Ewha Womans University, Seoul, South Korea.
Health Educ Behav. 2019 Dec;46(6):947-959. doi: 10.1177/1090198119859396. Epub 2019 Jul 26.
An adequate intake of fruits and vegetables (FVI) has shown benefits for reduced risk of manifesting chronic diseases. Thus, development of effective interventions to promote FVI is paramount. . To assess the effectiveness of eHealth interventions for FVI targeted to healthy population, in comparison with control groups, and identify the moderators contributing to their effectiveness. A database search was conducted in April 2016 and July 2018 using MEDLINE, PsycINFO, ERIC, Google Scholar, SciELO, and RISS, yielding 19 eligible studies. Risk of bias was assessed using Cochrane's Risk of Bias Tool. Random-effects model was used to calculate effect sizes (ES) by weighted standardized mean differences. This meta-analysis includes 19 studies and 6,894 participants. The most common eHealth tool used was Internet-based interventions ( = 10). Most of studies were conducted in adults ( = 11), followed by children ( = 4), and adolescents ( = 4). The minimum number of behavior change techniques (BCTs) used was one, and the maximum seven. The overall ES was small (0.26, < .001), favoring eHealth interventions. The between-studies heterogeneity was large ( = 62.77%, < .001). Subgroup analyses showed that the components with larger ES were tailored interventions (0.27, < .001), computer-based interventions (0.44, < .001), and use of ≥7 BCTs (0.42, < .001). . All studies showed a positive ES favoring interventions. Large heterogeneity could be explained in part by the number of BCTs and type of eHealth tool used. Nonetheless, more concrete evidence regarding other intervention components effectiveness was limited by small sample size. The use of eHealth tools for the improvement of FVI showed to be more effective compared with nonintervention and interventions not using these technologies. Nonetheless, more research is needed to determine the specific combination of intervention components that could translate into larger effectiveness.
摄入足够的水果和蔬菜（FVI）已被证明有助于降低患慢性病的风险。因此，开发有效的干预措施来促进 FVI 至关重要。评估针对健康人群的 FVI 的电子健康干预措施与对照组相比的有效性，并确定有助于其有效性的调节因素。 2016 年 4 月和 2018 年 7 月，使用 MEDLINE、PsycINFO、ERIC、Google Scholar、SciELO 和 RISS 进行了数据库搜索，共纳入 19 项符合条件的研究。使用 Cochrane 偏倚风险工具评估偏倚风险。使用加权标准化均数差计算效应大小（ES）。 这项荟萃分析包括 19 项研究和 6894 名参与者。最常用的电子健康工具是基于互联网的干预措施（n = 10）。大多数研究在成年人中进行（n = 11），其次是儿童（n = 4）和青少年（n = 4）。使用的行为改变技术（BCT）最少为 1 个，最多为 7 个。总体 ES 较小（0.26，<0.001），有利于电子健康干预措施。研究间异质性较大（ = 62.77%，<0.001）。亚组分析表明，ES 较大的组分是针对性干预措施（0.27，<0.001）、基于计算机的干预措施（0.44，<0.001）和使用≥7 个 BCT（0.42，<0.001）。 所有研究均显示干预措施的 ES 为正，有利于干预措施。较大的异质性在一定程度上可以用 BCT 的数量和使用的电子健康工具类型来解释。尽管如此，由于样本量小，关于其他干预措施有效性的具体证据有限。 与非干预和不使用这些技术的干预相比，使用电子健康工具来改善 FVI 更为有效。然而，仍需要更多的研究来确定可以转化为更大效果的干预措施的具体组合。
