Physical Education Department, Hohai University, Nanjing 210024, China.
School of Educational Studies, University Sains Malaysia, Penang 11800, Malaysia.
Int J Environ Res Public Health. 2022 Dec 25;20(1):318. doi: 10.3390/ijerph20010318.
Insufficient physical activity (PA) and excessive sedentary behavior (SB) are detrimental to physical and mental health. This systematic review and meta-analysis aimed to identify whether e-health interventions are effective for improving PA and SB in college students. Five electronic databases, including Medline, Web of Science, Embase, Cochrane Library, and ProQuest, were searched to collect relevant randomized controlled trials up to 22 June 2022. In total, 22 trials (including 31 effects) with 8333 samples were included in this meta-analysis. The results showed that e-health interventions significantly improved PA at post-intervention (SMD = 0.32, 95% CI: 0.19, 0.45, p < 0.001) compared with the control group, especially for total PA (SMD = 0.34, 95% CI: 0.10, 0.58, p = 0.005), moderate to vigorous PA (SMD = 0.17, 95% CI: 0.01, 0.32, p = 0.036), and steps (SMD = 0.75, 95% CI: 0.23, 1.28, p < 0.001. There were no significant effects for both PA at follow-up (SMD = 0.24, 95% CI: − 0.01, 0.49, p = 0.057) and SB (MD = −29.11, 95% CI: −70.55, 12.32, p = 0.17). The findings of subgroup analyses indicated that compared to the control group, interventions in the group of general participants (SMD = 0.45, 95% CI: 0.27, 0.63, p < 0.001), smartphone apps (SMD = 0.46, 95% CI: 0.19, 0.73, p = 0.001), and online (SMD = 0.23, 95% CI: 0.04, 0.43, p < 0.001) can significantly improve PA at post-intervention. Moreover, the intervention effects were significant across all groups of theory, region, instrument, duration, and female ratio. At follow-up, interventions in groups of developing region (SMD = 1.17, 95% CI: 0.73, 1.62, p < 0.001), objective instrument (SMD = 0.83, 95% CI: 0.23, 1.42, p = 0.007), duration ≤ 3-month (SMD = 1.06, 95% CI: 0.72, 1.39, p < 0.001), and all female (SMD = 0.79, 95% CI: 0.02, 1.56, p = 0.044) can significantly improve PA. The evidence of this meta-analysis shows that e-health interventions can be taken as promising strategies for promoting PA. The maintenance of PA improvement and the effect of interventions in reducing SB remain to be further studied. Educators and health practitioners should focus on creating multiple e-health interventions with individualized components.
体力活动不足和过度久坐行为对身心健康都有害。本系统评价和荟萃分析旨在确定电子健康干预措施是否能有效提高大学生的体力活动和久坐行为。截至 2022 年 6 月 22 日，我们检索了 5 个电子数据库，包括 Medline、Web of Science、Embase、Cochrane Library 和 ProQuest，以收集相关的随机对照试验。共有 22 项试验（包括 31 项效果）涉及 8333 个样本被纳入本荟萃分析。结果表明，与对照组相比，电子健康干预措施在干预后显著提高了体力活动（SMD = 0.32，95%CI：0.19，0.45，p < 0.001），尤其是总体力活动（SMD = 0.34，95%CI：0.10，0.58，p = 0.005）、中等到剧烈体力活动（SMD = 0.17，95%CI：0.01，0.32，p = 0.036）和步数（SMD = 0.75，95%CI：0.23，1.28，p < 0.001）。但在随访时，体力活动（SMD = 0.24，95%CI：−0.01，0.49，p = 0.057）和久坐行为（MD =−29.11，95%CI：−70.55，12.32，p = 0.17）的效果不显著。亚组分析结果表明，与对照组相比，一般参与者组（SMD = 0.45，95%CI：0.27，0.63，p < 0.001）、智能手机应用程序组（SMD = 0.46，95%CI：0.19，0.73，p = 0.001）和在线组（SMD = 0.23，95%CI：0.04，0.43，p < 0.001）在干预后体力活动显著提高。此外，所有理论、地区、仪器、持续时间和女性比例组的干预效果均显著。在随访时，发展中地区组（SMD = 1.17，95%CI：0.73，1.62，p < 0.001）、客观仪器组（SMD = 0.83，95%CI：0.23，1.42，p = 0.007）、持续时间≤3 个月组（SMD = 1.06，95%CI：0.72，1.39，p < 0.001）和全女性组（SMD = 0.79，95%CI：0.02，1.56，p = 0.044）干预后体力活动显著提高。本荟萃分析的证据表明，电子健康干预措施可以作为促进体力活动的有前途的策略。体力活动改善的维持和干预减少久坐行为的效果仍需进一步研究。教育者和健康从业者应专注于创建具有个性化组件的多种电子健康干预措施。
