Digital versus nondigital behavioral interventions on cardiovascular risk reduction: systematic review and meta-analysis

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◆ 논문 초록 (Abstract)

OBJECTIVES: We aimed to assess whether digital behavioral interventions improve cardiovascular risk factors more effectively than nondigital behavioral interventions. METHODS: We searched 7 electronic databases from January 1, 1990, to April 4, 2024. We performed a random-effects meta-analysis to pool the effects of digital versus nondigital interventions on body composition, blood pressure, blood glucose, and lipid concentrations. We also conducted subgroup analyses based on intervention duration, risk of bias, and intervention types. We reported outcomes as mean differences with their 95% confidence intervals (CIs). We assessed the quality of the included studies using the Cochrane Risk of Bias 2 tool. RESULTS: We included 34 randomized controlled trials with 17 389 participants. The meta-analysis found no significant differences between digital and nondigital behavioral interventions for 11 cardiovascular risk factors. However, subgroup analyses showed that digital dietary interventions significantly reduced body weight (MD = -0.66, 95% CI [-1.26, -0.06]), body mass index-BMI (MD = -0.25, 95% CI [-0.43, -0.07]), and fasting blood glucose (MD = -0.31, 95% CI [-0.57, -0.05]) compared to nondigital interventions. Digital physical activity interventions lowered total cholesterol (MD = -3.55, 95% CI [-4.63, -2.46]) compared to nondigital interventions. Combined digital interventions (dietary, physical activity, and smoking cessation) significantly decreased BMI (MD = -0.20, 95% CI [-0.36, -0.04]) compared to nondigital interventions. No significant differences were found by risk of bias or intervention duration. CONCLUSIONS: Digital behavioral interventions are as effective as nondigital interventions in reducing cardiovascular risk factors, making both essential components of cardiovascular disease prevention and management. This study compared digital health interventions, such as mHealth and telehealth, wearable devices, virtual reality, web-based platforms, and social networking apps, with nondigital approaches, including face-to-face programs and printed educational materials, to evaluate the effects of these interventions in reducing heart disease risk factors. We conducted a comprehensive electronic search of peer-reviewed research studies published between January 1, 1990, and April 4, 2024. We systematically extracted each study’s intervention details. Then, we summarized and compared the effects of digital and nondigital intervention approaches across key heart-health measures, such as weight, blood pressure, blood sugar, and cholesterol. The results showed that digital and nondigital interventions had similar effects on improving cardiovascular disease risk factors. However, in detailed comparisons, digital diet interventions achieved greater weight loss and better blood-sugar control, and digital physical activity interventions lowered cholesterol levels more effectively than nondigital interventions, on average. Moreover, digital interventions that combined diet, exercise, and smoking cessation also showed significant weight reduction. Overall, our study highlights that digital behavioral interventions are as effective as nondigital ones at reducing heart disease risk factors. Both methods offer valuable options for preventing and managing heart disease.

◆ 원문 정보
저자: Berhe FT, Shifti DM, Veerman JL, Aminde L, Ahmed KY et al.
저널: Ann Behav Med
연도: 2025
DOI: 10.1093/abm/kaaf043

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