This review of meta-analyses of outcome studies of adults receiving Computer-Based Health Education (CBHE) has two goals. The first is to provide an overview of the efficacy of CBHE interventions, and the second is to identify moderators of these effects. A systematic literature search resulted in 15 meta-analyses of 278 controlled outcome studies. The meta-analyses were analysed with regard to reported (overall) effect sizes, heterogeneity and interaction effects. The results indicate a positive relationship between CBHE interventions and improvements in health-related outcomes, with small overall effect sizes compared to non-computer-based interventions. The sustainability of the effects was observed for up to six months. Outcome moderators (31 variables) were studied in 12 meta-analyses and were clustered into three categories: intervention features (20 variables), participant characteristics (five variables) and study features (six variables). No relationship with effectiveness was found for four intervention features, theoretical background, use of internet and e-mail, intervention setting and self-monitoring; two participant features, age and gender; and one study feature, the type of analysis. Regarding the other 24 identified features, no consistent results were observed across meta-analyses. To enhance the effectiveness of CBHE interventions, moderators of effects should be studied as single constructs in high-quality study designs. http://www.journalofinterdisciplinarysciences.com/ https://www.linkedin.com/in/leontienvreeburg/
BackgroundPromoting physical activity (PA) in patients during and/or after an inpatient stay appears important but challenging. Interventions using activity trackers seem promising to increase PA and enhance recovery of physical functioning.ObjectiveTo review the effectiveness of physical activity interventions using activity trackers on improving PA and physical functioning, compared to usual care in patients during and/or after inpatient care. In addition, it was determined whether the following intervention characteristics increase the effectiveness of these interventions: the number of behaviour change techniques (BCTs) used, the use of a theoretical model or the addition of coaching by a health professional.DesignSystematic review and meta-analysis.Data SourcesPubMed, EMBASE, Cinahl, SportDiscus and Web of Science databases were searched in March 2020 and updated in March 2021.Eligibility criteria for selecting studiesRandomized controlled trials (RCTs) including interventions using activity trackers and feedback on PA in adult patients during, or less than 3 months after, hospitalization or inpatient rehabilitation.MethodsFollowing database search and title and abstract screening, articles were screened on full text for eligibility and then assessed for risk of bias by using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses, including subgroup analysis on intervention characteristics, were conducted for the outcomes PA and physical functioning.ResultsOverall, 21 RCTs totalling 2355 patients were included. The trials covered a variety of clinical areas. There was considerable heterogeneity between studies. For the 13 studies that measured PA as an outcome variable(N = 1435), a significant small positive effect in favour of the intervention was found (standardized mean difference (SMD) = 0.34; 95%CI 0.12–0.56). For the 13 studies that measured physical functioning as an outcome variable (N = 1415) no significant effect was found (SMD = 0.09; 95%CI -0.02 - 0.19). Effectiveness on PA seems to improve by providing the intervention both during and after the inpatient period and by using a theoretical model, multiple BCTs and coaching by a health professional.ConclusionInterventions using activity trackers during and/or after inpatient care can be effective in increasing the level of PA. However, these improvements did not necessarily translate into improvements in physical functioning. Several intervention characteristics were found to increase the effectiveness of PA interventions.Trial registrationRegistered in PROSPERO (CRD42020175977) on March 23th, 2020.
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Healthy gestational weight gain (GWG) is associated with better pregnancy outcomes and with improved health in the later lives of women and babies. In this thesis the author describes the process of developing an intervention to help pregnant women reach a healthy GWG. The need for this intervention was derived from discussions with midwives, working in primary care in the Netherlands. In this introduction, the author describes the background of the larger project “Promoting Health Pregnancy”, of which this study is a part (1.2), the problem of unhealthy GWG (1.3-1.6) and offers a brief introduction to the theoretical framework of the study and to the subsequent chapters (1.7-1.9).
