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      Programas de intervención a través de internet para la reducción de peso en adultos con sobrepeso y obesidad: una revisión sistemática Translated title: Intervention programs through the Internet for weight loss in adults with overweight and obesity: a systematic review

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          Abstract

          Resumen Introducción El auge de la tecnología ha posibilitado el desarrollo de programas vía Internet para abordar el problema de la obesidad, como apoyo complementario a programas presenciales. El presente estudio evalúa la evidencia sobre programas vía Internet realizados en personas adultas con sobrepeso y obesidad, analizando los recursos y componentes principales de las intervenciones. Material y Métodos Se realizó una revisión sistemática en las bases de datos Web of Science y Scopus. Se seleccionaron estudios de intervención en línea para la reducción de peso en población adulta. Bajo los lineamientos PRISMA, se analizó la información extrayendo datos de autoría, año de publicación, diseño del estudio, duración de la intervención, variables para evaluar la eficacia y resultados. Resultados Se analizaron 21 artículos, que reportan diferencias significativas en peso tras intervención en línea contrastadas con modalidades presenciales o grupos control. Los programas enfatizan cambios en dieta, incremento de actividad física, auto monitoreo, fijación de metas y disponibilidad de redes sociales como variables que garantizan eficacia. La retroalimentación por parte de profesionales y las redes de apoyo parecen ser cruciales para la adherencia y el logro de reducciones de peso significativas. Conclusiones El aprovechamiento de la tecnología puede ser un aliado que lleve a cambios significativos en el peso de personas que viven con sobrepeso u obesidad.

          Translated abstract

          Abstract Introduction The rise of technology has enabled the development of programs via Internet to address the problem of obesity, as complementary support in face-to-face programs. The objective of this study is to evaluate the evidence on Internet programs carried out in overweight and obese adults, analyzing the resources and main components of the interventions. Material and Methods A systematic review was conducted in the electronic databases Web of Science and Scopus. Original online intervention studies for weight reduction in the adult population were selected. The information was analyzed; authorship data, year of publication, study design, intervention length, variables to evaluate efficacy and results were extracted. The review was carried out following the PRISMA guidelines. Results 21 articles were analyzed, which report significant differences in weight after online intervention contrasted with face-to-face modalities or control groups. The programs emphasize changes in diet, increased physical activity, self-monitoring, goal setting, and availability of social networks as variables that guarantee effectiveness. Feedback from professionals as well as having support networks seem to be crucial for adherence and achieving significant weight reductions. Conclusions Taking advantage of technology can be an ally that leads to significant changes in the weight of people who are overweight or obese.

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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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            An Online Community Improves Adherence in an Internet-Mediated Walking Program. Part 1: Results of a Randomized Controlled Trial

            Background Approximately half of American adults do not meet recommended physical activity guidelines. Face-to-face lifestyle interventions improve health outcomes but are unlikely to yield population-level improvements because they can be difficult to disseminate, expensive to maintain, and inconvenient for the recipient. In contrast, Internet-based behavior change interventions can be disseminated widely at a lower cost. However, the impact of some Internet-mediated programs is limited by high attrition rates. Online communities that allow participants to communicate with each other by posting and reading messages may decrease participant attrition. Objective Our objective was to measure the impact of adding online community features to an Internet-mediated walking program on participant attrition and average daily step counts. Methods This randomized controlled trial included sedentary, ambulatory adults who used email regularly and had at least 1 of the following: overweight (body mass index [BMI] ≥ 25), type 2 diabetes, or coronary artery disease. All participants (n = 324) wore enhanced pedometers throughout the 16-week intervention and uploaded step-count data to the study server. Participants could log in to the study website to view graphs of their walking progress, individually-tailored motivational messages, and weekly calculated goals. Participants were randomized to 1 of 2 versions of a Web-based walking program. Those randomized to the “online community” arm could post and read messages with other participants while those randomized to the “no online community" arm could not read or post messages. The main outcome measures were participant attrition and average daily step counts over 16 weeks. Multiple regression analyses assessed the effect of the online community access controlling for age, sex, disease status, BMI, and baseline step counts. Results Both arms significantly increased their average daily steps between baseline and the end of the intervention period, but there were no significant differences in increase in step counts between arms using either intention-to-treat or completers analysis. In the intention-to-treat analysis, the average step count increase across both arms was 1888 ± 2400 steps. The percentage of completers was 13% higher in the online community arm than the no online community arm (online community arm, 79%, no online community arm, 66%, P = .02). In addition, online community arm participants remained engaged in the program longer than no online community arm participants (hazard ratio = 0.47, 95% CI = 0.25 - 0.90, P = .02). Participants with lower baseline social support posted more messages to the online community (P < .001) and viewed more posts (P < .001) than participants with higher baseline social support. Conclusion Adding online community features to an Internet-mediated walking program did not increase average daily step counts but did reduce participant attrition. Participants with low baseline social support used the online community features more than those with high baseline social support. Thus, online communities may be a promising approach to reducing attrition from online health behavior change interventions, particularly in populations with low social support. Trial Registration NCT00729040; http://clinicaltrials.gov/ct2/show/NCT00729040 (Archived by WebCite at http://www.webcitation.org/5v1VH3n0A)
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              Why Are Health Care Interventions Delivered Over the Internet? A Systematic Review of the Published Literature

