Bailey J V, Murray E, Rait G, Mercer C H, Morris R W, Peacock R, Cassell J, Nazareth I
Research Department of Primary Care and Population Health, University College London, Upper Third Floor, Rowland Hill Street, London NW3 2PF, UK.
Int J STD AIDS. 2012 Jun;23(6):408-13. doi: 10.1258/ijsa.2011.011221.
This systematic review was conducted to determine the effects of self-help interactive computer-based interventions (ICBIs) for sexual health promotion. We searched 40 databases for randomized controlled trials (RCTs) of computer-based interventions, defining 'interactive' as programmes that require contributions from users to produce personally relevant material. We conducted searches and analysed data using Cochrane Collaboration methods. Results of RCTs were pooled using a random-effects model with standardized mean differences for continuous outcomes and odds ratios (ORs) for binary outcomes, with heterogeneity assessed using the I(2) statistic. We identified 15 RCTs of ICBIs (3917 participants). Comparing ICBIs to minimal interventions, there were significant effects on sexual health knowledge (standardized mean difference [SMD] 0.72, 95% confidence interval [CI] 0.27-1.18); safer sex self-efficacy (SMD 0.17, 95% CI 0.05-0.29); safer-sex intentions (SMD 0.16, 95% CI 0.02-0.30); and sexual behaviour (OR 1.75, 95% CI 1.18-2.59). ICBIs had a greater impact on sexual health knowledge than face-to-face interventions did (SMD 0.36, 95% CI 0.13-0.58). ICBIs are effective tools for learning about sexual health, and show promising effects on self-efficacy, intention and sexual behaviour. More data are needed to analyse biological outcomes and cost-effectiveness.
本系统评价旨在确定基于计算机的自助式交互式干预措施（ICBIs）对促进性健康的效果。我们检索了40个数据库，以查找基于计算机的干预措施的随机对照试验（RCTs），将“交互式”定义为需要用户提供信息以生成个人相关资料的程序。我们使用Cochrane协作方法进行检索和数据分析。RCTs的结果采用随机效应模型进行合并，连续结局采用标准化均数差值，二分结局采用比值比（ORs），异质性采用I(2)统计量进行评估。我们确定了15项ICBIs的RCTs（3917名参与者）。将ICBIs与最小干预措施进行比较，对性健康知识有显著影响（标准化均数差值[SMD] 0.72，95%置信区间[CI] 0.27 - 1.18）；安全性行为自我效能感（SMD 0.17，95% CI 0.05 - 0.29）；安全性行为意图（SMD 0.16，95% CI 0.02 - 0.30）；以及性行为（OR 1.75，95% CI 1.18 - 2.59）。ICBIs对性健康知识的影响比对面对面干预措施的影响更大（SMD 0.36，95% CI 0.13 - 0.58）。ICBIs是了解性健康的有效工具，并且对自我效能感、意图和性行为显示出有前景的效果。需要更多数据来分析生物学结局和成本效益。
