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      Information Technology and Lifestyle: A Systematic Evaluation of Internet and Mobile Interventions for Improving Diet, Physical Activity, Obesity, Tobacco, and Alcohol Use

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          Abstract

          Background

          Novel interventions are needed to improve lifestyle and prevent noncommunicable diseases, the leading cause of death and disability globally. This study aimed to systematically review, synthesize, and grade scientific evidence on effectiveness of novel information and communication technology to reduce noncommunicable disease risk.

          Methods and Results

          We systematically searched PubMed for studies evaluating the effect of Internet, mobile phone, personal sensors, or stand‐alone computer software on diet, physical activity, adiposity, tobacco, or alcohol use. We included all interventional and prospective observational studies conducted among generally healthy adults published between January 1990 and November 2013. American Heart Association criteria were used to evaluate and grade the strength of evidence. From 8654 abstracts, 224 relevant reports were identified. Internet and mobile interventions were most common. Internet interventions improved diet (N=20 studies) (Class IIa A), physical activity (N=33), adiposity (N=35), tobacco (N=22), and excess alcohol (N=47) (Class I A each). Mobile interventions improved physical activity (N=6) and adiposity (N=3) (Class I A each). Evidence limitations included relatively brief durations (generally <6 months, nearly always <1 year), heterogeneity in intervention content and intensity, and limited representation from middle/low‐income countries.

          Conclusions

          Internet and mobile interventions improve important lifestyle behaviors up to 1 year. This systematic review supports the need for long‐term interventions to evaluate sustainability.

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          Most cited references20

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association.

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              A review of eHealth interventions for physical activity and dietary behavior change.

              To review eHealth intervention studies for adults and children that targeted behavior change for physical activity, healthy eating, or both behaviors. Systematic literature searches were performed using five databases: MEDLINE, PsychInfo, CINAHL, ERIC, and the Cochrane Library to retrieve articles. Articles published in scientific journals were included if they evaluated an intervention for physical activity and/or dietary behaviors, or focused on weight loss, used randomized or quasi-experimental designs, measured outcomes at baseline and a follow-up period, and included an intervention where participants interacted with some type of electronic technology either as the main intervention or an adjunct component. All studies were published between 2000 and 2005. Eighty-six publications were initially identified, of which 49 met the inclusion criteria (13 physical activity publications, 16 dietary behaviors publications, and 20 weight loss or both physical activity and diet publications), and represented 47 different studies. Studies were described on multiple dimensions, including sample characteristics, design, intervention, measures, and results. eHealth interventions were superior to comparison groups for 21 of 41 (51%) studies (3 physical activity, 7 diet, 11 weight loss/physical activity and diet). Twenty-four studies had indeterminate results, and in four studies the comparison conditions outperformed eHealth interventions. Published studies of eHealth interventions for physical activity and dietary behavior change are in their infancy. Results indicated mixed findings related to the effectiveness of eHealth interventions. Interventions that feature interactive technologies need to be refined and more rigorously evaluated to fully determine their potential as tools to facilitate health behavior change.
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                Author and article information

                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                31 August 2016
                September 2016
                : 5
                : 9 ( doiID: 10.1002/jah3.2016.5.issue-9 )
                : e003058
                Affiliations
                [ 1 ] Institute for Health Metrics and EvaluationUniversity of Washington Seattle WA
                [ 2 ] Friedman School of Nutrition Science & PolicyTufts University Boston MA
                [ 3 ]Saint Joseph Hospital Chicago IL
                [ 4 ] Sackler Institute for Nutrition ScienceNew York Academy of Sciences New York NY
                [ 5 ] Division of Rheumatology, Allergy and ImmunologyBrigham and Women's Hospital Boston MA
                [ 6 ] Department of EpidemiologyHarvard School of Public Health Boston MA
                [ 7 ] Division of Chest Medicine Department of Internal MedicineNational Yang‐Ming University Hospital IlanTaiwan
                [ 8 ] Institute of Clinical MedicineNational Yang‐Ming University TaipeiTaiwan
                [ 9 ]Cardinal Tien College of Healthcare and Management New TaipeiTaiwan
                [ 10 ]Global Alliance for Improved Nutrition New York NY
                Author notes
                [*] [* ] Correspondence to: Ashkan Afshin, MD, MPH, MSc, ScD, 2301 5th Avenue, Suite 600, Seattle, WA 98121. E‐mail: aafshin@ 123456uw.edu
                Article
                JAH31692
                10.1161/JAHA.115.003058
                5079005
                27581172
                3373217c-9df8-4ccd-b413-ca6b47dc7ee6
                © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 09 December 2015
                : 07 July 2016
                Page count
                Pages: 13
                Funding
                Funded by: Sackler Institute for Nutrition Science
                Funded by: Robert Wood Johnson Foundation
                Funded by: Gates Foundation
                Funded by: GlaxoSmithKline
                Funded by: Sigma Tau
                Funded by: Pronova
                Funded by: National Institutes of Health
                Categories
                Original Research
                Original Research
                Epidemiology
                Custom metadata
                2.0
                jah31692
                September 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.4 mode:remove_FC converted:27.09.2016

                Cardiovascular Medicine
                alcohol,diet,internet,mobile,obesity,physical activity,smoking,diet and nutrition,epidemiology,exercise,lifestyle

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