移动技术向参与者提供的性健康干预措施：随机对照试验的系统评价和荟萃分析。

Sexual health interventions delivered to participants by mobile technology: a systematic review and meta-analysis of randomised controlled trials.

机构信息

Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK

Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.

出版信息

Sex Transm Infect. 2021 May;97(3):190-200. doi: 10.1136/sextrans-2020-054853. Epub 2021 Jan 15.

DOI:10.1136/sextrans-2020-054853

PMID:33452130

Abstract

BACKGROUND

The use of mobile technologies to prevent STIs is recognised as a promising approach worldwide; however, evidence has been inconclusive, and the field has developed rapidly. With about 1 million new STIs a day globally, up-to-date evidence is urgently needed.

OBJECTIVE

To assess the effectiveness of mobile health interventions delivered to participants for preventing STIs and promoting preventive behaviour.

METHODS

We searched seven databases and reference lists of 49 related reviews (January 1990-February 2020) and contacted experts in the field. We included randomised controlled trials of mobile interventions delivered to adolescents and adults to prevent sexual transmission of STIs. We conducted meta-analyses and assessed risk of bias and certainty of evidence following Cochrane guidance.

RESULTS

After double screening 6683 records, we included 22 trials into the systematic review and 20 into meta-analyses; 18 trials used text messages, 3 used smartphone applications and 1 used Facebook messages as delivery modes. The certainty of evidence regarding intervention effects on STI/HIV occurrence and adverse events was low or very low. There was moderate certainty of evidence that in the short/medium-term text messaging interventions had little or no effect on condom use (standardised mean differences (SMD) 0.02, 95% CI -0.09 to 0.14, nine trials), but increased STI/HIV testing (OR 1.83, 95% CI 1.41 to 2.36, seven trials), although not if the standard-of-care control already contained an active text messaging component (OR 1.00, 95% CI 0.68 to 1.47, two trials). Smartphone application messages also increased STI/HIV testing (risk ratio 1.40, 95% CI 1.22 to 1.60, subgroup analysis, two trials). The effects on other outcomes or of social media or blended interventions is uncertain due to low or very low certainty evidence.

CONCLUSIONS

Text messaging interventions probably increase STI/HIV testing but not condom use in the short/medium term. Ongoing trials will report the effects on biological and other outcomes.

摘要

背景

在全球范围内，使用移动技术预防性传播感染（STIs）已被认为是一种有前途的方法；然而，证据尚无定论，而且该领域发展迅速。目前全球每天约有 100 万例新的性传播感染，因此急需最新的证据。

目的

评估向参与者提供的移动健康干预措施预防性传播感染和促进预防性行为的效果。

方法

我们检索了 7 个数据库和 49 篇相关综述的参考文献列表（1990 年 1 月至 2020 年 2 月），并联系了该领域的专家。我们纳入了针对青少年和成年人的预防性传播感染的移动干预措施的随机对照试验。我们按照 Cochrane 指南进行了荟萃分析，并评估了偏倚风险和证据确定性。

结果

经过两次筛选 6683 条记录后，我们将 22 项试验纳入系统评价，20 项试验纳入荟萃分析；18 项试验使用短信，3 项试验使用智能手机应用程序，1 项试验使用 Facebook 消息作为传递方式。关于干预措施对性传播感染/艾滋病毒发生和不良事件影响的证据确定性为低或极低。有中等确定性证据表明，在短期/中期内，短信干预对使用避孕套的影响很小或没有（标准化均数差（SMD）0.02，95%置信区间（CI）-0.09 至 0.14，9 项试验），但增加了性传播感染/艾滋病毒检测（比值比（OR）1.83，95%CI 1.41 至 2.36，7 项试验），但如果标准护理对照中已经包含了主动短信干预措施（OR 1.00，95%CI 0.68 至 1.47，2 项试验）则不然。智能手机应用程序消息也增加了性传播感染/艾滋病毒检测（风险比 1.40，95%CI 1.22 至 1.60，亚组分析，2 项试验）。由于低或极低确定性证据，社交媒体或混合干预措施对其他结果的影响尚不确定。