Yan Yong Yang, Chan Lily Man Lee, Wang Man Ping, Kwok Jojo Yan Yan, Anderson Craig S, Lee Jung Jae
School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia.
NPJ Digit Med. 2024 Mar 18;7(1):72. doi: 10.1038/s41746-024-01067-y.
The effects of technology-supported behavior change interventions for reducing sodium intake on health outcomes in adults are inconclusive. Effective intervention characteristics associated with sodium reduction have yet to be identified. A systematic review and meta-analysis were conducted, searching randomized controlled trials (RCTs) published between January 2000 and April 2023 across 5 databases (PROSPERO: CRD42022357905). Meta-analyses using random-effects models were performed on 24-h urinary sodium (24HUNa), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Subgroup analysis and meta-regression of 24HUNa were performed to identify effective intervention characteristics. Eighteen RCTs involving 3505 participants (51.5% female, mean age 51.6 years) were included. Technology-supported behavior change interventions for reducing sodium intake significantly reduced 24HUNa (mean difference [MD] -0.39 gm/24 h, 95% confidence interval [CI] -0.50 to -0.27; I = 24%), SBP (MD -2.67 mmHg, 95% CI -4.06 to -1.29; I = 40%), and DBP (MD -1.39 mmHg, 95% CI -2.31 to -0.48; I = 31%), compared to control conditions. Interventions delivered more frequently (≤weekly) were associated with a significantly larger effect size in 24HUNa reduction compared to less frequent interventions (>weekly). Other intervention characteristics, such as intervention delivery via instant messaging and participant-family dyad involvement, were associated with larger, albeit non-significant, effect sizes in 24HUNa reduction when compared to other subgroups. Technology-supported behavior change interventions aimed at reducing sodium intake were effective in reducing 24HUNa, SBP, and DBP at post-intervention. Effective intervention characteristics identified in this review should be considered to develop sodium intake reduction interventions and tested in future trials, particularly for its long-term effects.
技术支持的行为改变干预措施对降低成年人钠摄入量及健康结局的影响尚无定论。与钠减少相关的有效干预特征尚未确定。我们进行了一项系统综述和荟萃分析，检索了2000年1月至2023年4月期间在5个数据库中发表的随机对照试验（RCTs）（PROSPERO：CRD42022357905）。对24小时尿钠（24HUNa）、收缩压（SBP）和舒张压（DBP）进行了随机效应模型的荟萃分析。对24HUNa进行亚组分析和荟萃回归，以确定有效的干预特征。纳入了18项RCTs，涉及3505名参与者（51.5%为女性，平均年龄51.6岁）。与对照条件相比，技术支持的行为改变干预措施显著降低了24HUNa（平均差值[MD]-0.39 gm/24 h，95%置信区间[CI]-0.50至-0.27；I²=24%）、SBP（MD-2.67 mmHg，95%CI-4.06至-1.29；I²=40%）和DBP（MD-1.39 mmHg，95%CI-2.31至-0.48；I²=31%）。与干预频率较低（>每周）的干预措施相比，干预频率较高（≤每周）的措施在降低24HUNa方面的效应量显著更大。与其他亚组相比，其他干预特征，如通过即时通讯进行干预和参与者-家庭二元参与，在降低24HUNa方面的效应量更大，尽管不显著。旨在降低钠摄入量的技术支持的行为改变干预措施在干预后有效降低了24HUNa、SBP和DBP。本综述中确定的有效干预特征应在制定钠摄入量减少干预措施时予以考虑，并在未来试验中进行测试，特别是其长期效果。
