Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis.
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SUBMITTER: Gomes AI
PROVIDER: S-EPMC8081248 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveIn Ethiopia, despite the implementation of several interventions to improve infant and young child feeding (IYCF) practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia.Source of informationA systematic search was conducted on seven computerised bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies published between the year 2000 and May 2021.Study eligibility criteriaInterventional studies that measured IYCF indicators (early initiation of breast feeding (EIBF), exclusive breast feeding (EBF), the introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet) as outcome variables were included.Study appraisal and synthesisAll included studies were examined for biases related to interventional studies (ie, selection bias, performance bias, attrition bias, detection bias and reporting bias). Author reports of effect size measures were used to narratively report the findings of each study.ResultsOf the 23 eligible studies, 14 studies were quasi-experimental and 9 studies were cluster randomised trials (CRTs). Eight quasi-experimental studies had a serious risk of bias, while two CRTs had a high risk of bias. Four studies for EBF and six studies for EIBF showed significant impacts of policy advocacy, health service strengthening, interpersonal communication, community mobilisation and mass media campaigns. Six studies for MDD and three studies for MMF indicated significant effects of community-level and health facility complementary feeding promotions on infants and young children. Interventions that delivered in combination increased the impacts in improving EIBF, MDD and MMF compared with a single intervention.ConclusionOur review showed that 12 out of 21 eligible studies that implemented in the form of community-level and health facility interventions improved EIBF, EBF, and/or MDD in Ethiopia.Protocol registration numberPROSPERO, CRD42020155519.
| S-EPMC8370540 | biostudies-literature
Project description:BackgroundEfforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated.ObjectiveThe primary aim of this systematic review was to answer the following research question: What is the effect of tailored Web-based pain management interventions for adults on pain intensity compared with usual care, face-to-face interventions, and standardized Web-based interventions? A secondary aim was to examine the effects of these interventions on physical and psychological functions.MethodsWe conducted a systematic review of articles published from January 2000 to December 2015. We used the DerSimonian-Laird random effects models with 95% confidence intervals to calculate effect estimates for all analyses. We calculated standardized mean differences from extracted means and standard deviations, as outcome variables were measured on different continuous scales. We evaluated 5 different outcomes: pain intensity (primary outcome), pain-related disability, anxiety, depression, and pain catastrophizing. We assessed effects according to 3 time intervals: short term (<1 month), medium term (1-6 months), and long term (6-12 months).ResultsAfter full-text review, we excluded 31 articles, resulting in 17 eligible studies. Only 1 study concerned acute pain and was removed from the meta-analysis, resulting in 16 studies available for quantitative assessment. Compared with standard care or a waiting list, tailored Web-based intervention showed benefits immediately after, with small effect sizes (<0.40) for pain intensity (10 randomized controlled trials [RCTs], n=1310, P=.003) and pain-related disability (6 RCTs, n=953, P<.001). No other improvements were observed at follow-up in the medium and long terms. Compared with the active control group, no improvements were found for the primary outcome (pain intensity) or any of the outcomes except for a small effect size on pain catastrophizing (2 RCTs, n=333, P<.001) immediately after the intervention.ConclusionsTailored Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression. An interesting finding was that some efficacy was shown on pain catastrophizing compared with active control interventions. Considering the diversity of approaches used in tailored Web-based interventions for chronic pain management, their efficacy is yet to be explored. Moreover, their contribution to acute pain management is embryonic.Trial registrationInternational prospective register of systematic reviews (PROSPERO): CRD42015027669; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42015027669 (Archived by WebCite at http://www. webcitation.org/6uneWAuyR).
