Which Combinations of Techniques and Modes of Delivery in Internet-Based Interventions Effectively Change Health Behavior? A Meta-Analysis

BACKGROUND Smartphone applications (apps) have shown potential in enhancing weight management in the Western population in the short to medium term. With a rapidly growing obesity burden in the Asian populations, researchers are turning to apps as a service delivery platform to reach a greater target audience to efficiently tackle the problem. OBJECTIVE This systematic review and meta-analysis aimed to determine the efficacy of interventions incorporating apps in facilitating weight loss and health behavior change in the Asian population. METHODS Six databases were searched in June 2020. Eligible studies were controlled trials utilizing an app in the intervention in participants aged 18 years or above and from an Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses and post-hoc analyses were conducted to determine the effects of adding app to usual care and study duration. The primary outcome was absolute or percentage weight change while secondary outcomes were changes to lifestyle behaviors. RESULTS A total of 21 studies were included in this review and 17 were selected for the meta-analysis. The pooled effect size across 14 randomized controlled trials for weight change was small to moderate (Hedges’ g = -0.28, 95% CI = -0.44 to -0.12) however, this was not representative of long-term studies (more than a year). Stand-alone app interventions were inefficacious for weight loss but supplementing multi-component usual care with an app led to statistically significant weight change (Hedges’ g = -0.25 95% CI = -0.43 to -0.07). Asian apps were largely culturally adapted and multi-functional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes. CONCLUSIONS More evidence is required to determine the efficacy of apps in the long term and address app non-usage to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multi-component intervention to facilitate study designs that are most effective and cost-efficient for weight management. CLINICALTRIAL PROSPERO REGISTRATION: CRD42020165240.

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Magatartás-változtatás az egészségügyben: a motivációs interjú

Orvosi Hetilap ◽

10.1556/650.2017.30825 ◽

2017 ◽

Vol 158 (34) ◽

pp. 1331-1337

Author(s):

Dávid Pócs ◽

Csaba Hamvai ◽

Oguz Kelemen

Keyword(s):

Health Behavior ◽

Motivational Interview ◽

Health Behavior Change ◽

Evidence Based ◽

Good Doctor ◽

Internal Motivation ◽

Internal Resources ◽

Change Talk ◽

Public Health Data ◽

Change Health Behavior

Abstract: Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor–patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient’s motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient’s change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor–patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient’s resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the ‘why’ to change health behavior rather than the ‘how’, and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331–1337.

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Use of Wearable Monitoring Devices to Change Health Behavior

JAMA ◽

10.1001/jama.2015.3530 ◽

2015 ◽

Vol 313 (18) ◽

pp. 1865 ◽

Cited By ~ 2

Author(s):

Maria Jose Miguez-Burbano ◽

Emma Ergon

Keyword(s):

Health Behavior ◽

Change Health Behavior ◽

Monitoring Devices

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Helping COPD patients change health behavior in order to improve their quality of life

International Journal of Chronic Obstructive Pulmonary Disease ◽

10.2147/copd.s34211 ◽

2013 ◽

pp. 335 ◽

Cited By ~ 19

Author(s):

Pere Almagro ◽

Castro

Keyword(s):

Quality Of Life ◽

Health Behavior ◽

Copd Patients ◽

Change Health Behavior

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Supplemental Material for The Impact of Self-Affirmation on Health-Behavior Change: A Meta-Analysis

Health Psychology ◽

10.1037/hea0000116.supp ◽

2014 ◽

Keyword(s):

Health Behavior ◽

Behavior Change ◽

Meta Analysis ◽

Health Behavior Change ◽

The Impact

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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

Journal of Medical Internet Research ◽

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

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