Oosterveen Emilie, Tzelepis Flora, Ashton Lee, Hutchesson Melinda J
School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia; Division of Human Nutrition, Wageningen University, The Netherlands.
School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; Hunter New England Population Health, Wallsend, NSW 2287, Australia.
Prev Med. 2017 Jun;99:197-206. doi: 10.1016/j.ypmed.2017.01.009. Epub 2017 Jan 25.
A systematic review of randomized control trials (RCT) was undertaken to evaluate the effectiveness of eHealth behavioral interventions aiming to improve smoking rates, nutrition behaviors, alcohol intake, physical activity levels and/or obesity (SNAPO) in young adults. Seven electronic databases were searched for RCTs published in English from 2000 to April 2015 and evaluating eHealth interventions aiming to change one or multiple SNAPO outcomes, and including young adult (18-35years) participants. Of 2,159 articles identified, 45 studies met the inclusion criteria. Most interventions targeted alcohol (n=26), followed by smoking (n=7), physical activity (n=4), obesity (n=4) and nutrition (n=1). Three interventions targeted multiple behaviors. The eHealth interventions were most often delivered via websites (79.5%). Most studies (n=32) compared eHealth interventions to a control group (e.g. waiting list control, minimal intervention), with the majority (n=23) showing a positive effect on a SNAPO outcome at follow-up. Meta-analysis demonstrated a significantly lower mean number of drinks consumed/week in brief web or computer-based interventions compared to controls (Mean Difference -2.43 [-3.54, -1.32], P<0.0001, n=10). Sixteen studies compared eHealth delivery modes, with inconsistent results across target behaviors and technology types. Nine studies compared eHealth to other modes of delivery (e.g. in person) with all finding no difference in SNAPO outcomes between groups at follow-up. This review provides some evidence for the efficacy of eHealth SNAPO interventions for young adults, particularly in the short-term and for alcohol interventions. But there is insufficient evidence for their efficacy in the longer-term, as well as which mode of delivery is most effective.
开展了一项对随机对照试验(RCT)的系统评价,以评估电子健康行为干预措施对改善年轻人吸烟率、营养行为、酒精摄入量、身体活动水平和/或肥胖(SNAPO)情况的有效性。检索了七个电子数据库,查找2000年至2015年4月期间以英文发表的、评估旨在改变一项或多项SNAPO结果的电子健康干预措施且纳入了青年(18 - 35岁)参与者的随机对照试验。在识别出的2159篇文章中,45项研究符合纳入标准。大多数干预措施针对酒精摄入(n = 26),其次是吸烟(n = 7)、身体活动(n = 4)、肥胖(n = 4)和营养(n = 1)。三项干预措施针对多种行为。电子健康干预措施最常通过网站提供(79.5%)。大多数研究(n = 32)将电子健康干预措施与对照组(如等待名单对照、最小干预)进行比较,其中大多数(n = 23)在随访时对SNAPO结果显示出积极影响。荟萃分析表明,与对照组相比,简短的基于网络或计算机的干预措施使每周平均饮酒量显著降低(平均差值 -2.43 [-3.54, -1.32],P < 0.0001,n = 10)。16项研究比较了电子健康的提供方式,不同目标行为和技术类型的结果不一致。9项研究将电子健康与其他提供方式(如面对面)进行比较,所有研究均发现随访时两组之间在SNAPO结果上没有差异。本综述为电子健康SNAPO干预措施对年轻人的疗效提供了一些证据,特别是在短期和酒精干预方面。但在长期疗效以及哪种提供方式最有效方面,证据不足。