Department of Physiotherapy, Guy's & St Thomas' Hospital NHS Foundation Trust, London, UK.
Department of Population and Health Sciences, King's College London, London, UK.
Syst Rev. 2023 Mar 30;12(1):59. doi: 10.1186/s13643-023-02207-3.
Low socioeconomic status (SES) is associated with increased rates of overweight and obesity. Proponents of electronic health (eHealth) hypothesise that its inclusion in weight management interventions can improve efficacy by mitigating typical barriers associated with low SES.
To establish the scope of eHealth weight management interventions for people with overweight and obesity from a low SES. Secondary objectives were to determine the efficacy of eHealth interventions in facilitating weight loss, physical activity and fitness improvements.
Four databases and grey literature were systematically searched to identify eligible studies published in English from inception to May 2021. Studies examining an eHealth intervention with low SES participants were included. Outcomes included temporal change in weight and BMI, anthropometry, physiological measures and physical activity levels. The number and heterogeneity of studies precluded any meta-analyses; thus, a narrative review was undertaken.
Four experimental studies with low risk of bias were reviewed. There was variance in how SES was defined. Study aims and eHealth media also varied and included reducing/maintaining weight or increasing physical activity using interactive websites or voice responses, periodic communication and discourse via telephone, social media, text messaging or eNewsletters. Irrespectively, all studies reported short-term weight loss. eHealth interventions also increased short-term physical activity levels where it was assessed, but did not change anthropometry or physiological measures. None reported any effect on physical fitness.
This review revealed short-term effects of eHealth interventions on weight loss and increased physical activity levels for low SES participants. Evidence was limited to a small number of studies, with small to moderate sample sizes. Inter-study comparison is challenging because of considerable variability. Future work should prioritise how to utilise eHealth in the longer term either as a supportive public health measure or by determining its long-term efficacy in engendering volitional health behaviour changes.
PROSPERO CRD42021243973.
低社会经济地位（SES）与超重和肥胖的发生率增加有关。电子健康（eHealth）的支持者假设，将其纳入体重管理干预措施可以通过减轻与低 SES 相关的典型障碍来提高疗效。
确定针对 SES 较低的超重和肥胖人群的 eHealth 体重管理干预措施的范围。次要目的是确定 eHealth 干预措施在促进减肥、增加体力活动和改善健康方面的效果。
系统检索了四个数据库和灰色文献，以确定从开始到 2021 年 5 月期间发表的符合条件的英文研究。纳入了研究 SES 参与者的 eHealth 干预措施的研究。结果包括体重和 BMI、人体测量、生理指标和体力活动水平的时间变化。由于研究数量和异质性，任何荟萃分析都不适用；因此，进行了叙述性综述。
综述了四项低偏倚风险的实验研究。SES 的定义存在差异。研究目的和 eHealth 媒体也各不相同，包括使用互动网站或语音回复、定期通过电话、社交媒体、短信或电子通讯进行交流和对话来减轻/维持体重或增加体力活动。无论如何，所有研究都报告了短期体重减轻。无论是否进行评估，eHealth 干预措施都增加了短期体力活动水平，但没有改变人体测量或生理指标。没有一项研究报告对身体健康有任何影响。
本综述揭示了 eHealth 干预措施对 SES 较低的参与者短期减肥和增加体力活动水平的影响。证据仅限于少数研究，样本量较小至中等。由于存在很大的变异性，因此很难进行研究间比较。未来的工作应优先考虑如何在更长时间内利用 eHealth，无论是作为一种支持性的公共卫生措施，还是通过确定其在引发自愿健康行为改变方面的长期疗效。
PROSPERO CRD42021243973。
