一项基于信息与通信技术的干预措施对促进儿童和青少年身体活动行为改变的系统评价。
A systematic review of information and communication technology-based interventions for promoting physical activity behavior change in children and adolescents.
作者信息
Lau Patrick W C, Lau Erica Y, Wong Del P, Ransdell Lynda
机构信息
Department of Physical Education, Hong Kong Baptist University, Hong Kong, China.
出版信息
J Med Internet Res. 2011 Jul 13;13(3):e48. doi: 10.2196/jmir.1533.
BACKGROUND
A growing body of research has employed information and communication technologies (ICTs) such as the Internet and mobile phones for disseminating physical activity (PA) interventions with young populations. Although several systematic reviews have documented the effects of ICT-based interventions on PA behavior, very few have focused on children and adolescents specifically.
OBJECTIVES
The present review aimed to systematically evaluate the efficacy and methodological quality of ICT-based PA interventions for children and adolescents based on evidence from randomized controlled trials.
METHODS
Electronic databases Medline, PsycInfo, CINAHL, and Web of Science were searched to retrieve English language articles published in international academic peer-reviewed journals from January 1, 1997, through December 31, 2009. Included were articles that provided descriptions of interventions designed to improve PA-related cognitive, psychosocial, and behavioral outcomes and that used randomized controlled trial design, included only children (6-12 years old) and adolescents (13-18 years old) in both intervention and control groups, and employed Internet, email, and/or short message services (SMS, also known as text messaging) as one or more major or assistive modes to deliver the intervention.
RESULTS
In total, 9 studies were analyzed in the present review. All studies were published after 2000 and conducted in Western countries. Of the 9 studies, 7 demonstrated positive and significant within-group differences in at least one psychosocial or behavioral PA outcome. In all, 3 studies reported positive and significant between-group differences favoring the ICT group. When between-group differences were compared across studies, effect sizes were small in 6 studies and large in 3 studies. With respect to methodological quality, 7 of the 9 studies had good methodological quality. Failure to report allocation concealment, blinding to outcome assessment, and lack of long-term follow-up were the criteria met by the fewest studies. In addition, 5 studies measured the intervention exposure rate and only 1 study employed objective measures to record data.
CONCLUSION
The present review provides evidence supporting the positive effects of ICTs in PA interventions for children and adolescents, especially when used with other delivery approaches (ie, face-to-face). Because ICT delivery approaches are often mixed with other approaches and these studies sometimes lack a comparable control group, additional research is needed to establish the true independent effects of ICT as an intervention delivery mode. Although two-thirds of the studies demonstrated satisfactory methodological quality, several quality criteria should be considered in future studies: clear descriptions of allocation concealment and blinding of outcome assessment, extension of intervention duration, and employment of objective measures in intervention exposure rate. Due to the small number of studies that met inclusion criteria and the lack of consistent evidence, researchers should be cautious when interpreting the findings of the present review.
背景
越来越多的研究采用互联网和手机等信息通信技术(ICT)向年轻人群体传播身体活动(PA)干预措施。尽管有几项系统评价记录了基于ICT的干预措施对PA行为的影响,但很少有研究专门针对儿童和青少年。
目的
本综述旨在基于随机对照试验的证据,系统评价基于ICT的PA干预措施对儿童和青少年的疗效和方法学质量。
方法
检索电子数据库Medline、PsycInfo、CINAHL和Web of Science,以获取1997年1月1日至2009年12月31日在国际学术同行评审期刊上发表的英文文章。纳入的文章应描述旨在改善与PA相关的认知、心理社会和行为结果的干预措施,并采用随机对照试验设计,干预组和对照组仅包括儿童(6 - 12岁)和青少年(13 - 18岁),并采用互联网、电子邮件和/或短消息服务(SMS,也称为短信)作为一种或多种主要或辅助方式来实施干预。
结果
本综述共分析了9项研究。所有研究均在2000年后发表,且在西方国家进行。在这9项研究中,7项研究表明在至少一项心理社会或行为PA结果方面,组内存在积极且显著的差异。总体而言,3项研究报告了有利于ICT组的组间积极且显著的差异。在比较各研究的组间差异时,6项研究的效应量较小,3项研究的效应量较大。在方法学质量方面,9项研究中有7项具有良好的方法学质量。未报告分配隐藏、对结果评估的盲法以及缺乏长期随访是符合这些标准的研究最少的情况。此外,5项研究测量了干预暴露率,只有1项研究采用客观测量方法记录数据。
结论
本综述提供了证据支持ICT在儿童和青少年PA干预中的积极作用,特别是与其他实施方法(即面对面)结合使用时。由于ICT实施方法通常与其他方法混合使用,且这些研究有时缺乏可比的对照组,因此需要更多研究来确定ICT作为一种干预实施模式的真正独立效应。尽管三分之二的研究显示出令人满意的方法学质量,但未来研究应考虑几个质量标准:明确描述分配隐藏和对结果评估的盲法、延长干预持续时间以及在干预暴露率方面采用客观测量方法。由于符合纳入标准的研究数量较少且缺乏一致的证据,研究人员在解释本综述的结果时应谨慎。