背景:发展不良的生活方式行为会增加各种慢性年龄相关疾病的风险,包括心血管疾病,肥胖,和阿尔茨海默病。关于基于电子健康的多种健康行为改变(MHBC)干预措施管理生活方式风险行为的有效性的证据有限。
目的:本系统评估的目的是评估eHealthMHBC干预措施在改变≥50岁人群中≥2种主要生活方式风险行为方面的有效性。
方法:在6个电子数据库中进行了文献检索-PubMed,Embase,WebofScience,Scopus,科克伦图书馆,和SPORTDiscus-从成立到2024年5月1日。符合条件的研究是针对6种感兴趣行为中≥2种的电子健康干预措施的随机对照试验:饮酒,吸烟,饮食,身体活动(PA),久坐的行为,和睡眠。
结果:共纳入34篇35项研究。基于eHealth的MHBC干预措施显着提高了戒烟率(比值比2.09,95%CI1.62-2.70;P<.001),水果摄入量(标准化平均差[SMD]0.18,95%CI0.04-0.32;P=0.01),蔬菜摄入量(SMD0.17,95%CI0.05-0.28;P=.003),自我报告的总PA(SMD0.22,95%CI0.02-0.43;P=0.03),并客观测量了中度至重度PA(SMD0.25,95%CI0.09-0.41;P=0.002);此外,干预措施降低了脂肪摄入量(SMD-0.23,95%CI-0.33至-0.13;P<.001)。没有观察到酒精使用的影响,久坐的行为,或睡觉。进行了敏感性分析以测试合并结果的稳健性。此外,使用等级(建议等级评估,发展,和评估)框架。
结论:基于eHealth的MHBC干预措施可能是增加PA的有希望的策略,改善饮食,减少老年人的吸烟。然而,效果大小很小。进一步的高品质,需要以老年人为导向的研究来开发可以改变多种行为的电子健康干预措施。
背景:PROSPERO国际系统评价前瞻性注册CRD42023444418;https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023444418。
BACKGROUND: Developing adverse lifestyle behaviors increases the risk of a variety of chronic age-related diseases, including cardiovascular disease, obesity, and Alzheimer disease. There is limited evidence regarding the effectiveness of eHealth-based multiple health behavior change (MHBC) interventions to manage lifestyle risk behaviors.
OBJECTIVE: The purpose of this systematic evaluation was to assess the effectiveness of eHealth MHBC interventions in changing ≥2 major lifestyle risk behaviors in people aged ≥50 years.
METHODS: The literature search was conducted in 6 electronic databases-PubMed, Embase, Web of Science, Scopus, Cochrane Library, and SPORTDiscus-from inception to May 1, 2024. Eligible studies were randomized controlled trials of eHealth interventions targeting ≥2 of 6 behaviors of interest: alcohol use, smoking, diet, physical activity (PA), sedentary behavior, and sleep.
RESULTS: A total of 34 articles with 35 studies were included. eHealth-based MHBC interventions significantly increased smoking cessation rates (odds ratio 2.09, 95% CI 1.62-2.70; P<.001), fruit intake (standardized mean difference [SMD] 0.18, 95% CI 0.04-0.32; P=.01), vegetable intake (SMD 0.17, 95% CI 0.05-0.28; P=.003), self-reported total PA (SMD 0.22, 95% CI 0.02-0.43; P=.03), and objectively measured moderate to vigorous PA (SMD 0.25, 95% CI 0.09-0.41; P=.002); in addition, the interventions decreased fat intake (SMD -0.23, 95% CI -0.33 to -0.13; P<.001). No effects were observed for alcohol use, sedentary behavior, or sleep. A sensitivity analysis was conducted to test the robustness of the pooled results. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) framework.
CONCLUSIONS: eHealth-based MHBC interventions may be a promising strategy to increase PA, improve diet, and reduce smoking among older adults. However, the effect sizes were small. Further high-quality, older adult-oriented research is needed to develop eHealth interventions that can change multiple behaviors.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews CRD42023444418; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023444418.