| S-EPMC5701966 | biostudies-literature
Project description:BackgroundApproaches to support the health and well-being of family caregivers of adults with chronic conditions are increasingly important given the key roles caregivers play in helping family members to live in the community. Web-based interventions to support caregivers have the potential to lessen the negative health impacts associated with caregiving and result in improved health outcomes.ObjectiveThe primary objective of this systematic review and meta-analysis was to examine the effect of caregiver-focused, Web-based interventions, compared with no or minimal Web-based interventions, on caregiver outcomes. The secondary objective was to assess the effect of different types of Web-based interventions (eg, education, peer and professional psychosocial support, and electronic monitoring of the care recipient), compared with no or minimal Web-based interventions, on caregiver outcomes.MethodsMEDLINE, EMBASE, CIHAHL, PsychInfo, Cochrane, and AgeLine were searched from January 1995 to April 2017 for relevant randomized controlled trials (RCTs) or controlled clinical trials (CCTs) that compared caregiver-focused, Web-based intervention programs with no or minimal Web-based interventions for caregivers of adults with at least one chronic condition. Studies were included if they involved: adult family or friend caregivers (aged ?18 years) of adults living in the community with a chronic condition; a caregiver-focused, Web-based intervention of education or psychosocial support or electronic monitoring of the care recipient; and general caregiver outcomes (ie, burden, life satisfaction, self-efficacy or mastery, reaction to problem behavior, self-esteem, strain, and social support). Title and abstract as well as full-text screening were completed in duplicate. Data were extracted by a single reviewer and verified by a second reviewer, and risk of bias assessments were completed accordingly. Where possible, data for these caregiver outcomes were meta-analyzed.ResultsThe search yielded 7927 unique citations, of which 294 studies were screened at full text. Of those, 14 studies met the inclusion criteria; 12 were RCTs and 1 study was a CCT. One study used an RCT design in 1 country and a CCT design in 2 other countries. The beneficial effects of any Web-based intervention program, compared with no or minimal Web-based intervention, resulted in a mean increase of 0.85 points (95% CI 0.12 to 1.57) for caregiver self-esteem, a mean increase of 0.36 points (95% CI 0.11 to 0.62) for caregiver self-efficacy or mastery, and a mean decrease of 0.32 points (95% CI -0.54 to -0.09) for caregiver strain. However, the results are based on poor-quality studies.ConclusionsThe review found evidence for the positive effects of Web-based intervention programs on self-efficacy, self-esteem, and strain of caregivers of adults living with a chronic condition. Further high-quality research is needed to inform the effectiveness of specific types of Web-based interventions on caregiver outcomes.Trial registrationPROSPERO CRD42018091715; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=91715 (Archived by WebCite at http://www.webcitation.org/738zAa5F5).
| S-EPMC6229518 | biostudies-literature
Project description:BackgroundWeb-based mindfulness interventions are increasingly delivered through the internet to treat mental health conditions.ObjectiveThe objective of this study was to determine the effectiveness of web-based mindfulness interventions in clinical mental health populations. Secondary aims were to explore the impact of study variables on the effectiveness of web-based mindfulness interventions.MethodsWe performed a systematic review and meta-analysis of studies investigating the effects of web-based mindfulness interventions on clinical populations.ResultsThe search strategy yielded 12 eligible studies. Web-based mindfulness interventions were effective in reducing depression in the total clinical sample (n=656 g=-0.609, P=.004) and in the anxiety disorder subgroup (n=313, g=-0.651, P<.001), but not in the depression disorder subgroup (n=251, P=.18). Similarly, web-based mindfulness interventions significantly reduced anxiety in the total clinical sample (n=756, g=-0.433, P=.004) and the anxiety disorder subgroup (n=413, g=-0.719, P<.001), but not in the depression disorder group (n=251, g=-0.213, P=.28). Finally, web-based mindfulness interventions improved quality of life and functioning in the total sample (n=591, g=0.362, P=.02) in the anxiety disorder subgroup (n=370, g=0.550, P=.02) and mindfulness skills in the total clinical sample (n=251, g=0.724, P<.001).ConclusionsResults support the effectiveness of web-based mindfulness interventions in reducing depression and anxiety and in enhancing quality of life and mindfulness skills, particularly in those with clinical anxiety. Results should be interpreted with caution given the high heterogeneity of web-based mindfulness interventions and the low number of studies included.
| S-EPMC6231788 | biostudies-literature
Project description:BackgroundThe increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed.ObjectiveThe aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups.MethodsLiterature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group.ResultsA total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25).ConclusionsThe results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.
