电子健康营养干预措施对中年和老年人的有效性:系统评价和荟萃分析。
Effectiveness of eHealth Nutritional Interventions for Middle-Aged and Older Adults: Systematic Review and Meta-analysis.
机构信息
Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore, Singapore.
Department of Pharmacology, National University of Singapore, Singapore, Singapore.
出版信息
J Med Internet Res. 2021 May 17;23(5):e15649. doi: 10.2196/15649.
BACKGROUND
The risk of development of chronic diseases related to poor nutrition increases with age. In the face of an aging population, it is important for health care sectors to find solutions in delivering health services efficiently and effectively to middle-aged and older adults.
OBJECTIVE
The aim of this systematic review and meta-analysis was to consolidate the literature that reported the effectiveness of eHealth apps in delivering nutritional interventions for middle-aged and older adults.
METHODS
A literature search from five databases (PubMed, CINAHL, Cochrane, Web of Science, and Global Health) from the past 5 years was performed. Studies were selected for inclusion that used eHealth to deliver nutritional interventions to adults aged 40 years and above, and reported health and behavioral outcomes. Two independent reviewers searched for research articles and assessed the eligibility of studies to be included in the review. A third reviewer resolved disagreements on study inclusion. We also assessed the quality of the included studies using the CONSORT 2010 checklist.
RESULTS
A total of 70 studies were included for analysis. The study quality ranged from 44% to 85%. The most commonly used eHealth intervention type was mobile apps (22/70, 31%). The majority of studies (62/70, 89%) provided multicomponent health interventions, which aimed to improve nutrition and other health behaviors (eg, exercise, smoking cessation, medication adherence). Meta-analysis results indicated high and significant heterogeneity; hence, conclusions based on these results should be considered with caution. Nonetheless, the results generally showed that eHealth interventions improved anthropometric and clinical outcomes, but not behavioral outcomes such as fruit and vegetable consumption.
CONCLUSIONS
The use of eHealth apps to deliver health interventions has been increasing in recent years, and these apps have the potential to deliver health services to a larger group of people. Our findings showed that the effectiveness of eHealth apps to deliver health interventions for middle-aged to older adults was supported by the improvement of anthropometric and clinical outcomes. Future work could aim to develop research frameworks in administering eHealth interventions to address heterogeneity in this field of research.
背景
与营养不良相关的慢性病风险随着年龄的增长而增加。面对人口老龄化,医疗保健部门必须找到解决方案,以便有效地向中年和老年人提供医疗服务。
目的
本系统评价和荟萃分析的目的是整合报告电子健康应用程序在为中年和老年人提供营养干预方面有效性的文献。
方法
对过去 5 年来自 5 个数据库(PubMed、CINAHL、Cochrane、Web of Science 和全球健康)的文献进行了检索。选择使用电子健康为 40 岁及以上成年人提供营养干预,并报告健康和行为结果的研究纳入本研究。两名独立评审员搜索研究文章,并评估研究纳入本综述的资格。第三名评审员解决了纳入研究的分歧。我们还使用 CONSORT 2010 清单评估了纳入研究的质量。
结果
共有 70 项研究纳入分析。研究质量从 44%到 85%不等。最常用的电子健康干预类型是移动应用程序(22/70,31%)。大多数研究(62/70,89%)提供了多组分健康干预,旨在改善营养和其他健康行为(如锻炼、戒烟、药物依从性)。荟萃分析结果表明存在高度显著的异质性;因此,基于这些结果得出的结论应谨慎考虑。尽管如此,结果普遍表明,电子健康干预措施改善了人体测量和临床结果,但不能改善水果和蔬菜摄入量等行为结果。
结论
近年来,使用电子健康应用程序提供健康干预的情况有所增加,这些应用程序有可能为更多的人提供医疗服务。我们的研究结果表明,电子健康应用程序为中年及以上人群提供健康干预的有效性得到了人体测量和临床结果改善的支持。未来的工作可以旨在制定管理电子健康干预的研究框架,以解决该研究领域的异质性问题。