Systematic review and meta-analysis of remotely delivered interventions using self-monitoring or tailored feedback to change dietary behavior.
Systematic review and meta-analysis of remotely delivered interventions using self-monitoring or tailored feedback to change dietary behavior.
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DOI：
10.1093/ajcn/nqx048
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发表时间：
2018-02-01
期刊：
影响因子：
--
通讯作者：
Scarborough P
中科院分区：
文献类型：
--
作者：
Teasdale N;Elhussein A;Butcher F;Piernas C;Cowburn G;Hartmann-Boyce J;Saksena R;Scarborough P
饮食的自我监测（SM）和定制反馈（TF）已被建议作为改变饮食行为的工具。新技术允许用户远程监控行为，从而有可能提高覆盖范围、依从性和结果。我们进行了系统的文献综述和荟萃分析，以解决以下问题：远程独立交付（即，没有人类接触）的干预措施，使用SM或TF有效地改变饮食行为？2016年10月检索了5个数据库（2017年9月更新）。仅纳入1990年以后发表的随机对照试验。试验可以包括任何没有饮食失调史的成年人群，在没有直接接触的情况下提供SM或TF干预，并记录实际饮食消费作为结果。三名评估员独立筛选检索结果。两位评审员提取了研究特征、干预细节和结局，并使用科克伦工具评估了偏倚风险。结果被转换为标准化的平均差异，并纳入一个3级（个人和结果嵌套在研究中）随机效应荟萃分析。确定了26项研究，包含21，262名参与者。大多数研究被判定为不明确或存在高偏倚风险。荟萃分析显示，与对照组相比，干预组的饮食改善，标准化平均差异为0.17（95% CI：0.10，0.24; P < 0.0001）。荟萃分析的I2统计量为0.77，表明结果存在显著异质性。一项“剔除一项研究”的敏感性分析表明，没有一项研究对结果产生过度影响。包含自我调节方法的独立干预措施对饮食行为有很小但很重要的影响，整合这些元素在未来的干预措施中可能很重要。然而，研究结果中存在大量差异，无法用我们探索的特征来解释，并且大多数研究都存在偏倚风险。
Self-monitoring (SM) of diet and tailored feedback (TF) have been suggested as tools for changing dietary behavior. New technologies allow users to monitor behavior remotely, potentially improving reach, adherence, and outcomes. We conducted a systematic literature review and meta-analysis to address the following question: are remotely delivered standalone (i.e., no human contact) interventions that use SM or TF effective in changing eating behaviors? Five databases were searched in October 2016 (updated in September 2017). Only randomized controlled trials published after 1990 were included. Trials could include any adult population with no history of disordered eating which delivered an SM or TF intervention without direct contact and recorded actual dietary consumption as an outcome. Three assessors independently screened the search results. Two reviewers extracted the study characteristics, intervention details, and outcomes, and assessed risk of bias using the Cochrane tool. Results were converted to standardized mean differences and incorporated into a 3-level (individuals and outcomes nested in studies) random effects meta-analysis. Twenty-six studies containing 21,262 participants were identified. The majority of the studies were judged to be unclear or at high risk of bias. The meta-analysis showed dietary improvement in the intervention group compared to the control group with a standardized mean difference of 0.17 (95% CI: 0.10, 0.24; P < 0.0001). The I2 statistic for the meta-analysis was 0.77, indicating substantial heterogeneity in results. A “one study removed” sensitivity analysis showed that no single study excessively influenced the results. Standalone interventions containing self-regulatory methods have a small but significant effect on dietary behavior, and integrating these elements could be important in future interventions. However, there was substantial variation in study results that could not be explained by the characteristics we explored, and there were risk-of-bias concerns with the majority of studies.
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影响因子：
3.8
作者：
Broekhuizen, Karen;Kroeze, Willemieke;van Poppel, Mireille N. M.;Oenema, Anke;Brug, Johannes
通讯作者：
Brug, Johannes
影响因子：
3.2
作者：
Burke LE;Swigart V;Warziski Turk M;Derro N;Ewing LJ
通讯作者：
Ewing LJ
影响因子：
4.4
作者：
Heimendinger, J;O'Neill, C;Lipkus, I
通讯作者：
Lipkus, I
影响因子：
5.4
作者：
Carfora, V.;Caso, D.;Conner, M.
通讯作者：
Conner, M.
系统评价与饮食和体育锻炼干预效果提高有关的干预组件评论。
影响因子：
4.5
作者：
Greaves CJ;Sheppard KE;Abraham C;Hardeman W;Roden M;Evans PH;Schwarz P;IMAGE Study Group
通讯作者：
IMAGE Study Group