Staff Nurse I, Health Promotion Board, Singapore.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Int J Med Inform. 2018 Dec;120:20-30. doi: 10.1016/j.ijmedinf.2018.09.019. Epub 2018 Sep 28.
Internet-based self-monitoring intervention offers accessibleand convenient weight management. This review aimed to systematically review the evidence on the effectiveness of internet-based self-monitoring intervention for overweight and obese adolescents.
PubMed, CINAHL, Cochrane Library, EMBASE, ProQuest, PsycINFO and SCOPUS were systematically searched for randomised controlled trials (RCTs) from inception until December 13, 2017. The risk of bias and strength of evidence was assessed using the Cochrane Collaboration Risk of Bias Tool and the Grading of Recommendations, Assessment, Development and Evaluations criteria. Meta-analysis was performed on the RevMan software using a random effects model. The overall effect was assessed using effect size (Cohen'sd)and heterogeneity was evaluated using Cochrane Q and I values. PROSPERO database #CRD42016050089.
A total of 6841 records were identified. Six RCTs in 10 articles were selected amongst 505 adolescents across three countries who were overweight and obese. The meta-analysis revealed a small effect on the reduction of body mass index (BMI) and BMI z-scores (d = 0.30, 95% CI: -0.48 to -0.12). Subgroup analyses suggest the use of daily multicomponent self-monitoring, specified goal setting, face-to-face counselling and parental involvement. The overall quality of evidence was low due to the risk of bias and imprecision.
Internet-based self-monitoring intervention is a possible approach for overweight and obese adolescents to reduce their BMI. Further well-designed RCTs with follow-up data and large sample sizes are needed to ensure the robustness of the evidence.
基于互联网的自我监测干预提供了便捷的体重管理方式。本综述旨在系统评价基于互联网的自我监测干预对超重和肥胖青少年的有效性。
从建库至 2017 年 12 月 13 日，我们系统检索了 PubMed、CINAHL、Cochrane Library、EMBASE、ProQuest、PsycINFO 和 SCOPUS 中关于随机对照试验（RCT）的文献。使用 Cochrane 协作风险偏倚工具和推荐、评估、发展和评估（GRADE）标准评估风险偏倚和证据强度。使用 RevMan 软件进行荟萃分析，采用随机效应模型。使用效应大小（Cohen's d）评估总体效果，采用 Cochrane Q 和 I 值评估异质性。PROSPERO 数据库 #CRD42016050089。
共确定了 6841 条记录。在来自三个国家的 505 名超重和肥胖青少年中，有 6 项 RCT 涉及 10 篇文章入选。荟萃分析显示，体重指数（BMI）和 BMI z 评分降低有较小的效果（d = 0.30，95%CI：-0.48 至-0.12）。亚组分析表明，每天使用多组分自我监测、明确目标设定、面对面咨询和父母参与可能会有效果。由于存在偏倚风险和不精确性，整体证据质量较低。
基于互联网的自我监测干预可能是一种减轻超重和肥胖青少年 BMI 的方法。需要进一步开展设计良好的 RCT，以获得随访数据和大样本量，从而确保证据的稳健性。
