Messiah Sarah E, Sacher Paul M, Yudkin Joshua, Ofori Ashley, Qureshi Faisal G, Schneider Benjamin, Hoelscher Deanna M, de la Cruz-Muñoz Nestor, Barlow Sarah E
University of Texas Health Sciences Center at Houston, School of Public Health & the Center for Pediatric Population Health, Children's Health, Dallas, USA.
Childhood Nutrition Research Centre, University College London, UK.
Digit Health. 2020 Jan 7;6:2055207619898987. doi: 10.1177/2055207619898987. eCollection 2020 Jan-Dec.
To date the application of eHealth strategies among adults and adolescents undergoing metabolic and bariatric surgery (MBS) has not been systematically reviewed. This study comprehensively examines eHealth intervention studies among MBS patients within the RE-AIM framework to assess reach, effectiveness, adoption, implementation and maintenance of these efforts.
A search was conducted using PubMed, EMBASE, CINAHL, PsycNET and SCOPUS of original research relating to eHealth strategies for MBS patients published in peer-reviewed journals and revealed 38 published articles between 2011 and 2019.
Studies varied widely in terms of design (qualitative to randomized controlled trials) and eHealth delivery method (telemedicine to blog post content) with a balance of pre- or post-MBS use. No studies included adolescents and very few reported (1) a conceptual framework to support study design/outcomes; and (2) race/ethnicity composition.
Although some studies report that eHealth strategies/interventions are effective in producing post-MBS weight loss and other positive health outcomes, most are pilot studies or have study design limitations. There is an opportunity for development of (1) tailored eHealth interventions to support pre- and post-MBS sustained behavior change and improved outcomes; and (2) rigorous studies that employ robust conceptual frameworks so dissemination and implementation efforts can be mapped to construct-driven outcomes.
迄今为止，尚未对接受代谢和减重手术（MBS）的成年人及青少年中电子健康策略的应用进行系统评价。本研究在RE-AIM框架内全面考察了MBS患者中的电子健康干预研究，以评估这些措施的覆盖范围、有效性、采用情况、实施情况及维持情况。
使用PubMed、EMBASE、CINAHL、PsycNET和SCOPUS对发表在同行评审期刊上的与MBS患者电子健康策略相关的原创研究进行检索，共检索到2011年至2019年间发表的38篇文章。
研究在设计（从定性研究到随机对照试验）和电子健康交付方式（从远程医疗到博客文章内容）方面差异很大，且MBS术前或术后使用情况均衡。没有研究纳入青少年，很少有研究报告（1）支持研究设计/结果的概念框架；以及（2）种族/民族构成。
尽管一些研究报告称电子健康策略/干预措施在MBS术后减重及其他积极健康结果方面有效，但大多数是试点研究或存在研究设计局限性。有机会开展以下工作：（1）定制电子健康干预措施，以支持MBS术前和术后持续的行为改变并改善结果；（2）开展采用强大概念框架的严谨研究，以便将传播和实施工作映射到基于结构的结果上。
