Whitehall Jamie M, Cook Erica J, Vseteckova Jitka, Jones Kerry, Pappas Yannis, Donald Louisa, Chater Angel M
Research Centre for Health Service Organisation and Delivery, Institute for Health Research, University of Bedfordshire, Vicarage Street, Luton, LU1 3JU, United Kingdom.
Centre for Health Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, United Kingdom.
Int J Obes (Lond). 2025 Jun 7. doi: 10.1038/s41366-025-01811-8.
Obesity rates are continually rising and remote weight management interventions appear to demonstrate feasible prospects. Previous reviews have investigated influential factors to engagement of such interventions in community settings; however, limited research has examined adults' engagement in remote weight management programmes.
To systematically review the influences on the engagement of adults living with excess weight in synchronous (real time), remote health interventions for weight management.
A systematic review of 12 databases was conducted from inception to October 2023. Studies were included if they delivered a synchronous, remote weight management intervention with participants that were ≥18 years old with a body mass index ≥27.5 kg/m. A narrative synthesis with inductive thematic analysis was conducted to iteratively extrapolate barriers and facilitators to engagement. This set of themed influences were then deductively mapped to the COM-B model of behaviour change and the Theoretical Domains Framework (TDF).
From 36,359 studies screened, 39 studies met the inclusion criteria. A total of 57 themed influences were iteratively coded and mapped to the COM-B model: physical capability (n = 2); psychological capability (n = 10), reflective motivation (n = 17); automatic motivation (n = 10); physical opportunity (n = 7); and social opportunity (n = 11) with the assistance of the TDF to guide the coding. Barriers to engagement (n = 18) included concerns surrounding privacy, time burden to engage, embarrassment/anxiety surrounding self-disclosure, technical issues, access to technology, and access to the internet. Facilitators to engagement (n = 39) included digital competency, familiarity with technology, self-monitoring, tailored feedback, convenience, accountability, regular check-ins, support from a professional, social support, peer support, ease of use and simplicity.
There are a number of things to consider in relation to capability, opportunity and motivation when designing remote weight management interventions. This review provides evidence to specific barriers and facilitators that if addressed could optimise future efforts.
肥胖率持续上升，远程体重管理干预措施似乎展现出可行的前景。以往的综述研究了社区环境中此类干预措施参与度的影响因素；然而，针对成年人参与远程体重管理项目的研究有限。
系统综述对超重成年人参与同步（实时）远程健康体重管理干预措施的影响因素。
对12个数据库进行了从创建到2023年10月的系统综述。纳入的研究需为对年龄≥18岁、体重指数≥27.5kg/m²的参与者实施同步远程体重管理干预措施。采用归纳主题分析进行叙述性综合分析，以反复推断参与的障碍和促进因素。然后将这组主题影响因素演绎映射到行为改变的COM-B模型和理论领域框架（TDF）。
在筛选的36359项研究中，39项研究符合纳入标准。共对57个主题影响因素进行了反复编码，并在TDF的协助下映射到COM-B模型：身体能力（n = 2）；心理能力（n = 10），反思性动机（n = 17）；自动性动机（n = 10）；身体机会（n = 7）；以及社会机会（n = 11）。参与的障碍（n = 18）包括对隐私的担忧、参与的时间负担、自我披露的尴尬/焦虑、技术问题、技术获取、互联网接入。参与的促进因素（n = 39）包括数字能力、对技术的熟悉程度、自我监测、个性化反馈、便利性、问责制、定期检查、专业人员支持、社会支持、同伴支持、易用性和简单性。
在设计远程体重管理干预措施时，有许多与能力、机会和动机相关的因素需要考虑。本综述为特定的障碍和促进因素提供了证据，若加以解决可优化未来的努力。
