Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Prev Med. 2010 Sep-Oct;51(3-4):214-21. doi: 10.1016/j.ypmed.2010.06.004. Epub 2010 Jun 15.
Computer-tailored interventions have become increasingly common for facilitating improvement in behaviors related to chronic disease and health promotion. A sufficient number of outcome studies from these interventions are now available to facilitate the quantitative analysis of effect sizes, permitting moderator analyses that were not possible with previous systematic reviews.
The present study employs meta-analytic techniques to assess the mean effect for 88 computer-tailored interventions published between 1988 and 2009 focusing on four health behaviors: smoking cessation, physical activity, eating a healthy diet, and receiving regular mammography screening. Effect sizes were calculated using Hedges g. Study, tailoring, and demographic moderators were examined by analyzing between-group variance and meta-regression.
Clinically and statistically significant overall effect sizes were found across each of the four behaviors. While effect sizes decreased after intervention completion, dynamically tailored interventions were found to have increased efficacy over time as compared with tailored interventions based on one assessment only. Study effects did not differ across communication channels nor decline when up to three behaviors were identified for intervention simultaneously.
This study demonstrates that computer-tailored interventions have the potential to improve health behaviors and suggests strategies that may lead to greater effectiveness of these techniques.
计算机定制干预措施已越来越多地用于促进与慢性病和健康促进相关行为的改善。现在，这些干预措施已经有足够数量的结果研究，可以促进效应大小的定量分析，从而可以进行以前的系统评价无法进行的调节分析。
本研究采用荟萃分析技术，评估了 1988 年至 2009 年间发表的 88 项针对四种健康行为（戒烟、体育活动、健康饮食和定期接受乳房 X 光筛查）的计算机定制干预措施的平均效应。使用 Hedges g 计算效应大小。通过分析组间方差和元回归，研究了定制和人口统计学调节因素。
在四项行为中的每一项中都发现了具有临床和统计学意义的总体效应大小。虽然干预完成后效应大小降低，但与仅基于一次评估的定制干预相比，动态定制干预随着时间的推移被发现具有更高的疗效。研究效果在不同的沟通渠道之间没有差异，当同时确定三种行为进行干预时，效果也没有下降。
本研究表明，计算机定制干预措施有可能改善健康行为，并提出了可能提高这些技术有效性的策略。
