Personalised eHealth interventions in adults with overweight and obesity: A systematic review and meta-analysis of randomised controlled trials

Lau, Ying; Chee, Daniel Guang Hui; Chow, Xue Ping; Cheng, Ling Jie; Wong, Suei Nee

doi:10.1016/j.ypmed.2020.106001

Cited by 47 publications

(47 citation statements)

References 56 publications

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“…Although our study design cannot point to which BCTs explain the difference in effectiveness across the groups, the BCTs of social support, personalized feedback, and self-monitoring of behaviors, which only the platform groups received, were important intervention differences. The efficacy of these BCTs in promoting weight loss has been reported by other studies [ 28 ].…”

Section: Discussionsupporting

confidence: 62%

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial

Du¹,

Andrade²,

Diniz³

et al. 2020

J Med Internet Res

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Background The effect of computer- or human-delivered personalized feedback on the effectivess of web-based behavior change platforms for weight loss is unclear. Objective We aimed to compare the effectiveness of a web-based behavior change intervention personalized through either computerized or human-delivered feedback with a nonpersonalized intervention in promoting weight loss in community-based adults with overweight or obesity. Methods This pragmatic, 3-group, parallel-arm, randomized trial recruited students and staff in a Brazilian public university who were aged 18 to 60 years, had a BMI of ≥25 kg/m2, and were not pregnant. Participants were allocated to one of 3 groups: platform only (24-week behavior change program delivered using a web platform with personalized computer-delivered feedback), platform plus coaching (same 24-week web-based behavior change program plus 12 weeks of personalized feedback delivered online by a dietitian), or waiting list (nonpersonalized dietary and physical activity recommendations delivered through an e-booklet and videos). Self-reported weight at 24 weeks was the primary outcome. Changes in dietary and physical activity habits within 24 weeks were secondary outcomes. Results Among the 1298 participants, 375 (28.89%) were lost to follow-up. In the intention-to-treat analysis, the platform-only and platform plus coaching groups had greater mean weight loss than the waiting-list group at 24 weeks (–1.08 kg, 95% CI –1.41 to –0.75 vs –1.57 kg, 95% CI –1.92 to –1.22 vs –0.66 kg, 95% CI –0.98 to –0.34, respectively). The platform-only and platform plus coaching groups, compared with the waiting list group, had a greater increase in the consumption of vegetables (3%, 95% CI 1% to 6% vs 5%, 95% CI 2% to 8% vs –3%, 95% CI –5% to 0%) and fruits (9%, 95% CI 6% to 12% vs 6%, 95% CI 2% to 9% vs 2%, 95% CI 0% to 6%) and a larger reduction in ultraprocessed food intake (–18%, 95% CI –23% to –13% vs –25%, 95% CI –30% to –20% vs –12%, 95% CI –16% to –8%). Changes in physical activity did not differ across the groups. Engagement was higher in the platform plus coaching group than in the platform-only group (7.6 vs 5.2 completed sessions; P=.007). Longer usage of the platform was associated with clinically meaningful (≥5%) weight loss (odds ratio 1.02, 95% CI 1.01 to 1.04). Conclusions The web-based behavior change programs with computer- and human-delivered personalized feedback led to greater, albeit small-magnitude, weight loss within 24 weeks. Improvement in multiple dietary habits, but not physical activity, were also greater in the personalized programs compared with the nonpersonalized one. The human-delivered personalized feedback by the online dietitian coach increased user engagement with the program and was associated with a significantly higher chance of clinically meaningful weight loss. Trial Registration ClinicalTrials.gov NCT03435445; https://clinicaltrials.gov/ct2/show/NCT03435445 International Registered Report Identifier (IRRID) RR2-10.2196/10.1186/s12889-018-5882-y

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Section: Discussionsupporting

confidence: 62%

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial

Du¹,

Andrade²,

Diniz³

et al. 2020

J Med Internet Res

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“…The literature of weight management is extensive and findings on DBCIs for weight loss are promising (e.g., [13][14][15][16][17]). However, in the context of WLM, the few existing reviews have reported positive albeit often small effects of DBCIs with considerable between-study variability.…”

