Key result
eHealth lifestyle interventions modestly improve clinical and behavioral outcomes, with or without human support.
Why the study?
Findings are inconsistent regarding whether eHealth lifestyle interventions for patients with cardiometabolic diseases require support from a human professional or if self-help interventions are equally effective.
Do eHealth lifestyle interventions improve clinical and behavioral health outcomes in patients with cardiometabolic risk factors, and does human support modify this effect?
Meta-Analysis (n=20,781)
Do eHealth lifestyle interventions improve clinical and behavioral health outcomes in patients with cardiometabolic risk factors, and does human support modify this effect?
Standardized Mean Difference: 0.1
p-value: p=<0.001
Self-help eHealth lifestyle interventions are equally as effective as human-supported ones in producing small but significant improvements in clinical and behavioral outcomes for patients with cardiometabolic diseases.
Self-help eHealth interventions match human-supported ones for cardiometabolic outcomes; extends evidence for scalable digital delivery without added support.
OBJECTIVE: eHealth is a useful tool to deliver lifestyle interventions for patients with cardiometabolic diseases. However, there are inconsistent findings about whether these eHealth interventions should be supported by a human professional, or whether self-help interventions are equally effective. METHODS: Databases were searched between January 1995 and October 2021 for randomized controlled trials on cardiometabolic diseases (cardiovascular disease, chronic kidney disease, type 1 and 2 diabetes mellitus) and eHealth lifestyle interventions. A multilevel meta-analysis was used to pool clinical and behavioral health outcomes. Moderator analyses assessed the effect of intervention type (self-help versus human-supported), dose of human support (minor versus major part of intervention), and delivery mode of human support (remote versus blended). One hundred seven articles fulfilled eligibility criteria and 102 unique ( N = 20,781) studies were included. RESULTS: The analysis showed a positive effect of eHealth lifestyle interventions on clinical and behavioral health outcomes ( p < .001). However, these effects were not moderated by intervention type ( p = .169), dose ( p = .698), or delivery mode of human support ( p = .557). CONCLUSIONS: This shows that self-help eHealth interventions are equally effective as human-supported ones in improving health outcomes among patients with cardiometabolic disease. Future studies could investigate whether higher-quality eHealth interventions compensate for a lack of human support.Meta-analysis registration: PROSPERO CRD42021269263 .
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Rodrigues et al. (2023) conducted a meta-analysis in Cardiometabolic diseases and risk factors (n=20,781). eHealth lifestyle interventions vs. Passive control, non-web-based intervention, or less extensive web-based intervention was evaluated on Clinical and behavioral health outcomes (Hedges g 0.10, p=<0.001). eHealth lifestyle interventions significantly improved clinical and behavioral health outcomes (Hedges g 0.10, p < 0.001), with no significant difference in effectiveness between self-help and human-supported interventions.
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