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 Lifestyle choices like poor diet and smoking are a major cause of
death and disease worldwide, the researchers write in the Journal of
the American Heart Association, and digital tools may be a low-cost
and more accessible option for people looking to improve their
health.
“Our results suggest internet-based and mobile-based interventions
can be effective tools for behavioral modification,” said lead
author Dr. Ashkan Afshin, the Assistant Professor of Global Health
at the University of Washington in Seattle.
“We also found these programs were more effective if they included
some interactions with healthcare providers,” Afshin added by email.
Afshin and his team reviewed 224 studies of the effectiveness of
programs targeting improved diet, exercise, weight loss, smoking
cessation or reducing alcohol use and employing web, mobile,
personal sensors or stand-alone software technologies.
The studies were published between 1990 and 2013 and most were done
in high-income countries, including the U.S., Australia and European
nations.
The majority of interventions lasted less than six months and nearly
all ran for less than one year. The researchers note that more
research is needed to determine how well the programs work over the
long term.
Overall, interventions using web-based programs did produce results
with regard to improved diet, physical activity, body fat loss and
reducing or quitting tobacco and alcohol.
Mobile interventions, including apps and text-message reminders,
helped people improve their physical activity and lose excess body
fat, but didn’t show improvements in other areas.
For web-based programs targeting weight loss, the researchers looked
at 35 studies, 24 of which showed significant improvements after the
intervention. Most studies lasted between six weeks and six months
and only 10 studies followed participants for more than a year to
see if the results were sustained.
Similarly, there were 24 studies targeting diet, such as increasing
daily fruit or vegetable intake, and 14 found substantial
improvements. Out of five studies that compared an online program to
a conventional intervention, two found the online intervention was
more effective, two found equal effects and one found no significant
effect from either.
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Afshin’s team also found that web-based programs to help people
become more physically active were highly effective, with 88 percent
helping people exercise more.
Among web-based programs for quitting smoking, 77 percent increased
people’s success. Mobile texting programs were less helpful, and
only two out of seven helped people stop smoking for at least one
week.
Among web-based programs to cut down alcohol use, about 83 percent
were shown to be helpful.
“Programs that have components such as goal-setting and
self-monitoring and use multiple modes of communication and tailored
messages tended to be more effective,” Afshin said.
Brie Turner-McGrievy, a behavioral researcher at the University of
South Carolina in Columbia, noted that participants in many
traditional, in-person interventions may not have much support in
between meetings.
With technology, however, real-time feedback is possible, she said
by email. “We are able to adapt our interventions as participants
are engaging in healthy or unhealthy behaviors throughout the day.”
Though traditional methods may still have some advantages, this is
changing as technology changes, said Turner-McGrievy, who was not
involved in the new study.
Afshin noted that tech interventions can be combined with in-person
care as well. “Clinicians . . . can use such programs to help their
patients improve their lifestyle behaviors and reduce the risk of
chronic disease such as cardiovascular disease and diabetes,” he
said.
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