School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Prev Med. 2021 Aug;149:106608. doi: 10.1016/j.ypmed.2021.106608. Epub 2021 May 11.
Family-based eHealth interventions to reduce cardiovascular disease risk have potential as a primary prevention strategy to improve the health of parents and their children. This systematic review evaluated the effectiveness of such interventions in modifying parent and child/adolescent risk factors such as body mass index, physical activity, dietary intakes and alcohol use. Five electronic databases were searched up to April 2020. Of 2193 articles identified, seven randomised controlled trials met inclusion criteria and were reviewed. Data were extracted regarding study setting, design, methods, eHealth technology used, intervention and control group components, retention rates, outcome measures, incentives and limitations. Risk of bias and quality assessment were carried out using Cochrane methods. A qualitative narrative data synthesis of the studies was conducted. Our review found that three studies showed an improvement in alcohol use among parents and adolescents as a result of the eHealth intervention. Among children/adolescents, two studies showed an improvement in dietary intake, one study showed an improvement in physical activity, and one study showed an improvement in body mass index as a result of the eHealth intervention. Interventions appeared more likely to be effective if they were theory-based, had longer follow-up periods, were incentivised and included regular interaction. Our findings suggest that, despite a paucity of high-quality trials, there is some evidence that family-based eHealth interventions have potential to reduce cardiovascular disease risk. However, more sufficiently powered, higher-quality trials with theory driven, clearly described interventions and unambiguous outcomes are needed.
基于家庭的电子健康干预措施作为一种主要的预防策略，具有改善父母和子女健康的潜力。本系统评价评估了此类干预措施在改变父母和儿童/青少年风险因素（如体重指数、身体活动、饮食摄入和饮酒）方面的有效性。截至 2020 年 4 月，我们对五个电子数据库进行了搜索。在 2193 篇文章中，有 7 项随机对照试验符合纳入标准并进行了审查。我们提取了关于研究背景、设计、方法、使用的电子健康技术、干预和对照组组成、保留率、结果测量、激励措施和局限性的数据。使用 Cochrane 方法对偏倚风险和质量进行了评估。对研究进行了定性叙述性数据综合分析。我们的综述发现，三项研究表明，电子健康干预措施改善了父母和青少年的饮酒行为。在儿童/青少年中，两项研究显示饮食摄入有所改善，一项研究显示身体活动有所改善，一项研究显示体重指数有所改善。如果干预措施基于理论、具有较长的随访期、有激励措施且包括定期互动，则更有可能有效。我们的研究结果表明，尽管高质量试验相对较少，但有一些证据表明，基于家庭的电子健康干预措施有可能降低心血管疾病风险。然而，需要更多具有足够效力、更高质量、具有理论驱动、明确描述干预措施和明确结果的试验。
