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Nutrition and Physical Activity: Community-based Digital Health and Telephone Interventions to Increase Healthy Eating and Physical Activity

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 31 studies (search period: January 2009- June 2020).

The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to nutrition, physical activity and obesity prevention and control.

Context

Digital health interventions have the potential to reach a large number of people (Beleigoli et al., 2019) to foster or support behavior change (Michie et al, 2018). In the United States, 93% of adults use the internet (Pew Research Center, 2021a); 85% have access to a smartphone (Pew Research Center, 2021b); and 77% have home broadband (Pew Research Center, 2021a).

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement.

The systematic review included 31 studies.

Physical Activity

  • Physical activity increased by a median of 24 minutes per week (12 studies).

Dietary Behaviors

  • Fruit and vegetable intake increased by a median of 0.55 servings per day (12 studies).
  • Energy intake decreased by a median of 134 kilocalories per day (9 studies).
  • Intake of energy dense, nutrient poor foods decreased (4 studies).

Weight-related

  • Body mass index decreased by a median of 0.33 kilograms per meter squared (12 studies).

Summary of Economic Evidence

A systematic review of economic evidence has not been conducted.

Applicability

The finding should be applicable to adults in high income countries who are interested in improving these behaviors in a variety of community settings regardless of gender, income level, race, or ethnicity.

Evidence Gaps

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • What are the effects of digital health interventions among adults with a follow-up period extending past six months?
  • What are the effects of incorporating wearable devices or trackers in the intervention?
  • What are the effects of adding social media to the intervention?

Study Characteristics

  • Included studies were conducted in high-income countries.
  • Ten studies reported on population density, six were conducted in urban settings, three were conducted in rural areas, one was conducted in urban and rural areas.
  • Across all studies, participants had a mean age of 46.4 years. Studies reported higher proportions of females than males (on average, 63% were female).
  • Fourteen studies reported socioeconomic status (SES) indicators and found similar effectiveness among low- and mixed-income populations.
  • The 15 U.S. studies reported racial and ethnic distributions. Studies included participants who self-identified as White (13 studies), Black or African American (6 studies), Hispanic or Latino (7 studies), or Asian (6 studies). Two studies only recruited participants who identified as Black or African American.
  • Intervention duration ranged from two weeks to 12 months, with a median duration of 3.5 months. Most of the interventions were implemented for less than six months (22 studies).