Effectiveness of Weight Loss Interventions Delivered Using EHealth Technologies: A Systematic Review

Megan Rollo* Rebecca Krukowski*
Jean Harvey* Clare Collins*
Megan Rollo*, University of Newcastle, Newcastle, Australia
Melinda Hutchesson, University of Newcastle, Newcastle, Australia
Rebecca Krukowski*, The University of Tennessee, Tennessee, United States
Louisa Ells, Teesside University, Tees Valley, United Kingdom
Jean Harvey*, University of Vermont, Vermont, United States
Philip Morgan, University of Newcastle, Newcastle, Australia
Robin Callister, University of Newcastle, Newcastle, Australia
Ronald Plotnikoff, University of Newcastle, Newcastle, Australia
Clare Collins*, University of Newcastle, Newcastle, Australia

Track: Research
Presentation Topic: Web 2.0 approaches for behaviour change, public health and biosurveillance
Presentation Type: Oral presentation
Submission Type: Single Presentation

Building: Sheraton Maui Resort
Room: B - Kapalua
Date: 2014-11-14 11:00 AM – 11:45 AM
Last modified: 2014-09-04

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Background: Due to the high prevalence of overweight and obesity among adults, cost-effective interventions that achieve significant weight loss and have a broad reach are required. Previous research highlights the potential of eHealth interventions to achieve weight loss, with systematic reviews indicating significantly greater weight loss using web-based weight loss interventions compared to no or minimal intervention control groups, and similar weight loss to traditional treatment approaches. However, reviews have been restricted to only one eHealth form, i.e. Internet, and therefore do not evaluate the effectiveness of emerging information technologies e.g. Smartphones. Furthermore, this is a rapidly expanding research area, and previous reviews are limited to studies published prior to 2011.
Objective: This systematic review aimed to determine the effectiveness of eHealth interventions for weight loss in adults.
Methods: Randomized controlled trials published in the English language from 1995 to May 2013 in adults aged ≥18 years, and comparing weight loss interventions delivered using eHealth technologies to: a control group; another delivery mode (e.g. face to face); or another eHealth intervention; and reporting a weight-related primary outcome were eligible for inclusion. Eight electronic databases (Cochrane Library, MEDLINE/PREMEDLINE, EMBASE, CINAHL, Web of Science, Scopus, PubMed, and PsycINFO) were searched using pre-defined keywords, and reference lists of all retrieved articles were reviewed to locate additional studies. Two authors independently screened titles and abstracts and full-text articles for inclusion. One reviewer extracted data from included studies, which was checked for consistency by a second reviewer.
Results: Of 3275 articles identified, 50 studies met the inclusion criteria, with a total of 16244 participants (Mean 325, Median 121, Range 21-2862). Interventions ranged from 6 weeks to 2 years (Mean 31.1 weeks), with post-intervention retention rates ranging from 16-98% (Mean 74.9%). The primary eHealth technologies used were websites (n=34), mobile phones (n=3), computers (n=4), monitoring devices (e.g. accelerometers) (n=6), podcasts (n=2) and personal digital assistants (n=1). Considering all eHealth technologies collectively, of the studies (n=25) comparing an eHealth intervention to a control or minimal intervention group, 64% reported greater weight loss in the eHealth intervention group. Two out of three studies comparing an eHealth intervention to another mode of intervention delivery (e.g. face to face) found no significant difference in weight loss achieved between the two groups. Studies (n=18) comparing an eHealth intervention to another eHealth intervention with additional features and/or technologies reported mixed results; 50% reported significantly greater weight loss in the additional eHealth features/ technologies group, and 44% found no between group difference in weight loss.
Conclusions: Findings confirm previous systematic review findings and suggest eHealth interventions achieve greater weight loss than no or minimal interventions, and similar weight loss to other modes of treatment delivery such as face-to-face sessions. Meta-analysis is required to confirm these findings. Further investigation of how new technologies can be effectively incorporated into eHealth interventions and how existing technologies can be used in innovative ways to optimize the impact on weight loss is warranted.

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