Section: Introductionmentioning

confidence: 99%

What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review

Encantado¹,

Palmeira²,

Silva³

et al. 2021

Preprint

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Background: Behavioural interventions for weight loss maintenance have shown beneficial effects for weight loss maintenance. While the digital upgrade of behavioural interventions brings an enormous potential to tackle public health challenges, there is limited knowledge about the components of these interventions, i.e., its content, delivery and the theoretical approaches.Objective: To identify the core components of digital behaviour change interventions for weight loss maintenance targeting physical activity, in terms of: i) Behaviour Change Techniques; ii) Mechanisms of Action; iii) Modes of Delivery; iv) Dose; and v) Tailoring/Personalisation. In addition, the links between these components were investigated.Methods: A literature search was performed in 5 electronic databases: PubMed; Embase; CINHAL; PsycINFO, and Web of Science. Two reviewers independently screened the identified papers and extracted data related with the study characteristics and behaviour change techniques, mechanism of action, mode of delivery, dose, and tailoring, using standardized classifications whenever available (e.g., behaviour change techniques taxonomy). Results: Seventeen articles reporting eleven original studies were selected. Two studies were protocols, nine studies presented results for weight change and all but one showed no significant differences between the intervention and control groups. Eight studies (73%) provided adequate information on Behaviour Change Techniques. Five studies (45%) provided partial information about how the Behaviour Change Techniques were linked to mechanisms of action, and only one study (0.9%) described these links for all the techniques. Around half of the studies reported the modes through which behaviour change techniques were delivered. Descriptions of dose were present in most studies, but with minimal information. The use of tailoring or personalisation approaches was mentioned in eight studies (73%), but descriptions of what was tailored and how were minimal. Conclusions: The compilation of information regarding intervention components was difficult due to the lack of information and systematisation in reporting across papers. This is particularly true for the reporting of the links between behaviour change techniques and the other core intervention components. This information is crucial to help us understand in the context of behaviour change interventions what works or does not work, how it works and why.

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“…According to the World Health Organization, one of the main health problems among children and young people in the 21st century worldwide is obesity [1]. The global prevalence of obesity and overweight in the [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] year old population has increased dramatically between 1975 and 2016 [2].…”

Section: Introductionmentioning

confidence: 99%

“…The effectiveness of eHealth systems has been studied in the systematic review by Lau et al [13], who studied tailored eHealth interventions in overweight and obese adults. They concluded that personalised eHealth interventions is a suitable approach for overweight and obese adults to reduce weight, BMI, waist circumference and blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Social-Network-Based eHealth Intervention on the Improvement of Healthy Habits among Children

Benítez-Andrades

Ramos

García-Ordás

et al. 2020

Sensors

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This study shows the feasibility of an eHealth solution for tackling eating habits and physical activity in the adolescent population. The participants were children from 11 to 15 years old. An intervention was carried out on 139 students in the intervention group and 91 students in the control group, in two schools during 14 weeks. The intervention group had access to the web through a user account and a password. They were able to create friendship relationships, post comments, give likes and interact with other users, as well as receive notifications and information about nutrition and physical activity on a daily basis and get (virtual) rewards for improving their habits. The control group did not have access to any of these features. The homogeneity of the samples in terms of gender, age, body mass index and initial health-related habits was demonstrated. Pre-and post-measurements were collected through self-reports on the application website. After applying multivariate analysis of variance, a significant alteration in the age-adjusted body mass index percentile was observed in the intervention group versus the control group, as well as in the PAQ-A score and the KIDMED score. It can be concluded that eHealth interventions can help to obtain healthy habits. More research is needed to examine the effectiveness in achieving adherence to these new habits.

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Personalised eHealth interventions in adults with overweight and obesity: A systematic review and meta-analysis of randomised controlled trials

Cited by 47 publications

References 56 publications

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial

Personalized Web-Based Weight Loss Behavior Change Program With and Without Dietitian Online Coaching for Adults With Overweight and Obesity: Randomized Controlled Trial

What goes on in digital behaviour change interventions for weight loss maintenance targeting physical activity: A Scoping Review

Feasibility of Social-Network-Based eHealth Intervention on the Improvement of Healthy Habits among Children

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