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Mersha AG, Bryant J, Booth K, Watson L, Kennedy M. The effectiveness of internet-based group behavioural interventions on lifestyle modifications: A systematic review. Prev Med 2024; 186:108099. [PMID: 39134180 DOI: 10.1016/j.ypmed.2024.108099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVES To examine the effectiveness of internet-based group interventions incorporating social support elements in addressing behaviours related to smoking, nutrition, alcohol consumption, physical activity, and obesity. METHODS A literature search was undertaken in six databases from inception to April 2024. Articles were eligible if they reported on group-based online interventions targeting smoking, nutrition, alcohol consumption, physical activity, and obesity, and included interactive features aimed at promoting social engagement and support. Two reviewers independently screened and assessed the quality of articles using Joanna Briggs Institute Critical Appraisal tools. A narrative analysis was used to synthesize and interpret the data to understand the effects of online interventions on lifestyle modifications. RESULTS A total of 4063 citations underwent screening, resulting in 32 articles being deemed eligible and included in this review. Most studies examined physical activity (n = 14), followed by obesity (n = 7) and smoking (n = 6), Most studies were conducted in the USA (n = 14) and Australia (n = 11). Websites were the most utilised mode of intervention delivery (n = 11), followed by Facebook (n = 7) and mobile apps (n = 5). Group-based internet interventions were effective in improving smoking cessation, increasing physical activity and addressing obesity. However, there is insufficient data to determine their effect on promoting healthy nutrition and reducing alcohol intake. CONCLUSION Group-based interventions delivered on the internet are effective in changing various health behaviours. This approach can offer large scale and cost-effective means to deliver behavioural interventions. However, the long-term effects and strategies for maintaining the behaviour changes are lacking, underscoring the need for further research.
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Affiliation(s)
- Amanual Getnet Mersha
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia.
| | - Jamie Bryant
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia
| | - Kade Booth
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia
| | - Levi Watson
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia; Equity in Health and Wellbeing Research Program, Hunter Medical Research Institute, University of Newcastle, New Lambton, New South Wales, Australia
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Johannes C, Roman NV, Onagbiye SO, Titus S, Leach LL. Strategies and Best Practices That Enhance the Physical Activity Levels of Undergraduate University Students: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:173. [PMID: 38397664 PMCID: PMC10888190 DOI: 10.3390/ijerph21020173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/28/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
Significant numbers of undergraduate university students are not meeting the physical activity guidelines recommended by the World Health Organisation. These guidelines suggest that university students should aim for 150-300 min of moderate or 75-150 min of vigorous physical activity. Strategic interventions need to be implemented to address this global public health concern. The aim of this study was to review the strategies and best practices to enhance the physical activity levels of undergraduate university students. Utilising the PRISMA guidelines, electronic databases-PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, CINAHL, SAGE, and SPORTDiscus-were searched between September 2022 and February 2023 using terms and synonyms related to physical activity, strategies, best practices, and undergraduate university students. Studies were critically assessed for their quality using an adapted version of the CASP and RE-AIM frameworks. Eleven articles met the inclusion criteria for the review. The studies reported the use of social media platforms, mobile phone applications, web-based technology, online text messages, in-person classes, and an "exergame" as methods to increase engagement in physical activity. Findings from this review indicated that validated questionnaires emerged as the predominant measurement tool. Furthermore, the frequent use of social network sites served as a best practice for implementing and promoting physical activity interventions. It is recommended that universities promote health-enhancing physical activities based on current trends and strategies, such as technology-based interventions and the use of social media, that are relevant to contemporary university students.
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Affiliation(s)
- Chanté Johannes
- Department of Sports, Recreation, and Exercise Science, University of the Western Cape, Cape Town 7535, South Africa; (S.O.O.); (S.T.); (L.L.L.)
| | - Nicolette V. Roman
- Centre for Interdisciplinary Studies of Children, Families, and Society, University of the Western Cape, Cape Town 7535, South Africa;
| | - Sunday O. Onagbiye
- Department of Sports, Recreation, and Exercise Science, University of the Western Cape, Cape Town 7535, South Africa; (S.O.O.); (S.T.); (L.L.L.)
