scholarly journals Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review

10.2196/17572 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e17572 ◽  
Author(s):  
Dorothy Szinay ◽  
Andy Jones ◽  
Tim Chadborn ◽  
Jamie Brown ◽  
Felix Naughton
Keyword(s):  
Systematic Review ◽  
Low Cost ◽  
Theoretical Domains Framework ◽  
Well Being ◽  
Database Systems ◽  
Health Impact ◽  
Cochrane Library ◽  
Smartphone Apps ◽  
Wide Range ◽  
Health And Well Being

Background The public health impact of health and well-being digital interventions is dependent upon sufficient real-world uptake and engagement. Uptake is currently largely dependent on popularity indicators (eg, ranking and user ratings on app stores), which may not correspond with effectiveness, and rapid disengagement is common. Therefore, there is an urgent need to identify factors that influence uptake and engagement with health and well-being apps to inform new approaches that promote the effective use of such tools. Objective This review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults. Methods We conducted a systematic review of quantitative, qualitative, and mixed methods studies. Studies conducted on adults were included if they focused on health and well-being smartphone apps reporting on uptake and engagement behavior. Studies identified through a systematic search in Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Scopus, Cochrane library databases, DataBase systems and Logic Programming (DBLP), and Association for Computing Machinery (ACM) Digital library were screened, with a proportion screened independently by 2 authors. Data synthesis and interpretation were undertaken using a deductive iterative process. External validity checking was undertaken by an independent researcher. A narrative synthesis of the findings was structured around the components of the capability, opportunity, motivation, behavior change model and the theoretical domains framework (TDF). Results Of the 7640 identified studies, 41 were included in the review. Factors related to uptake (U), engagement (E), or both (B) were identified. Under capability, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E). Availability at low cost (U), positive tone, and personalization (E) were identified as physical opportunity factors, whereas recommendations for health and well-being apps (U), embedded health professional support (E), and social networking (E) possibilities were social opportunity factors. Finally, the motivation factors included positive feedback (E), available rewards (E), goal setting (E), and the perceived utility of the app (E). Conclusions Across a wide range of populations and behaviors, 26 factors relating to capability, opportunity, and motivation appear to influence the uptake of and engagement with health and well-being smartphone apps. Our recommendations may help app developers, health app portal developers, and policy makers in the optimization of health and well-being apps.

scholarly journals Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Dorothy Szinay ◽  
Andy Jones ◽  
Tim Chadborn ◽  
Jamie Brown ◽  
Felix Naughton
Keyword(s):  
Systematic Review ◽  
Low Cost ◽  
Theoretical Domains Framework ◽  
Well Being ◽  
Database Systems ◽  
Health Impact ◽  
Cochrane Library ◽  
Smartphone Apps ◽  
Wide Range ◽  
Health And Well Being

BACKGROUND The public health impact of health and well-being digital interventions is dependent upon sufficient real-world uptake and engagement. Uptake is currently largely dependent on popularity indicators (eg, ranking and user ratings on app stores), which may not correspond with effectiveness, and rapid disengagement is common. Therefore, there is an urgent need to identify factors that influence uptake and engagement with health and well-being apps to inform new approaches that promote the effective use of such tools. OBJECTIVE This review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults. METHODS We conducted a systematic review of quantitative, qualitative, and mixed methods studies. Studies conducted on adults were included if they focused on health and well-being smartphone apps reporting on uptake and engagement behavior. Studies identified through a systematic search in Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Scopus, Cochrane library databases, DataBase systems and Logic Programming (DBLP), and Association for Computing Machinery (ACM) Digital library were screened, with a proportion screened independently by 2 authors. Data synthesis and interpretation were undertaken using a deductive iterative process. External validity checking was undertaken by an independent researcher. A narrative synthesis of the findings was structured around the components of the capability, opportunity, motivation, behavior change model and the theoretical domains framework (TDF). RESULTS Of the 7640 identified studies, 41 were included in the review. Factors related to uptake (U), engagement (E), or both (B) were identified. Under <i>capability</i>, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E). Availability at low cost (U), positive tone, and personalization (E) were identified as physical <i>opportunity</i> factors, whereas recommendations for health and well-being apps (U), embedded health professional support (E), and social networking (E) possibilities were social <i>opportunity</i> factors. Finally, the <i>motivation</i> factors included positive feedback (E), available rewards (E), goal setting (E), and the perceived utility of the app (E). CONCLUSIONS Across a wide range of populations and behaviors, 26 factors relating to capability, opportunity, and motivation appear to influence the uptake of and engagement with health and well-being smartphone apps. Our recommendations may help app developers, health app portal developers, and policy makers in the optimization of health and well-being apps.

