Review of computer-generated outpatient health behavior interventions: Clinical encounters "in absentia"
Review of computer-generated outpatient health behavior interventions: Clinical encounters "in absentia"
复制标题
DOI：
10.1136/jamia.2001.0080062
复制
发表时间：
2001-01-01
影响因子：
6.4
通讯作者：
Dunbar, PJ
中科院分区：
文献类型：
--
作者：
Revere, D;Dunbar, PJ
目的：为了评估计算机生成的健康行为干预的有效性证据-临床遭遇“缺席”-作为门诊环境中面对面患者护理的扩展。数据来源：系统化电子数据库和多种来源的人工搜索（1996-1999）并检索灰色文献，以确定使用计算机进行的临床试验，产生健康行为干预，以激励个人采取治疗方案，重点是病人互动的干预措施和使用健康行为models.Study选择：合格标准包括随机对照研究与一些证据的工具的可靠性和有效性;使用至少一个患者交互式针对性或定制的反馈、提醒或教育干预，旨在影响或改善所述健康行为;以及一个干预变量与健康行为之间的关联。按输送器械描述研究（印刷、自动电话、计算机和移动的通信）和干预类型（个性化、有针对性和定制）。我们采用定性的方法来分析检索集，并探讨问题的病人互动的计算机生成的行为interventionsSystems.Data Synthesis：研究的方法，质量，受试者人数和特点，测量的影响和健康行为的重点有很大不同。在37项合格的试验中，34项（91.9%）报告了统计学显著或改善的结果。14项研究使用了有针对性的干预措施; 23项研究使用了定制的干预措施。在14项针对性干预研究中，13项（92.9%）报告了改善的结果。在23个量身定制的干预研究，21（91.3%）报告改善outcomes.Conclusions：文献表明，计算机生成的健康行为干预是有效的。虽然有证据表明，定制的干预措施可以更积极地影响健康行为的变化比可以有针对性的，个性化的或通用的干预措施，很少有研究比较不同的定制协议彼此。只有那些使用印刷品和电话设备的研究报告了他们的方法的理论基础。未来的研究需要确定哪些模型最适合哪些健康行为，某些输送设备是否更适合不同的健康行为，以及门诊护理如何从患者使用便携式设备中受益。
Objective: To evaluate evidence of the effectiveness of computer-generated health behavior interventions-clinical encounters "in absentia"-as extensions of face-to-face patient care in an ambulatory setting.Data Sources: Systematic electronic database and manual searches of multiple sources (1996-1999) plus search for gray literature were conducted to identify clinical trials using computer-generated health behavior interventions to motivate individuals to adopt treatment regimens, focusing on patient-interactive interventions and use of health behavior models.Study Selection: Eligibility criteria included randomized controlled studies with some evidence of instrument reliability and validity; use of at least one patient-interactive targeted or tailored feedback, reminder, or educational intervention intended to influence or improve a stated health behavior; and an association between one intervention variable and a health behavior.Data Extraction: Studies were described by delivery device (print, automated telephone, computer, and mobile communication) and intervention type (personalized, targeted, and tailored). We employed qualitative methods to analyze the retrieval set and explore the issue of patient-interactive computer-generated behavioral intervention systems.Data Synthesis: Studies varied widely in methodology, quality, subject number, and characteristics, measurement of effects and health behavior focus. Of 37 eligible trials, 34 (91.9 percent) reported either statistically significant or improved outcomes. Fourteen studies used targeted interventions; 23 used tailored. Of the 14 targeted intervention studies, 13 (92.9 percent) reported improved outcomes. Of the 23 tailored intervention studies, 21 (91.3 percent) reported improved outcomes.Conclusions: The literature indicates that computer-generated health behavior interventions are effective. While there is evidence that tailored interventions can more positively affect health behavior change than can targeted, personalized or generic interventions, there is little research comparing different tailoring protocols with one another. Only those studies using print and telephone devices reported a theoretic basis for their methodology. Future studies need to identify which models are best suited to which health behavior, whether certain delivery devices are more appropriate for different health behaviors, and how ambulatory care can benefit from patients' use of portable devices.