28, 95% CI 1.19 to 1.39).ConclusionsOur review suggests that paternal tobacco smoking and alcohol consumption in the prenatal period are associated with poorer offspring mental health, particularly hyperactivity/ADHD. Future investigation using methods that allow stronger causal inference is needed to further investigate if these associations are causal.

scholarly journals The relationship between pregnancy intentions and diet or physical activity behaviours in the preconception and antenatal periods: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Isaac Nkrumah ◽  
Madelon North ◽  
Emily Jane Kothe ◽  
Tze Lin Chai ◽  
Stephanie Pirotta ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Pregnancy Intention ◽  
Risk Of Bias ◽  
Folate Intake ◽  
Caffeine Intake ◽  
Pregnancy Intentions ◽  
Diet And Physical Activity ◽  
Meta Analyses

Introduction: Healthy preconception and antenatal diet and physical activity behaviours are crucial to prevent adverse maternal and offspring outcomes. These behaviours are thought to be linked to pregnancy intentions. The aim of this study was to conduct a systematic review and meta-analysis to determine the association between women’s pregnancy intentions and diet or physical activity behaviours in the preconception and antenatal periods. Methods: Medline Complete, PsycINFO, CINAHL Complete, Global Health, Embase, and INFORMIT: Health Subset were searched in September 2018 for studies that evaluated relationships between pregnancy intentions and dietary and physical activity behaviours. Risk of bias was assessed and random effects meta-analyses were conducted for dietary (food groups; energy and macronutrients; diet quality; and caffeine, iodine and folate intake) and physical activity outcomes.Results: Of 2623 screened records, 19 eligible studies were identified. Overall risk of bias was moderate to high. Twelve studies measured diet/physical activity behaviours during preconception, 5 during pregnancy, and 2 across both periods. Eleven studies measured pregnancy intention retrospectively, and 8 prospectively measured pregnancy intention. The number of studies available for meta-analyses of individual dietary and physical activity outcomes ranged from 2 to 5. Pregnancy intentions were not associated with preconception fruit, vegetable, or caffeine intake or physical activity. Antenatally, women with intended pregnancies were more likely to report healthier diets, lower caffeine intake and higher physical activity. Insufficient studies were available to conduct subgroup comparisons for prospective/retrospective assessment.Discussion: Pregnancy intentions were not associated with preconception diet or physical activity behaviours. In contrast, antenatally, women with intended pregnancies demonstrated better diet and physical activity behaviours. Given the small number of studies available for meta-analyses, further research is needed to consolidate our findings. Meanwhile, health professionals can assess women’s pregnancy intentions during preconception and pregnancy and encourage a healthy lifestyle.PROSPERO registration number CRD42018107854.

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 Effect of Supplements on Endurance Exercise in the Older Population: Systematic Review

2020 ◽  
Vol 17 (14) ◽  
pp. 5224
Author(s):  
Alejandro Martínez-Rodríguez ◽  
Bernardo J. Cuestas-Calero ◽  
María Hernández-García ◽  
María Martíez-Olcina ◽  
Manuel Vicente-Martínez ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Sodium Bicarbonate ◽  
Older Women ◽  
Meta Analysis ◽  
Individual Characteristics ◽  
Protein Supplementation ◽  
Older Population ◽  
Beta Alanine ◽  
Positive Effects

Background: Ageing is associated with changes of physical and physiological parameters, but there is evidence that regular physical activity could minimize these effects. Additionally, the older population presents a great risk of suboptimal nutrition. Therefore, the purpose of this study was to review the evidence of nutritional strategies and endurance exercises in the older population. Methods: A systematic review was performed based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. The search was carried out in three different databases: PubMed, Web of Science, and SPORTDiscus. Results: Eight studies were included in the present review. The use of caffeine and beta-alanine supplementation with proteins have been found to be beneficial in both sexes. In older women, a balanced diet, an increase in protein, supplementation with beta hydroxy methyl butyrate, and supplementation with sodium bicarbonate have been favorable. However, no benefit has been seen in older men with sodium bicarbonate or ubiquinone supplementation. Nevertheless, the use of supplements should be prescribed according to individual characteristics and physical activity. Conclusions: Caffeine and high protein supplement with beta-alanine may provide positive effects in the older population. In addition, in older women, bicarbonate supplementation and beta-hydroxyethyl butyrate (HMB), lysine, and arginine supplementation have shown positive effects on exercise performance.

Telephone Delivery of Health Behaviour Change Interventions: A Systematic Review

2020 ◽  
Author(s):  
Kirsteen Bigland ◽  
Marie Johnston
Keyword(s):  
Physical Activity ◽  
Alcohol Consumption ◽  
Waiting Times ◽  
Health Behaviours ◽  
Dropping Out ◽  
Attrition Rates ◽  
Face To Face ◽  
Phone Calls ◽  
Time Required

Background: Behaviours are among the leading causes of preventable disease worldwide and effective, feasible interventions are required. Telephone delivery could reduce costs, logistic barriers and waiting times. This review aims to systematically review evidence for the efficacy, feasibility and acceptability of theory-based, solely telephone-delivered interventions to change diet, physical activity, smoking and alcohol consumption.Method: A structured search of Medline, Embase, Cinahl and PsycInfo was conducted for studies published in English between 2005 and 2020. Included studies reported interventions with a stated theoretical basis delivered to adults solely via verbal telephone to change smoking, alcohol consumption, diet or exercise.Results: From a search returning 4751 studies, 32 were included in the review: nine physical activity, six smoking, five diet, three alcohol consumption and nine with combined focus. Twenty-six reported significant behavioural improvements. Interventions typically involved approximately 6 phone calls, average 19.4 minutes duration, over 3-6 months. In 10 studies gathering quantitative participant feedback, telephone interventions were rated positively by over 65% of participants. Numbers of participants dropping out of the studies did not largely differ based upon which group they were engaging in; intervention, control or follow-up (M = 17.4%, 20.7% and 12.8% respectively).Conclusion: Satisfaction was high, attrition rates acceptable and the time required feasible. Given their effectiveness, telephone interventions to improve health behaviours would appear to be acceptable and feasible while offering possible advantages over face-to-face interventions.

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