title: A systematic review of eHealth behavioral interventions targeting smoking, nutrition, alcohol, physical activity and/or obesity for young adults.
abstract: A systematic review of randomized control trials (RCT) was undertaken to evaluate the effectiveness of eHealth behavioral interventions aiming to improve smoking rates, nutrition behaviors, alcohol intake, physical activity levels and/or obesity (SNAPO) in young adults. Seven electronic databases were searched for RCTs published in English from 2000 to April 2015 and evaluating eHealth interventions aiming to change one or multiple SNAPO outcomes, and including young adult (18-35years) participants. Of 2,159 articles identified, 45 studies met the inclusion criteria. Most interventions targeted alcohol (n=26), followed by smoking (n=7), physical activity (n=4), obesity (n=4) and nutrition (n=1). Three interventions targeted multiple behaviors. The eHealth interventions were most often delivered via websites (79.5%). Most studies (n=32) compared eHealth interventions to a control group (e.g. waiting list control, minimal intervention), with the majority (n=23) showing a positive effect on a SNAPO outcome at follow-up. Meta-analysis demonstrated a significantly lower mean number of drinks consumed/week in brief web or computer-based interventions compared to controls (Mean Difference -2.43 [-3.54, -1.32], P<0.0001, n=10). Sixteen studies compared eHealth delivery modes, with inconsistent results across target behaviors and technology types. Nine studies compared eHealth to other modes of delivery (e.g. in person) with all finding no difference in SNAPO outcomes between groups at follow-up. This review provides some evidence for the efficacy of eHealth SNAPO interventions for young adults, particularly in the short-term and for alcohol interventions. But there is insufficient evidence for their efficacy in the longer-term, as well as which mode of delivery is most effective.
authors.affiliation: School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia; Division of Human Nutrition, Wageningen University, The Netherlands.
authors.forename: Emilie
authors.initials: E
authors.lastname: Oosterveen
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia; Hunter New England Population Health, Wallsend, NSW 2287, Australia.
authors.forename: Flora
authors.initials: F
authors.lastname: Tzelepis
authors.affiliation: School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia.
authors.forename: Lee
authors.initials: L
authors.lastname: Ashton
authors.affiliation: School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre in Physical Activity and Nutrition, Hunter Building (HA12), University of Newcastle, Callaghan, NSW 2308, Australia. Electronic address: Melinda.hutchesson@newcastle.edu.au.
authors.forename: Melinda J
authors.initials: MJ
authors.lastname: Hutchesson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D001521:Behavior Therapy; D006801:Humans; D009752:Nutritional Status; D009765:Obesity / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012907:Smoking; D017216:Telemedicine
keywords: Alcohol; Intervention; Nutrition; Obesity; Physical activity; Smoking; Systematic review; Young adults; eHealth