Effects Of Ehealth Multiple Health Behaviour Change Intervention On Physical Activity,Diet And Weight Among Patients With Non-communicable Diseases

BackgroundInsufficient physical activity and unhealthy diet are the main risk factors for noncommunicable diseases.The improvements of physical activity,healthy diet and weight control have been the main targets of health interventions for patients with noncommunicable diseases.In the recent 20 years,eHealth Multiple Health Behaviors Change intervention,an emerging intervention paradigm,has been widely utilized in the field of medical service,education and health promotion.However,the intervention effect of such studies remains unknown.In the present thesis,a meta-analysis was conducted to evaluate the effectiveness of eHealth Multiple Health Behaviors Change interventions for physical activity,diet and weight among patients with noncommunicable disease.In addition,the present thesis also addressed the problem whether the intervention effectiveness was associated with intervention duration,language,subjects'age and gender.MethodsGuided by the PRISMA reporting guidelines,a series of structured electronic searches were performed in 7 databases?4 English databases including PsycINFO,PubMed,Scopus,SPORTDiscus and 3 Chinese databases including CNKI,WANFANG DATA,CQVIP?with searching strategies extended from January 1^st,2000until November 30^th,2018.Study inclusion and exclusion criteria was established according to PICO?Participants,Intervention,Comparison,Outcome?Principle.The quality of included studies was assessed by Cochrane Risk of Bias Assessment Guide.Data extraction was performed according to the unified extraction tool.The effect sizes were synthesized into standardized mean difference by using SPSS 22.0,and the relevant plots and tables were made by using Review Manager 5.3.ResultsAfter a series of structured screenings,22 studies met the inclusion criteria for the subsequent data extraction.Among them,12 articles published in English and 10articles published in Chinese.The results demonstrated that both the physical activity[SMD=0.97,95%CI?0.64,1.29?,Z=5.78,P<0.00001]and diet[SMD=0.57,95%CI?0.36,0.77?,Z=5.44,P<0.00001]of intervention groups were significantly improved compared with control group.No significant difference was demonstrated in weight between intervention and control groups[SMD=-0.68,95%CI?-1.39,0.02?,Z=1.90,P=0.06].The outcomes of subgroup analysis demonstrated that studies published in Chinese had higher intervention effectiveness in physical activity and diet than those published in English;The intervention effectiveness of the subgroup of average age less than 50 was higher than the subgroup of average age no less than 50on diet significantly,but not on physical activity between the two subgroups.The intervention effectiveness was not significantly different between the two subgroups of intervention duration and gender proportion on both physical activity and diet.ConclusionsPhysical activity and diet can be improved significantly by eHealth Multiple Health Behaviors Change intervention among patients with noncommunicable diseases.However,the intervention does not significantly change the weight status for patients with noncommunicable disease.The current thesis makes a significant contribution to the eHealth and noncommunicable diseases-related literature by identifying research priorities and providing preliminary evidence for clinical decision making.Based on this thesis,it is expected that further investigation will make recommended improvement on the intervention design in order to ultimately enhance the well-being of NCD patients.