scholarly journals Gamification in Apps and Technologies for Improving Mental Health and Well-Being: Systematic Review

10.2196/13717 ◽  
2019 ◽  
Vol 6 (6) ◽  
pp. e13717 ◽  
Author(s):  
Vanessa Wan Sze Cheng ◽  
Tracey Davenport ◽  
Daniel Johnson ◽  
Kellie Vella ◽  
Ian B Hickie
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Behavior Change ◽  
Positive Reinforcement ◽  
Well Being ◽  
Health Behavior Change ◽  
Cochrane Library ◽  
Current Application ◽  
Screening Process ◽  
Health And Well Being

BackgroundThere is little research on the application of gamification to mental health and well-being. Furthermore, usage of gamification-related terminology is inconsistent. Current applications of gamification for health and well-being have also been critiqued for adopting a behaviorist approach that relies on positive reinforcement and extrinsic motivators.ObjectiveThis study aimed to analyze current applications of gamification for mental health and well-being by answering 3 research questions (RQs). RQ1: which gamification elements are most commonly applied to apps and technologies for improving mental health and well-being? RQ2: which mental health and well-being domains are most commonly targeted by these gamified apps and technologies? RQ3: what reasons do researchers give for applying gamification to these apps and technologies? A systematic review of the literature was conducted to answer these questions.MethodsWe searched ACM Digital Library, CINAHL, Cochrane Library, EMBASE, IEEE Explore, JMIR, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science for qualifying papers published between the years 2013 and 2018. To answer RQ1 and RQ2, papers were coded for gamification elements and mental health and well-being domains according to existing taxonomies in the game studies and medical literature. During the coding process, it was necessary to adapt our coding frame and revise these taxonomies. Thematic analysis was conducted to answer RQ3.ResultsThe search and screening process identified 70 qualifying papers that collectively reported on 50 apps and technologies. The most commonly observed gamification elements were levels or progress feedback, points or scoring, rewards or prizes, narrative or theme, personalization, and customization; the least commonly observed elements were artificial assistance, unlockable content, social cooperation, exploratory or open-world approach, artificial challenge, and randomness. The most commonly observed mental health and well-being domains were anxiety disorders and well-being, whereas the least commonly observed domains were conduct disorder and bipolar disorders. Researchers’ justification for applying gamification to improving mental health and well-being was coded in 59% (41/70) of the papers and was broadly divided into 2 themes: (1) promoting engagement and (2) enhancing an intervention’s intended effects.ConclusionsOur findings suggest that the current application of gamification to apps and technologies for improving mental health and well-being does not align with the trend of positive reinforcement critiqued in the greater health and well-being literature. We also observed overlap between the most commonly used gamification techniques and existing behavior change frameworks. Results also suggest that the application of gamification is not driven by health behavior change theory, and that many researchers may treat gamification as a black box without consideration for its underlying mechanisms. We call for the inclusion of more comprehensive and explicit descriptions of how gamification is applied and the standardization of applied games terminology within and across fields.

scholarly journals Influences on the Uptake of Health and Well-being Apps and Curated App Portals: Think-Aloud and Interview Study

10.2196/27173 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e27173
Author(s):  
Dorothy Szinay ◽  
Olga Perski ◽  
Andy Jones ◽  
Tim Chadborn ◽  
Jamie Brown ◽  
...  
Keyword(s):  
Data Protection ◽  
Social Influences ◽  
Theoretical Domains Framework ◽  
Well Being ◽  
The Internet ◽  
Framework Analysis ◽  
Health Apps ◽  
Perceived Utility ◽  
Wide Range ◽  
Health And Well Being

