Department of Nursing Science, FI-20014, University of Turku.
Turku University Hospital, Health Village, Turku, Finland.
Health Promot Int. 2022 Oct 1;37(5). doi: 10.1093/heapro/daac085.
Refusal self-efficacy protects against risky health behavior. Digital interventions have the potential to support self-efficacy due to the enactive experience provided by digital technologies. The aim of this systematic literature review was to evaluate the evidence of digital interventions to support refusal self-efficacy in child and adolescent health promotion. Following the Cochrane Collaboration guidelines, five electronic databases were searched from 2009 to 2020. The studies were assessed by two independent reviewers according to the eligibility criteria. Eligible studies were included in the review, assessed for risk of bias, synthesized narratively and assessed for evidence quality with the GRADE approach. Twenty-three studies, that examined 18 different interventions, were included in the review. The interventions included various digital elements as means to support the child and adolescent refusal self-efficacy (e.g. games, videos, feedback and activities for regulating feelings). The interventions improving refusal self-efficacy were more often used at home setting and addressed the four sources of self-efficacy with different digital elements regardless of intervention duration and intensity. Although the results on intervention effects varied and the evidence quality remained low, the overall evidence concerning these interventions was encouraging. Based on the subgroup analysis, the results were mainly encouraging among girls. When these interventions are implemented in health promotion, their benefits and weaknesses need to be considered comprehensively. The results provide information for designing and developing digital interventions to support child and adolescent refusal self-efficacy. Further research with larger sample sizes and more rigorous study designs is needed to strengthen the evidence of these interventions.
拒绝自我效能感可以预防危险的健康行为。数字干预有潜力通过数字技术提供的能动体验来支持自我效能感。本系统文献综述的目的是评估数字干预措施在支持儿童和青少年健康促进中的拒绝自我效能感的证据。根据 Cochrane 协作组的指南，从 2009 年到 2020 年，对五个电子数据库进行了搜索。根据资格标准，由两名独立评审员对研究进行评估。符合条件的研究被纳入综述，评估偏倚风险，以叙述方式综合，并使用 GRADE 方法评估证据质量。23 项研究，共检查了 18 种不同的干预措施，被纳入综述。这些干预措施包括各种数字元素，作为支持儿童和青少年拒绝自我效能感的手段（例如，游戏、视频、反馈和调节情绪的活动）。提高拒绝自我效能感的干预措施更多地在家中环境中使用，并使用不同的数字元素针对自我效能感的四个来源，无论干预持续时间和强度如何。尽管干预效果的结果各不相同，证据质量仍然较低，但这些干预措施的总体证据令人鼓舞。根据亚组分析，结果主要在女孩中令人鼓舞。当这些干预措施在健康促进中实施时，需要全面考虑它们的优势和弱点。这些结果为设计和开发支持儿童和青少年拒绝自我效能感的数字干预措施提供了信息。需要进一步开展具有更大样本量和更严格研究设计的研究，以加强这些干预措施的证据。
