Department of Dietetics, National University Hospital, Singapore, Singapore.
School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia.
J Med Internet Res. 2021 Nov 16;23(11):e28185. doi: 10.2196/28185.
BACKGROUND: Smartphone apps have shown potential in enhancing weight management in Western populations in the short to medium term. With a rapidly growing obesity burden in Asian populations, researchers are turning to apps as a service delivery platform to reach a larger target audience to efficiently address the problem. OBJECTIVE: This systematic review and meta-analysis aims to determine the efficacy of interventions that incorporate apps in facilitating weight loss and health behavior change in the Asian population. METHODS: A total of 6 databases were searched in June 2020. The eligible studies included controlled trials in which an app was used in the intervention. The participants were aged 18 years or older and were of Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses, and post hoc analyses was conducted to determine the effects of adding an app to usual care and study duration. The primary outcome was absolute or percentage weight change, whereas the secondary outcomes were changes to lifestyle behaviors. RESULTS: A total of 21 studies were included in this review, and 17 (81%) were selected for the meta-analysis. The pooled effect size across 82% (14/17) of the randomized controlled trials for weight change was small to moderate (Hedges g=-0.26; 95% CI -0.41 to -0.11), indicating slightly greater weight loss achieved in the intervention group; however, this may not be representative of long-term studies (lasting for more than a year). Supplementing multicomponent usual care with an app led to greater weight loss (Hedges g=-0.28; 95% CI -0.47 to -0.09). Asian apps were largely culturally adapted and multifunctional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes. CONCLUSIONS: More evidence is required to determine the efficacy of apps in the long term and address the low uptake of apps to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multicomponent intervention to facilitate the designing of studies that are most effective and cost-efficient for weight management. TRIAL REGISTRATION: PROSPERO CRD42020165240; https://tinyurl.com/2db4tvn6.
背景:智能手机应用程序在短期至中期内显示出在西方人群中增强体重管理的潜力。亚洲人群肥胖负担迅速增加,研究人员正在将应用程序作为服务提供平台,以覆盖更大的目标受众,从而有效地解决这一问题。
目的:本系统评价和荟萃分析旨在确定在亚洲人群中,纳入应用程序的干预措施在促进减肥和健康行为改变方面的效果。
方法:2020 年 6 月,共检索了 6 个数据库。合格的研究包括使用应用程序进行干预的对照试验。参与者年龄在 18 岁或以上,且为亚洲人种。进行荟萃分析以检验干预效果,进行亚组分析和事后分析,以确定在常规护理和研究持续时间中添加应用程序的效果。主要结局是体重的绝对或百分比变化,次要结局是生活方式行为的变化。
结果:本综述共纳入 21 项研究,其中 17 项(81%)被纳入荟萃分析。82%(14/17)的随机对照试验中体重变化的汇总效应大小为小到中等(Hedges g=-0.26;95%CI-0.41 至-0.11),表明干预组体重减轻略多;然而,这可能不能代表长期研究(持续一年以上)。补充应用程序的多组分常规护理可导致更大的体重减轻(Hedges g=-0.28;95%CI-0.47 至-0.09)。亚洲应用程序在很大程度上进行了文化适应和多功能化,最常见的应用程序功能是与健康专业人员沟通以及自我监测行为和结果。
结论:需要更多证据来确定应用程序在长期内的效果,并解决应用程序低吸收率的问题,以最大程度地发挥干预的潜力。未来的研究应确定多组分干预的每个组成部分的效果,以促进设计最有效和最具成本效益的减肥研究。
试验注册:PROSPERO CRD42020165240;https://tinyurl.com/2db4tvn6。
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