Systems-Oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, Muncie, IN;
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Adv Nutr. 2017 May 15;8(3):449-462. doi: 10.3945/an.116.014100. Print 2017 May.
The use of mobile and wireless technologies and wearable devices for improving health care processes and outcomes (mHealth) is promising for health promotion among patients with chronic diseases such as obesity and diabetes. This study comprehensively examined published mHealth intervention studies for obesity and diabetes treatment and management to assess their effectiveness and provide recommendations for future research. We systematically searched PubMed for mHealth-related studies on diabetes and obesity treatment and management published during 2000-2016. Relevant information was extracted and analyzed. Twenty-four studies met inclusion criteria and varied in terms of sample size, ethnicity, gender, and age of the participating patients and length of follow-up. The mHealth interventions were categorized into 3 types: mobile phone text messaging, wearable or portable monitoring devices, and applications running on smartphones. Primary outcomes included weight loss (an average loss ranging from -1.97 kg in 16 wk to -7.1 kg in 5 wk) or maintenance and blood glucose reduction (an average decrease of glycated hemoglobin ranging from -0.4% in 10 mo to -1.9% in 12 mo); main secondary outcomes included behavior changes and patient perceptions such as self-efficacy and acceptability of the intervention programs. More than 50% of studies reported positive effects of interventions based on primary outcomes. The duration or length of intervention ranged from 1 wk to 24 mo. However, most studies included small samples and short intervention periods and did not use rigorous data collection or analytic approaches. Although some studies suggest that mHealth interventions are effective and promising, most are pilot studies or have limitations in their study designs. There is an essential need for future studies that use larger study samples, longer intervention (≥ 6 mo) and follow-up periods (≥ 6 mo), and integrative and personalized innovative mobile technologies to provide comprehensive and sustainable support for patients and health service providers.
移动和无线技术以及可穿戴设备在改善医疗保健流程和结果（移动医疗）方面具有广阔的前景，有望促进慢性病患者（如肥胖和糖尿病患者）的健康。本研究全面考察了已发表的移动医疗干预研究，以评估其在肥胖和糖尿病治疗与管理中的效果，并为未来的研究提供建议。我们系统地检索了 2000 年至 2016 年间发表的与移动医疗相关的糖尿病和肥胖治疗与管理的 PubMed 研究。提取并分析了相关信息。24 项研究符合纳入标准，这些研究在样本量、种族、性别和年龄以及随访时间方面存在差异。移动医疗干预措施分为 3 种类型：手机短信、可穿戴或便携式监测设备以及智能手机应用程序。主要结局指标包括体重减轻（16 周平均减少 1.97 公斤，5 周减少 7.1 公斤）或维持和血糖降低（糖化血红蛋白平均减少 0.4%，10 个月减少 1.9%，12 个月减少 1.9%）；主要次要结局指标包括行为改变和患者对干预计划的自我效能和可接受性等感知。超过 50%的研究报告了基于主要结局指标的干预措施的积极效果。干预的持续时间或长度从 1 周到 24 个月不等。然而，大多数研究样本量小，干预时间短，并且没有使用严格的数据收集或分析方法。尽管一些研究表明移动医疗干预措施有效且有前景，但大多数是试点研究或在研究设计上存在局限性。未来的研究非常需要使用更大的样本量、更长的干预（≥6 个月）和随访期（≥6 个月），以及综合和个性化的创新移动技术，为患者和医疗服务提供者提供全面和可持续的支持。