- Department of Health and Exercise Sciences, Frederick Community College, Frederick, MD 21701, USA
| | - Simone Titus
- Department of Sports, Recreation, and Exercise Science, University of the Western Cape, Cape Town 7535, South Africa; (S.O.O.); (S.T.); (L.L.L.)
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa
| | - Lloyd L. Leach
- Department of Sports, Recreation, and Exercise Science, University of the Western Cape, Cape Town 7535, South Africa; (S.O.O.); (S.T.); (L.L.L.)
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Peng S, Yuan F, Othman AT, Zhou X, Shen G, Liang J. The Effectiveness of E-Health Interventions Promoting Physical Activity and Reducing Sedentary Behavior in College Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:318. [PMID: 36612643 PMCID: PMC9819541 DOI: 10.3390/ijerph20010318] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Insufficient physical activity (PA) and excessive sedentary behavior (SB) are detrimental to physical and mental health. This systematic review and meta-analysis aimed to identify whether e-health interventions are effective for improving PA and SB in college students. Five electronic databases, including Medline, Web of Science, Embase, Cochrane Library, and ProQuest, were searched to collect relevant randomized controlled trials up to 22 June 2022. In total, 22 trials (including 31 effects) with 8333 samples were included in this meta-analysis. The results showed that e-health interventions significantly improved PA at post-intervention (SMD = 0.32, 95% CI: 0.19, 0.45, p < 0.001) compared with the control group, especially for total PA (SMD = 0.34, 95% CI: 0.10, 0.58, p = 0.005), moderate to vigorous PA (SMD = 0.17, 95% CI: 0.01, 0.32, p = 0.036), and steps (SMD = 0.75, 95% CI: 0.23, 1.28, p < 0.001. There were no significant effects for both PA at follow-up (SMD = 0.24, 95% CI: − 0.01, 0.49, p = 0.057) and SB (MD = −29.11, 95% CI: −70.55, 12.32, p = 0.17). The findings of subgroup analyses indicated that compared to the control group, interventions in the group of general participants (SMD = 0.45, 95% CI: 0.27, 0.63, p < 0.001), smartphone apps (SMD = 0.46, 95% CI: 0.19, 0.73, p = 0.001), and online (SMD = 0.23, 95% CI: 0.04, 0.43, p < 0.001) can significantly improve PA at post-intervention. Moreover, the intervention effects were significant across all groups of theory, region, instrument, duration, and female ratio. At follow-up, interventions in groups of developing region (SMD = 1.17, 95% CI: 0.73, 1.62, p < 0.001), objective instrument (SMD = 0.83, 95% CI: 0.23, 1.42, p = 0.007), duration ≤ 3-month (SMD = 1.06, 95% CI: 0.72, 1.39, p < 0.001), and all female (SMD = 0.79, 95% CI: 0.02, 1.56, p = 0.044) can significantly improve PA. The evidence of this meta-analysis shows that e-health interventions can be taken as promising strategies for promoting PA. The maintenance of PA improvement and the effect of interventions in reducing SB remain to be further studied. Educators and health practitioners should focus on creating multiple e-health interventions with individualized components.
