Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 8, 2024
Open Peer Review Period: Mar 7, 2024 - May 2, 2024
Date Accepted: Jun 1, 2024
(closed for review but you can still tweet)
Effectiveness of eHealth interventions to manage multiple lifestyle risk behaviors among older adults: a systematic review and meta-analysis
ABSTRACT
Background:
The development of adverse lifestyle behaviors increases the risk of a variety of chronic age-related diseases, including cardiovascular disease, obesity, and Alzheimer's disease. There is limited evidence regarding the effectiveness of eHealth-based multiple health behavior change (MHBC) for lifestyle risk behaviors.
Objective:
The purpose of this systematic evaluation is to assess the effectiveness of eHealth intervention in changing two or more major lifestyle risk behaviors in people aged 50 and older.
Methods:
The literature search was conducted in six electronic databases (PubMed, Embase, Web of Science, Scopus, Cochrane Library, and SPORT Discus) up to July 8, 2023. Eligible studies were randomized controlled trials of eHealth interventions targeting two or more of six behaviors of interest, including alcohol use, smoking, diet, physical activity (PA), sedentary behavior (SB), and sleep.
Results:
Thirty-two articles with 33 studies were included. eHealth-based MHBC interventions significantly increased the number of people who quit smoking (OR= 2.13 (95% CI 1.64 to 2.76), P<0.001), fruit intake (SMD=0.18 (95% CI 0.04 to 0.32), P= 0.01), vegetable intake (SMD=0.17 (95% CI 0.05 to 0.28), P=0.003), self-reported total PA (TPA) (SMD=0.22 (95% CI 0.02 to 0.43), P=0.03) and objectively measured moderate-to-vigorous physical activity (MVPA) (SMD=0.25 (95% CI 0.09 to 0.41), P= 0.002), and decreased the fat intake (SMD=-0.23 (95% CI -0.33 to -0.13), P<0.001). No effects were seen for alcohol use or SB or sleep. A sensitivity analysis was conducted to test the robustness of the pooled results. Moreover, the certainty of evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment.
Conclusions:
eHealth-based MHBC interventions may be a promising strategy to increase PA, improve diet, and reduce smoking in older adults. However, the effects were small. Further high-quality, older adult-oriented research is needed to develop eHealth interventions that can change multiple behaviors. Clinical Trial: PROSPERO CRD42023444418
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