JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) and web-based technological advances allow for new approaches to delivering behavioral interventions for chronic diseases such as obesity and diabetes. African Americans and Hispanics suffer a disproportionate burden of major chronic diseases.

Objective:

This manuscript reviews the evidence for mHealth and web-based interventions for diabetes and obesity in African American and Hispanic adults.

Methods:

Literature searches of PubMed/Medline, The Cochrane Library, EMBASE, CINAHL Plus, Global Health, Scopus and Library and Information source were conducted, searching for relevant English-language articles published from January 1, 1950 through September 2020. Articles identified by searches were reviewed by two investigators and, if meeting inclusion criteria, were extracted and assessed for risk of bias. Findings were summarized in tabular and narrative format. Quantitative synthesis (meta-analysis) was conducted to estimate pooled effects when three or more similar studies were identified. The overall strength of the evidence (SOE) was assessed as high, moderate, low, or insufficient based on risk of bias, consistency of findings, directness, precision, and other limitations.

Results:

The searches yielded 2358 electronic publications, 196 reports were found to be eligible for inclusion, and 6 studies met the eligibility criteria. All 6 included studies were randomized control trials. Five studies evaluated the effectiveness of an mHealth intervention for weight loss including one that evaluated the effectiveness for diabetes and one study focused on diabetes. Meta-analysis of five trials with a total of 688 participants showed that interventions were associated with weight loss over 14 weeks to 12 months (pooled difference in means, -2.5kg 95% CI, -3.5 to -1.4) The two studies that focused on diabetes reported an improvement in glycemic control in participants in intervention groups compared with control groups but only one was statistically significant.

Conclusions:

This analysis indicates that there are few published studies assessing mHealth among minority populations and focused on weight or diabetes. Although the overall strength of evidence was low for control of diabetes, it was moderate for weight loss and the current findings suggest that mHealth and web-based interventions may provide a promising approach for interventions among obese African American and Hispanic adults who have obesity or diabetes.