JMIR Publications

ABSTRACT

Background:

Non-communicable diseases (NCDs) bring heavy burdens of related premature deaths and huge medical costs globally. To date, there is an increasing number of studies combining a multiple health behavior change (MHBC) intervention paradigm with eHealth approaches to jointly promote weight-related health behaviors among people with NCD, yet a comprehensive summary of these studies is lacking. This review aims to meta-analyze the effectiveness and systematically summarize the characteristics of the relevant intervention studies for improving the outcomes of physical activity, healthy diet and weight among people with NCD.

Objective:

This review aims to meta-analyze the effectiveness and systematically summarize the characteristics of the relevant intervention studies for improving the outcomes of physical activity, healthy diet and weight among people with NCD.

Methods:

Following PRISMA guidelines, four electronic databases (PsycINFO, PubMed, Scopus, SPORTDiscus) were systematically searched to identify eligible articles with a series of inclusion and exclusion criteria. Article selection, quality assessment, and data extraction were performed by two authors independently. Standardized mean difference (SMD) was calculated to evaluate the effectiveness of interventions for three intervention outcomes (physical activity, healthy diet, and weight) respectively and subsequent subgroup analyses were performed for gender, age, intervention duration, channel, and theory. Calculations and figure production were facilitated by SPSS 22 and Review Manager 5.3.

Results:

Out of 664 original hits generated by the systematic searches, 15 eligible studies with moderate to high quality were included. No potential publication bias was detected by statistical analyses. Studies varied in intervention channel, intensity, and content. The meta-analysis revealed that the eHealth MHBC interventions significantly promoted physical activity (SMD=0.85, P=.008, 95% CI=0.23 - 1.47) and healthy diet (SMD=0.78, P=.02, 95% CI=0.13 - 1.43), but not helping with healthy weight status (SMD= -0.13, P=.43, 95% CI= -0.47 - 0.20) among people with NCDs, compared to the control conditions. Results from subgroup analysis indicated that theory-based interventions achieved better effect than non-theory-based interventions in promoting physical activity, and interventions with traditional approaches (short messages, telephone) than those of modern internet-based approaches in promoting healthy diet.

Conclusions:

This review indicated that the eHealth MHBC intervention obtained its preliminary success in promoting physical activity and healthy diet behaviors among NCD people. Future studies can make recommended improvement on the intervention design in order to achieve better intervention effectiveness. Clinical Trial: PROSPERO (Registration ID: CRD42019118629)