JMIR Publications

ABSTRACT

Background:

Young adulthood is a vulnerable period for unhealthy lifestyle adoption and excess weight gain. Scant attention has been focused on developing and evaluating effective weight gain prevention strategies for this age-group. Electronic health (eHealth) offers potential as a cost-effective solution with the capability to deliver convenient, individually-tailored, and contextually-meaningful interventions at scale.

Objective:

The primary aim of this systematic review was to evaluate the effectiveness of eHealth weight management interventions targeting young adults (aged 18 – 35 years). A secondary aim was to assess the quality of the current evidence base to inform future research and ensure future interventions are informed by rigorous and robust research findings.

Methods:

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic and Meta-Analyses guidelines. The search strategy was executed across 14 electronic databases: CINAHL, Cochrane Library, EBSCO, Embase, Emerald, ERIC, MEDLINE, Ovid, ProQuest, PsycINFO, PubMed, Science Direct, Scopus, and Web of Science. Two reviewers independently assessed records for eligibility: published in English (1980 to July 2017), evaluating eHealth weight management interventions targeting young adults (aged 18 – 35 years). Following this, data were extracted from studies that met the inclusion criteria. The methodological quality was assessed using the Effective Public Health Practice Project’s (EPHPP) Quality Assessment Tool. A narrative synthesis of effectiveness was then completed. At all stages, data were checked for accuracy by a third independent reviewer, with any discrepancies resolved through discussion.

Results:

Out of the 985 studies assessed for eligibility, 25 met the criteria for inclusion and were included in the narrative synthesis. Overall, eight studies reported positive weight-related outcomes (e.g. prevention of weight gain or the reversal of small weight gains), four reported mixed effects, and 12 did not report any significant changes compared with control groups. One study reported descriptive results only. According to the EPHPP Quality Assessment Tool, overall 22 studies were rated weak, three as moderate, and none as strong.

Conclusions:

Findings highlight the limited evidence base for successful eHealth weight management interventions targeting young adults. The large heterogeneity across intervention designs and outcomes necessitate further research to create a cumulative knowledge base of what works and what does not for weight management among this at-risk group. The quality of the evidence was generally assessed as weak. Future studies should aim to employ representative sampling and adopt strategies to increase participation and retention rates.