Background Health and well-being smartphone apps can provide a cost-effective solution to addressing unhealthy behaviors. The selection of these apps tends to occur in commercial app stores, where thousands of health apps are available. Their uptake is often influenced by popularity indicators. However, these indicators are not necessarily associated with app effectiveness or evidence-based content. Alternative routes to app selection are increasingly available, such as via curated app portals, but little is known about people’s experiences of them. Objective The aim of this study is to explore how people select health apps on the internet and their views on curated app portals. Methods A total of 18 UK-based adults were recruited through social media and asked during an in-person meeting to verbalize their thoughts while searching for a health or well-being app on the internet on a platform of their choice. The search was then repeated on 2 curated health app portals: the National Health Service Apps Library and the Public Health England One You App portal. This was followed by semistructured interviews. Data were analyzed using framework analysis, informed by the Capability, Opportunity, Motivation-Behavior model and the Theoretical Domains Framework. Results Searching for health and well-being apps on the internet was described as a minefield. App uptake appeared to be influenced by participants’ capabilities such as app literacy skills and health and app awareness, and opportunities including the availability of apps, app esthetics, the price of an app, and social influences. Motivation factors that seemed to affect the uptake were perceived competence, time efficiency, perceived utility and accuracy of an app, transparency about data protection, commitment and social identity, and a wide range of emotions. Social influences and the perceived utility of an app were highlighted as particularly important. Participants were not previously aware of curated portals but found the concept appealing. Curated health app portals appeared to engender trust and alleviate data protection concerns. Although apps listed on these were perceived as more trustworthy, their presentation was considered disappointing. This disappointment seemed to stem from the functionality of the portals, lack of user guidance, and lack of tailored content to an individual’s needs. Conclusions The uptake of health and well-being apps appears to be primarily affected by social influences and the perceived utility of an app. App uptake via curated health app portals perceived as credible may mitigate concerns related to data protection and accuracy, but their implementation must better meet user needs and expectations.

scholarly journals Workplace bullying and incivility: a systematic review of interventions

2014 ◽  
Vol 7 (1) ◽  
pp. 54-72 ◽  
Author(s):  
Margaret Hodgins ◽  
Sarah MacCurtain ◽  
Patricia Mannix-McNamara
Keyword(s):  
Systematic Review ◽  
Workplace Bullying ◽  
Negative Impact ◽  
Well Being ◽  
Content Type ◽  
Wide Range ◽  
Workplace Mistreatment ◽  
Positive Effect ◽  
Health And Well Being ◽  
Future Practice

Purpose – Workplace mistreatment has a negative impact on the health and well-being of approximately 20 per cent of workers. Despite this, few interventions have been evaluated and published. The purpose of this paper is to address the question “what interventions designed to reduce workplace bullying or incivility are effective and what can be learnt from evaluated interventions for future practice?” Design/methodology/approach – A systematic review was undertaken in which 11 electronic databases were searched, yielding 5,364 records. Following screening on abstract and title, 31 papers were retained for detailed review and quality assessment. Subsequently, 12 interventions to address workplace bullying or incivility were critically appraised. Findings – The papers spanned a wide range of approaches to and assumptions about resolving the problem of bullying and/or incivility. Half the studies focused on changing individual behaviours or knowledge about bullying or incivility, and duration of intervention ranged from two hours to two years. Only four studies were controlled before-after studies. Only three studies were classed as “moderate” in terms of quality, two of which were effective and one of which was partially effective. Originality/value – A final synthesis of results of the review indicate that multi-component, organisational level interventions appear to have a positive effect on levels of incivility, and should be considered as a basis for developing interventions to address workplace bullying.

scholarly journals Process, Practice and Progress: A Case Study of the Health Impact Assessment (HIA) of Brexit in Wales