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Affiliation(s)
- Sanying Peng
- Physical Education Department, Hohai University, Nanjing 210024, China
- School of Educational Studies, University Sains Malaysia, Penang 11800, Malaysia
| | - Fang Yuan
- College of International Languages and Cultures, Hohai University, Nanjing 210024, China
| | | | - Xiaogang Zhou
- School of Educational Studies, University Sains Malaysia, Penang 11800, Malaysia
| | - Gang Shen
- School of Physical Education, Changzhou University, Changzhou 213164, China
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
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Seiler J, Libby TE, Jackson E, Lingappa JR, Evans WD. Social Media–Based Interventions for Health Behavior Change in Low- and Middle-Income Countries: Systematic Review. J Med Internet Res 2022; 24:e31889. [PMID: 35436220 PMCID: PMC9052020 DOI: 10.2196/31889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/21/2021] [Accepted: 02/05/2022] [Indexed: 12/21/2022] Open
Abstract
Background Despite the wealth of evidence regarding effective health behavior change techniques using digital interventions to focus on residents of high-income countries, there is limited information of a similar nature for low- and middle-income countries. Objective The aim of this review is to identify and describe the available literature on effective social media–based behavior change interventions within low- and middle-income countries. Methods This systematic review was conducted in accordance with the 2009 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched PubMed, Embase, Elsevier, CINAHL, PsycInfo, and Global Index Medicus, and the final search was conducted on April 6, 2021. We excluded studies published before 2000 because of the subject matter. We included studies that evaluated interventions conducted at least partly on a social media platform. Results We identified 1832 studies, of which 108 (5.89%) passed title-abstract review and were evaluated by full-text review. In all, 30.6% (33/108) were included in the final analysis. Although 22 studies concluded that the social media intervention was effective, only 13 quantified the level of social media engagement, of which, few used theory (n=8) or a conceptual model (n=5) of behavior change. Conclusions We identified gaps in the settings of interventions, types and sectors of interventions, length of follow-up, evaluation techniques, use of theoretical and conceptual models, and discussions of the privacy implications of social media use. Trial Registration PROSPERO CRD42020223572; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=223572
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Affiliation(s)
- Jessie Seiler
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Tanya E Libby
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Emahlea Jackson
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - J R Lingappa
- Departments of Global Health, Medicine, and Pediatrics, University of Washington, Seattle, WA, United States
| | - W D Evans
- Departments of Prevention and Community Health & Global Health, George Washington University, Washington, DC, United States
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Xu L, Shi H, Shen M, Ni Y, Zhang X, Pang Y, Yu T, Lian X, Yu T, Yang X, Li F. The Effects of mHealth-Based Gamification Interventions on Participation in Physical Activity: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e27794. [PMID: 35113034 PMCID: PMC8855282 DOI: 10.2196/27794] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/29/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND It is well known that regular physical exercise has associated benefits; yet, participation remains suboptimal. Mobile health (mHealth) has become an indispensable medium to deliver behavior change interventions, and there is a growing interest in the gamification apps in mHealth to promote physical activity (PA) participation. Gamification could use game design elements (such as points, leaderboards, and progress bars), and it has the potential to increase motivation for PA and engagement. However, mHealth-based gamification interventions are still emerging, and little is known about the application status and efficacy of such interventions. OBJECTIVE This systematic review aims to investigate gamification apps in mHealth for improving PA levels and simultaneously summarize the impact of gamification interventions on PA participation. METHODS We searched PubMed, Scopus, Web of Science, Embase, CINAHL (EBSCO host), and IEEE Xplore from inception to December 20, 2020. Original empirical research exploring the effects of gamification interventions on PA participation was included. The papers described at least one outcome regarding exercise or PA participation, which could be subjective self-report or objective indicator measurement. Of note, we excluded studies about serious games or full-fledged games. RESULTS Of 2944 studies identified from the database search, 50 (1.69%) were included, and the information was synthesized. The review revealed that gamification of PA had been applied to various population groups and broadly distributed among young people but less distributed among older adults and patients with a disease. Most of the studies (30/50, 60%) combined gamification with wearable devices to improve PA behavior change, and 50% (25/50) of the studies used theories or principles for designing gamified PA interventions. The most frequently used game elements were goal-setting, followed by progress bars, rewards, points, and feedback. This review demonstrated that gamification interventions could increase PA participation; however, the results were mixed, and modest changes were attained, which could be attributed to the heterogeneity across studies. CONCLUSIONS Overall, this study provides an overview of the existing empirical research in PA gamification interventions and provides evidence for the efficacy of gamification in enhancing PA participation. High-quality empirical studies are needed in the future to assess the efficacy of a combination of gamification and wearable activity devices to promote PA, and further exploration is needed to investigate the optimal implementation of these features of game elements and theories to enhance PA participation.