| S-EPMC7605982 | biostudies-literature
Project description:Background & aimConcurrent estimates on the magnitude and evidence on the determinants of complementary feeding (CF) practices in Ethiopia are currently disparate. Hence, this systematic review and meta-analysis assessed the magnitude and determinants of CF among children age 6-23 months in Ethiopia.MethodsStudies from various databases published until July 2018 were identified, selected, extracted and assessed for risk of bias by two authors independently. A random-effects model was used to pool the prevalence and odds ratios (ORs).Results26 studies with 17, 383 children were included. The pooled prevalence estimate of timely initiated CF, minimum dietary diversity (DD), minimum meal frequency and minimum acceptable diet were 61.0%, 18.0%, 56.0%, and 10.0% respectively. The pooled prevalence of timely initiation and minimum DD were higher in Northern Ethiopia. On the other hand, except for the minimum meal frequency, all the three core indicators of CF were better in urban than rural settings. Child age, maternal and/or paternal education, paternal involvement, maternal DD, antenatal and postnatal care, and place of delivery were the main determinants that can increase appropriate CF practices.ConclusionThe reported estimates of the prevalence of core CF indicators in Ethiopia remained poor. Therefore, the authors would like to acknowledge the effort that has been done by the minister of health and its partners including Alive & Thrive to improving CF practices in the country, however, these programs should be done more thoroughly, and scaled up by applying and adapting tested, proven approaches and tools in contexts.
| S-EPMC6611936 | biostudies-literature
Project description:Considering the importance of schools for sustainable food offers and the formation of conscientious citizens on sustainability, this systematic review aimed to verify the recommendations on sustainability in school feeding policies and the sustainability practices adopted in schools. The research question that guided this study is "what are the recommendations on sustainability in school feeding policies and the sustainability practices adopted in schools?". This systematic review was prepared according to PRISMA, and its checklist was registered in PROSPERO. Specific search strategies for Scopus, Web of Science, Pubmed, Lilacs, Google Scholar, and ProQuest Dissertations & Theses Global were developed. The included studies' methodological quality was evaluated using the Meta-Analysis Statistical Assessment and Review Instrument (MASTARI). A total of 134 studies were selected for a full reading. Of these, 50 met the eligibility criteria and were included in the systematic review. Several sustainability practices were described. The most cited are school gardens and education activities for sustainability. However, actions carried out in food services were also mentioned, from the planning of menus and the purchase of raw materials (mainly local and organic foods, vegetarian/vegan menus) to the distribution of meals (reduction of organic and inorganic waste: composting, recycling, donating food, and portion sizes). Recommendations for purchasing sustainable food (organic, local, and seasonal), nutrition education focused on sustainability, and reducing food waste were frequent; this reinforces the need to stimulate managers' view, in their most varied spheres, for the priority that should be given to this theme, so that education for sustainability is universally part of the curricula. The importance of education in enabling individuals to promote sustainable development is reaffirmed in Sustainable Development Goal 4 (SDG 4). The development of assessment instruments can help monitor the evolution of sustainable strategies at schools and the main barriers and potentialities related to their implementation.
| S-EPMC8775006 | biostudies-literature
Project description:IntroductionExclusive Breastfeeding (EBF) rates remain low in both low-income and high-income countries despite World Health Organization recommendations for EBF till 6 months. Breastfeeding has been shown to have a protective effect against gastrointestinal infections, among other benefits. Large-scale interventions focusing on educating mothers about breastfeeding have the potential to increase breastfeeding prevalence, especially EBF, up to recommended standards and also to decrease infant morbidity.MethodsA systematic literature search was conducted for RCTs and quasi-experimental studies comparing breastfeeding education or support to routine care. The effect of interventions was observed for exclusive, predominant, partial and no breastfeeding rates. The time intervals of interest were day 1, <1 month, and 1 to 5 months. Outcome-specific evidence was graded according to the Child Health Epidemiology Reference Group (CHERG) rules using the adapted Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria and recommendations were made from studies in developing countries for inclusion into the Lives Saved Tool (LiST) model.ResultsAfter reviewing 4600 abstracts, 372 studies were selected for full text screening and 110 of these studies were finally included. Statistically significant increases in EBF rates as a result of breastfeeding promotion interventions were observed: 43% at day 1, 30% at <1 month, and 90% at 1-5 months. Rates of 'no breastfeeding' reduced by 32% at 1 day, 30% at <1 month, and 18% at 1-5 months. The effect of interventions on the rates of predominant and partial breastfeeding were non-significant.ConclusionBreastfeeding education and/or support increased EBF rates and decreased no breastfeeding rates at birth, <1 month and 1-5 months. Combined individual and group counseling appeared to be superior to individual or group counseling alone. Interventions in developing countries had a greater impact than those in developed countries.