2020 ◽  
Vol 17 (18) ◽  
pp. 6652
Author(s):  
Liz Green ◽  
Kathryn Ashton ◽  
Nerys Edmonds ◽  
Sumina Azam
Keyword(s):  
Impact Assessment ◽  
Health Impact Assessment ◽  
Well Being ◽  
Health Impact ◽  
World Health ◽  
Flexible Tool ◽  
Support Unit ◽  
Wide Range ◽  
The Impact ◽  
Health And Well Being

Health impact assessment (HIA) is a systematic and flexible tool, which is advocated by the World Health Organisation as a method through which to consider the impact of policies on the health and well-being of a population, and the inequalities that may arise because of it. In 2018, the HIA support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. It followed a five-step process for HIA and utilised a wide range of evidence sources and health intelligence including both quantitative and qualitative evidence. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers. It does not concentrate on the findings of the HIA in detail, but focusses on what worked and any challenges encountered. It has been used to progress the practice of HIA in Wales and demonstrates the value of HIA as a method to inform and influence complex decisions.

scholarly journals Connecting healthcare with income maximisation services, and their financial, health and well-being impacts for families with young children: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056297
Author(s):  
Jade Burley ◽  
Anna MH Price ◽  
Anneka Parker ◽  
Nora Samir ◽  
Anna Zhu ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Healthcare Service ◽  
Grey Literature ◽  
Well Being ◽  
Financial Hardship ◽  
Cochrane Library ◽  
Physical And Mental Health ◽  
The Impact ◽  
Health And Well Being

IntroductionPoverty has far-reaching and detrimental effects on children’s physical and mental health, across all geographies. Financial advice and income-maximisation services can provide a promising opportunity for shifting the physical and mental health burdens that commonly occur with financial hardship, yet awareness of these services is limited, and referrals are not systematically integrated into existing healthcare service platforms. We aim to map and synthesise evidence on the impact of healthcare-income maximisation models of care for families of children aged 0–5 years in high-income countries on family finances, parent/caregiver(s) or children’s health and well-being.Methods and analysisTo be included in the review, studies must be families (expectant mothers or parents/caregivers) of children who are aged between 0 and 5 years, accessing a healthcare service, include a referral from healthcare to an income-maximisation service (ie, financial counselling), and examine impacts on child and family health and well-being. A comprehensive electronic search strategy will be used to identify studies written in English, published from inception to January 2021, and indexed in MEDLINE, EMBase, PsycINFO, CINAHL, Proquest, Family & Society Studies Worldwide, Cochrane Library, and Informit Online. Search strategies will include terms for: families, financial hardship and healthcare, in various combinations. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies, and grey literature will also be searched. Data on objective and self-reported outcomes and study quality will be independently extracted by two review authors; any disagreements will be resolved through a third reviewer. The protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.Ethics and disseminationEthical approval is not required. The results will be disseminated widely via peer-reviewed publication and presentations at conferences related to this field.PROSPERO registration numberCRD42020195985.

scholarly journals Sentiment Analysis in Health and Well-Being: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Anastazia Zunic ◽  
Padraig Corcoran ◽  
Irena Spasic
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Sentiment Analysis ◽  
State Of The Art ◽  
Well Being ◽  
The State ◽  
Support Vector ◽  
Domain Specific ◽  
Wide Range ◽  
Health And Well Being