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Affiliation(s)
- Linqi Xu
- School of Nursing, Jilin University, Changchun, China
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Hongyu Shi
- School of Nursing, Jilin University, Changchun, China
| | - Meidi Shen
- School of Nursing, Peking University, Beijing, China
| | - Yuanyuan Ni
- Department of Anaesthesia, Bethune First Hospital of Jilin University, Changchun, China
| | - Xin Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Yue Pang
- School of Nursing, Jilin University, Changchun, China
| | - Tianzhuo Yu
- School of Nursing, Jilin University, Changchun, China
| | - Xiaoqian Lian
- School of Nursing, Jilin University, Changchun, China
| | - Tianyue Yu
- School of Nursing, Jilin University, Changchun, China
| | - Xige Yang
- Department of Anaesthesia, Bethune First Hospital of Jilin University, Changchun, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, China
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Boguszewicz-Kreft M, Kuczamer-Kłopotowska S, Kozłowski A, Ayci A, Abuhashesh M. The Theory of Planned Behaviour in Medical Tourism: International Comparison in the Young Consumer Segment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1626. [PMID: 32138240 PMCID: PMC7084921 DOI: 10.3390/ijerph17051626] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 11/28/2022]
Abstract
The Theory of Planned Behaviour (TPB) assumes the possibility of predicting and explaining humans' behaviour by identifying their intentions. The intentions are shaped by three groups of factors: attitudes towards, social norms and perceived behavioural control over the behaviour. The aim of the research is to examine the applicability of the TPB in medical tourism and to check whether there are differences in predicting the intentions of medical tourists from different countries. The study covered potential medical tourists-521 young consumers from three regionally important markets in medical tourism services: Jordan, Poland and Turkey. The study used a research survey to collect data, which were analysed using the multiple regression and analysis of variance methods. The research showed that the TPB model can be used in medical tourism. The results also show that the consumers' country of origin is a significant factor when predicting their intention to use medical tourism services.
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Affiliation(s)
- Monika Boguszewicz-Kreft
- Department of Marketing, Faculty of Finance and Management, WSB University in Gdańsk, 80-123 Gdańsk, Poland
| | | | - Arkadiusz Kozłowski
- Department of Statistics, Faculty of Management, University of Gdańsk, 81-824 Sopot, Poland;
| | - Ali Ayci
- Small and Medium Enterprises Development Organization of Turkey, Ankara 06050, Turkey;
| | - Mohammd Abuhashesh
- E-Marketing and Social Media Department, Princess Sumaya University for Technology (PSUT), Amman 11941, Jordan;
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Fang Y, Ma Y, Mo D, Zhang S, Xiang M, Zhang Z. Methodology of an exercise intervention program using social incentives and gamification for obese children. BMC Public Health 2019; 19:686. [PMID: 31159776 PMCID: PMC6547593 DOI: 10.1186/s12889-019-6992-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/16/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Traditional exercise [supervised exercise (SE)] intervention has been proved to be one of the most effective ways to improve metabolic health. However, most exercise interventions were on a high-cost and small scale, moreover lacking of the long-term effect due to low engagement. On the other hand, it was noteworthy that gamification and social incentives were promising strategies to increase engagement and sustain exercise interventions effects; as well as mobile technologies such as WeChat also can provide an appropriate platform to deploy interventions on a broader, low-cost scale. Thus, we aim to develop a novel exercise intervention ('S&G exercise intervention') that combines SE intervention with gamification and social incentives design through WeChat, with the aim of improving metabolic health and poor behaviors among overweight and obesity children. METHODS We propose a randomized controlled trial of a 'S&G exercise intervention' among 420 overweight and obese children who have at least one marker of metabolic syndrome. Children will be randomized to control or intervention group in a 1:1 ratio. The exercise intervention package includes intervention designs based on integrated social incentives and gamification theory, involving targeted essential volume and intensity of activity (skipping rope) as well as monitoring daily information and providing health advice by WeChat. Participants will undertake assessments at baseline, at end of intervention period, in the follow-up time at months 3,6,12. The primary outcome is outcome of metabolic health. Secondary outcomes include behavioral (e.g., diary physical activity, diet) and anthropometric measures (e.g., body fat rate and muscle mass). DISCUSSIONS This will be the first study to design an exercise intervention model that combines traditional supervised exercise (SE) intervention with gamification and social incentives theory through WeChat. We believed that this study could explore a low-cost, easy-to-popularize, and effective exercise intervention model for improving metabolic health and promote healthy among obese children. Furthermore, it will also provide important evidence for guidelines to prevent and improve metabolic health and health behaviors. TRIAL REGISTRATION 10-04-2019;Registration number: ChiCTR1900022396 .
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Affiliation(s)
- Yue Fang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Dandan Mo
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China
| | | | - Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, 200025, China.
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