دورية أكاديمية
أعرض في EDS

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

التفاصيل البيبلوغرافية
العنوان: Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.
المؤلفون: Metzendorf MI; Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany., Wieland LS; Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Richter B; Institute of General Practice, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
المصدر: The Cochrane database of systematic reviews [Cochrane Database Syst Rev] 2024 Feb 20; Vol. 2. Cochrane AN: CD013591. Date of Electronic Publication: 2024 Feb 20.
نوع المنشور: Journal Article; Systematic Review; Meta-Analysis; Review
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: England NLM ID: 100909747 Publication Model: Electronic Cited Medium: Internet ISSN: 1469-493X (Electronic) Linking ISSN: 13616137 NLM ISO Abbreviation: Cochrane Database Syst Rev
أسماء مطبوعة: Publication: 2004- : Chichester, West Sussex, England : Wiley
Original Publication: Oxford, U.K. ; Vista, CA : Update Software,
مواضيع طبية MeSH: Randomized Controlled Trials as Topic* , Overweight*/therapy , Smartphone* , Mobile Applications* , Obesity*/therapy , Exercise* , Weight Loss*, Humans ; Adolescent ; Adult ; Telemedicine ; Self Efficacy ; Cardiorespiratory Fitness ; Young Adult ; Diet, Healthy ; Female ; Quality of Life ; Male ; Bias ; Body Mass Index ; Behavior Therapy/methods
مستخلص: Background: Obesity is considered to be a risk factor for various diseases, and its incidence has tripled worldwide since 1975. In addition to potentially being at risk for adverse health outcomes, people with overweight or obesity are often stigmatised. Behaviour change interventions are increasingly delivered as mobile health (m-health) interventions, using smartphone apps and wearables. They are believed to support healthy behaviours at the individual level in a low-threshold manner.
Objectives: To assess the effects of integrated smartphone applications for adolescents and adults with overweight or obesity.
Search Methods: We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, and LILACS, as well as the trials registers ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform on 2 October 2023 (date of last search for all databases). We placed no restrictions on the language of publication.
Selection Criteria: Participants were adolescents and adults with overweight or obesity. Eligible interventions were integrated smartphone apps using at least two behaviour change techniques. The intervention could target physical activity, cardiorespiratory fitness, weight loss, healthy diet, or self-efficacy. Comparators included no or minimal intervention (NMI), a different smartphone app, personal coaching, or usual care. Eligible studies were randomised controlled trials of any duration with a follow-up of at least three months.
Data Collection and Analysis: We used standard Cochrane methodology and the RoB 2 tool. Important outcomes were physical activity, body mass index (BMI) and weight, health-related quality of life, self-efficacy, well-being, change in dietary behaviour, and adverse events. We focused on presenting studies with medium- (6 to < 12 months) and long-term (≥ 12 months) outcomes in our summary of findings table, following recommendations in the core outcome set for behavioural weight management interventions.
Main Results: We included 18 studies with 2703 participants. Interventions lasted from 2 to 24 months. The mean BMI in adults ranged from 27 to 50, and the median BMI z-score in adolescents ranged from 2.2 to 2.5. Smartphone app versus no or minimal intervention Thirteen studies compared a smartphone app versus NMI in adults; no studies were available for adolescents. The comparator comprised minimal health advice, handouts, food diaries, smartphone apps unrelated to weight loss, and waiting list. Measures of physical activity: at 12 months' follow-up, a smartphone app compared to NMI probably reduces moderate to vigorous physical activity (MVPA) slightly (mean difference (MD) -28.9 min/week (95% confidence interval (CI) -85.9 to 28; 1 study, 650 participants; moderate-certainty evidence)). We are very uncertain about the results of estimated energy expenditure and cardiorespiratory fitness at eight months' follow-up. A smartphone app compared with NMI probably results in little to no difference in changes in total activity time at 12 months' follow-up and leisure time physical activity at 24 months' follow-up. Anthropometric measures: a smartphone app compared with NMI may reduce BMI (MD of BMI change -2.6 kg/m 2 , 95% CI -6 to 0.8; 2 studies, 146 participants; very low-certainty evidence) at six to eight months' follow-up, but the evidence is very uncertain. At 12 months' follow-up, a smartphone app probably resulted in little to no difference in BMI change (MD -0.1 kg/m 2 , 95% CI -0.4 to 0.3; 1 study; 650 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in body weight change (MD -2.5 kg, 95% CI -6.8 to 1.7; 3 studies, 1044 participants; low-certainty evidence) at 12 months' follow-up. At 24 months' follow-up, a smartphone app probably resulted in little to no difference in body weight change (MD 0.7 kg, 95% CI -1.2 to 2.6; 1 study, 245 participants; moderate-certainty evidence). A smartphone app compared with NMI may result in little to no difference in self-efficacy for a physical activity score at eight months' follow-up, but the results are very uncertain. A smartphone app probably results in little to no difference in quality of life and well-being at 12 months (moderate-certainty evidence) and in little to no difference in various measures used to inform dietary behaviour at 12 and 24 months' follow-up. We are very uncertain about adverse events, which were only reported narratively in two studies (very low-certainty evidence). Smartphone app versus another smartphone app Two studies compared different versions of the same app in adults, showing no or minimal differences in outcomes. One study in adults compared two different apps (calorie counting versus ketogenic diet) and suggested a slight reduction in body weight at six months in favour of the ketogenic diet app. No studies were available for adolescents. Smartphone app versus personal coaching Only one study compared a smartphone app with personal coaching in adults, presenting data at three months. Two studies compared these interventions in adolescents. A smartphone app resulted in little to no difference in BMI z-score compared to personal coaching at six months' follow-up (MD 0, 95% CI -0.2 to 0.2; 1 study; 107 participants). Smartphone app versus usual care Only one study compared an app with usual care in adults but only reported data at three months on participant satisfaction. No studies were available for adolescents. We identified 34 ongoing studies.
Authors' Conclusions: The available evidence is limited and does not demonstrate a clear benefit of smartphone applications as interventions for adolescents or adults with overweight or obesity. While the number of studies is growing, the evidence remains incomplete due to the high variability of the apps' features, content and components, which complicates direct comparisons and assessment of their effectiveness. Comparisons with either no or minimal intervention or personal coaching show minor effects, which are mostly not clinically significant. Minimal data for adolescents also warrants further research. Evidence is also scarce for low- and middle-income countries as well as for people with different socio-economic and cultural backgrounds. The 34 ongoing studies suggest sustained interest in the topic, with new evidence expected to emerge within the next two years. In practice, clinicians and healthcare practitioners should carefully consider the potential benefits, limitations, and evolving research when recommending smartphone apps to adolescents and adults with overweight or obesity.
(Copyright © 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
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سلسلة جزيئية: ClinicalTrials.gov NCT02308176; NCT01092364; NCT01744535; NCT02818790; NCT03329079; NCT02595671; NCT02823379; NCT03270423; NCT04165707; NCT03500835; NCT03321331; NCT02829632; NCT03367936; NCT01693250; NCT03465306; NCT03651284; NCT02997943; NCT04708769; NCT01724632; NCT03788915; NCT01738256; NCT03973424; NCT03907462; NCT04465721
تواريخ الأحداث: Date Created: 20240220 Date Completed: 20240807 Latest Revision: 20240807
رمز التحديث: 20240808
مُعرف محوري في PubMed: PMC10877670
DOI: 10.1002/14651858.CD013591.pub2
PMID: 38375882
قاعدة البيانات: MEDLINE
الوصف
تدمد:1469-493X
DOI:10.1002/14651858.CD013591.pub2