BACKGROUND Sentiment analysis (SA) is a subfield of natural language processing whose aim is to automatically classify the sentiment expressed in a free text. It has found practical applications across a wide range of societal contexts including marketing, economy, and politics. This review focuses specifically on applications related to health, which is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” OBJECTIVE This study aimed to establish the state of the art in SA related to health and well-being by conducting a systematic review of the recent literature. To capture the perspective of those individuals whose health and well-being are affected, we focused specifically on spontaneously generated content and not necessarily that of health care professionals. METHODS Our methodology is based on the guidelines for performing systematic reviews. In January 2019, we used PubMed, a multifaceted interface, to perform a literature search against MEDLINE. We identified a total of 86 relevant studies and extracted data about the datasets analyzed, discourse topics, data creators, downstream applications, algorithms used, and their evaluation. RESULTS The majority of data were collected from social networking and Web-based retailing platforms. The primary purpose of online conversations is to exchange information and provide social support online. These communities tend to form around health conditions with high severity and chronicity rates. Different treatments and services discussed include medications, vaccination, surgery, orthodontic services, individual physicians, and health care services in general. We identified 5 roles with respect to health and well-being among the authors of the types of spontaneously generated narratives considered in this review: a sufferer, an addict, a patient, a carer, and a suicide victim. Out of 86 studies considered, only 4 reported the demographic characteristics. A wide range of methods were used to perform SA. Most common choices included support vector machines, naïve Bayesian learning, decision trees, logistic regression, and adaptive boosting. In contrast with general trends in SA research, only 1 study used deep learning. The performance lags behind the state of the art achieved in other domains when measured by F-score, which was found to be below 60% on average. In the context of SA, the domain of health and well-being was found to be resource poor: few domain-specific corpora and lexica are shared publicly for research purposes. CONCLUSIONS SA results in the area of health and well-being lag behind those in other domains. It is yet unclear if this is because of the intrinsic differences between the domains and their respective sublanguages, the size of training datasets, the lack of domain-specific sentiment lexica, or the choice of algorithms.

scholarly journals Sentiment Analysis in Health and Well-Being: Systematic Review

10.2196/16023 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e16023 ◽  
Author(s):  
Anastazia Zunic ◽  
Padraig Corcoran ◽  
Irena Spasic
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Sentiment Analysis ◽  
State Of The Art ◽  
Well Being ◽  
The State ◽  
Support Vector ◽  
Domain Specific ◽  
Wide Range ◽  
Health And Well Being

Background Sentiment analysis (SA) is a subfield of natural language processing whose aim is to automatically classify the sentiment expressed in a free text. It has found practical applications across a wide range of societal contexts including marketing, economy, and politics. This review focuses specifically on applications related to health, which is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Objective This study aimed to establish the state of the art in SA related to health and well-being by conducting a systematic review of the recent literature. To capture the perspective of those individuals whose health and well-being are affected, we focused specifically on spontaneously generated content and not necessarily that of health care professionals. Methods Our methodology is based on the guidelines for performing systematic reviews. In January 2019, we used PubMed, a multifaceted interface, to perform a literature search against MEDLINE. We identified a total of 86 relevant studies and extracted data about the datasets analyzed, discourse topics, data creators, downstream applications, algorithms used, and their evaluation. Results The majority of data were collected from social networking and Web-based retailing platforms. The primary purpose of online conversations is to exchange information and provide social support online. These communities tend to form around health conditions with high severity and chronicity rates. Different treatments and services discussed include medications, vaccination, surgery, orthodontic services, individual physicians, and health care services in general. We identified 5 roles with respect to health and well-being among the authors of the types of spontaneously generated narratives considered in this review: a sufferer, an addict, a patient, a carer, and a suicide victim. Out of 86 studies considered, only 4 reported the demographic characteristics. A wide range of methods were used to perform SA. Most common choices included support vector machines, naïve Bayesian learning, decision trees, logistic regression, and adaptive boosting. In contrast with general trends in SA research, only 1 study used deep learning. The performance lags behind the state of the art achieved in other domains when measured by F-score, which was found to be below 60% on average. In the context of SA, the domain of health and well-being was found to be resource poor: few domain-specific corpora and lexica are shared publicly for research purposes. Conclusions SA results in the area of health and well-being lag behind those in other domains. It is yet unclear if this is because of the intrinsic differences between the domains and their respective sublanguages, the size of training datasets, the lack of domain-specific sentiment lexica, or the choice of algorithms.

scholarly journals Gamification in Apps and Technologies for Improving Mental Health and Well-Being: Systematic Review (Preprint)

2019 ◽  
Author(s):  
Vanessa Wan Sze Cheng ◽  
Tracey Davenport ◽  
Daniel Johnson ◽  
Kellie Vella ◽  
Ian B Hickie
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Behavior Change ◽  
Positive Reinforcement ◽  
Well Being ◽  
Health Behavior Change ◽  
Cochrane Library ◽  
Current Application ◽  
Screening Process ◽  
Health And Well Being