| S-EPMC3847366 | biostudies-literature
Project description:ObjectiveBehavioral interventions targeting "free-living" physical activity (PA) and exercise that produce long-term glycemic control in adults with type 2 diabetes are warranted. However, little is known about how clinical teams should support adults with type 2 diabetes to achieve and sustain a physically active lifestyle.Research design and methodsWe conducted a systematic review of randomized controlled trials (RCTs) (published up to January 2012) to establish the effect of behavioral interventions (compared with usual care) on free-living PA/exercise, HbA(1c), and BMI in adults with type 2 diabetes. Study characteristics, methodological quality, practical strategies for increasing PA/exercise (taxonomy of behavior change techniques), and treatment fidelity strategies were captured using a data extraction form.ResultsSeventeen RCTs fulfilled the review criteria. Behavioural interventions showed statistically significant increases in objective (standardized mean difference [SMD] 0.45, 95% CI 0.21-0.68) and self-reported PA/exercise (SMD 0.79, 95% CI 0.59-0.98) including clinically significant improvements in HbA(1c) (weighted mean difference [WMD] -0.32%, 95% CI -0.44% to -0.21%) and BMI (WMD -1.05 kg/m(2), 95% CI -1.31 to -0.80). Few studies provided details of treatment fidelity strategies to monitor/improve provider training. Intervention features (e.g., specific behavior change techniques, interventions underpinned by behavior change theories/models, and use of ?10 behaviour change techniques) moderated effectiveness of behavioral interventions.ConclusionsBehavioral interventions increased free-living PA/exercise and produced clinically significant improvements in long-term glucose control. Future studies should consider use of theory and multiple behavior change techniques associated with clinically significant improvements in HbA(1c), including structured training for care providers on the delivery of behavioural interventions.
| S-EPMC3507564 | biostudies-literature
Project description:IntroductionInfant and young child feeding (IYCF) is the cornerstone of infant and child survival, healthy growth and development, healthy future generations and national development. In spite of the importance of optimal nutrition in low- and middle-income countries, there has been no review conducted in Ethiopia. Thus, the aim of this systematic review and meta-analysis is to estimate the national coverage and identify the associated factors of IYCF practices in Ethiopia.MethodsPubMed, Scopus, EMBASE, CINHAL, EBSCO, Web of Science and WHO Global Health Library databases will be searched for all available publications from 1 January 2000 to 30 September 2017. All published studies on the timely initiation of breast feeding, exclusive breast feeding and timely initiation of complementary feeding practice in Ethiopia will be screened, selected and reviewed. Bibliographies of identified articles and grey literature will be hand-searched as well. Heterogeneity of studies will be quantified using Higgins's method where I2 statistic >80% indicates substantial heterogeneity. Funnel plots and Egger's regression test will be used to assess potential publication bias. The Newcastle-Ottawa Scale (NOS) will be used to assess the quality of evidence and risk of bias. Meta-analysis and meta-regression will be carried out to estimate the pooled national prevalence rate and an OR of each associated factor of IYCF practices. Narrative synthesis will be performed if meta-analysis is not feasible due to the substantial heterogeneity of studies.Ethics and disseminationEthical clearance is not required for this study because primary data will not be collected. The results of this systematic review and meta-analysis will be published in a peer-reviewed journal and presented at an (inter)national research symposium.Systematic review registrationThis systematic review and meta-analysis has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017056768.
| S-EPMC5724140 | biostudies-literature