What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

Frontiers in Public Health

Cátia Oliveira²  Carmen Phang Romero²  Mario Simjanoski³  Flavio Kapciznki⁴  Raquel B. De Boni⁶  Marcelo Ribeiro-Alves⁷  Hugo Perazzo⁷  Rodolfo Castro⁸  Vicent Balanzá-Martínez⁹ 

[1] Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil;Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil;Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada;Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;Escola Nacional de Saúde Pública Sergio Arouca, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil;Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil;Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil;Instituto de Saúde Coletiva, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil;Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain;

关键词: digital health interventions;    lifestyle;    diet;    physical activity;    substance use;    stress management;   

DOI  :  10.3389/fpubh.2021.735624

来源: DOAJ

【 摘 要 】

Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods.Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change.Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites.Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention—but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.

【 授权许可】

Unknown