BACKGROUND There is little research on the application of gamification to mental health and well-being. Furthermore, usage of gamification-related terminology is inconsistent. Current applications of gamification for health and well-being have also been critiqued for adopting a behaviorist approach that relies on positive reinforcement and extrinsic motivators. OBJECTIVE This study aimed to analyze current applications of gamification for mental health and well-being by answering 3 research questions (RQs). RQ1: which gamification elements are most commonly applied to apps and technologies for improving mental health and well-being? RQ2: which mental health and well-being domains are most commonly targeted by these gamified apps and technologies? RQ3: what reasons do researchers give for applying gamification to these apps and technologies? A systematic review of the literature was conducted to answer these questions. METHODS We searched ACM Digital Library, CINAHL, Cochrane Library, EMBASE, IEEE Explore, JMIR, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science for qualifying papers published between the years 2013 and 2018. To answer RQ1 and RQ2, papers were coded for gamification elements and mental health and well-being domains according to existing taxonomies in the game studies and medical literature. During the coding process, it was necessary to adapt our coding frame and revise these taxonomies. Thematic analysis was conducted to answer RQ3. RESULTS The search and screening process identified 70 qualifying papers that collectively reported on 50 apps and technologies. The most commonly observed gamification elements were levels or progress feedback, points or scoring, rewards or prizes, narrative or theme, personalization, and customization; the least commonly observed elements were artificial assistance, unlockable content, social cooperation, exploratory or open-world approach, artificial challenge, and randomness. The most commonly observed mental health and well-being domains were anxiety disorders and well-being, whereas the least commonly observed domains were conduct disorder and bipolar disorders. Researchers’ justification for applying gamification to improving mental health and well-being was coded in 59% (41/70) of the papers and was broadly divided into 2 themes: (1) promoting engagement and (2) enhancing an intervention’s intended effects. CONCLUSIONS Our findings suggest that the current application of gamification to apps and technologies for improving mental health and well-being does not align with the trend of positive reinforcement critiqued in the greater health and well-being literature. We also observed overlap between the most commonly used gamification techniques and existing behavior change frameworks. Results also suggest that the application of gamification is not driven by health behavior change theory, and that many researchers may treat gamification as a black box without consideration for its underlying mechanisms. We call for the inclusion of more comprehensive and explicit descriptions of how gamification is applied and the standardization of applied games terminology within and across fields.

scholarly journals Effectiveness of Nutritional Education for Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 401-401
Author(s):  
Yue-Heng Yin ◽  
Liu Yat Justina
Keyword(s):  
Systematic Review ◽  
Physical Function ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Well Being ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Nutritional Education ◽  
Hand Search ◽  
Education Interventions

Abstract Obesity has been shown to intensify the decline of physical function and lead to frailty. Nutrition is an important method in managing obesity and frailty, while seldom reviews have ever explored the effects of nutritional education interventions. We conducted a systematic review (PROSPERO: CRD42019142403) to explore the effectiveness of nutritional education interventions in managing body composition and physio-psychosocial parameters related to frailty. Randomized controlled trials and quasi-experimental studies were searched in CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, PubMed and Scopus from 2001 to 2019. Hand search for the reference lists of included papers was conducted as well. We assessed the quality of included studies by Cochrane risk of bias tool. Meta-analyses and narrative synthesis were used to analyse the data. Two studies with low risk of bias were screened from 180 articles, which involved 177 older people with an average age of 69.69±4.08 years old. The results showed that nutritional education was significantly effective in reducing body weight and fat mass than exercises, and it was beneficial to enhancing physical function and psychosocial well-being. But the effects of nutritional education in increasing muscle strength were not better than exercises. The combined effects of nutritional education and exercises were superior than either exercises or nutritional education interventions solely in preventing the loss of lean mass and bone marrow density, and in improving physical function. Due to limited numbers of relevant studies, the strong evidence of effectiveness of nutritional education interventions on reversing frailty is still lacking.

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