              Background As Internet use grows, health interventions are increasingly being delivered online. Pioneering researchers are using the networking potential of the Internet, and several of them have evaluated these interventions. Objective The objective was to review the reasons why health interventions have been delivered on the Internet and to reflect on the work of the pioneers in this field in order to inform future research. Methods We conducted a qualitative systematic review of peer-reviewed evaluations of health interventions delivered to a known client/patient group using networked features of the Internet. Papers were reviewed for the reasons given for using the Internet, and these reasons were categorized. Results We included studies evaluating 28 interventions plus 9 interventions that were evaluated in pilot studies. The interventions were aimed at a range of health conditions. Reasons for Internet delivery included low cost and resource implications due to the nature of the technology; reducing cost and increasing convenience for users; reduction of health service costs; overcoming isolation of users; the need for timely information; stigma reduction; and increased user and supplier control of the intervention. A small number of studies gave the existence of Internet interventions as the only reason for undertaking an evaluation of this mode of delivery. Conclusions One must remain alert for the unintended effects of Internet delivery of health interventions due to the potential for reinforcing the problems that the intervention was designed to help. Internet delivery overcomes isolation of time, mobility, and geography, but it may not be a substitute for face-to-face contact. Future evaluations need to incorporate the evaluation of cost, not only to the health service but also to users and their social networks. When researchers report the outcomes of Internet-delivered health care interventions, it is important that they clearly state why they chose to use the Internet, preferably backing up their decision with theoretical models and exploratory work. Evaluation of the effectiveness of a health care intervention delivered by the Internet needs to include comparison with more traditional modes of delivery to answer the following question: What are the added benefits or disadvantages of Internet use that are particular to this mode of delivery?
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                Author and article information

                Journal
                renhyd
                Revista Española de Nutrición Humana y Dietética
                Rev Esp Nutr Hum Diet
                Academia Española de Nutrición y Dietética (Pamplona, Navarra, Spain )
                2173-1292
                2174-5145
                December 2020
                : 24
                : 4
                : 324-335
                Affiliations
                [2] Barcelona Cataluña orgnameUniversitat Autónoma de Barcelona orgdiv1Facultad de Psicología orgdiv2Departamento de Psicología Clínica y Psicobiología Spain
                [1] orgnameUniversidad Autónoma de Nuevo León orgdiv1Facultad de Psicología Mexico
                Article
                S2174-51452020000400004 S2174-5145(20)02400400004
                10.14306/renhyd.24.4.984
                8aeed502-a846-4f50-8f25-56a97c951483

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 10 January 2020
                : 17 June 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 57, Pages: 12
                Product

                SciELO Spain

                Categories
                Investigaciones

                Obesidad,Weight Loss,Internet-Based Intervention,Obesity,Adult,Pérdida de Peso,Intervención Basada en la Internet,Adulto

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