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Instant messaging-based applications are increasingly used to deliver interventions designed to promote health behavior change. However, the effectiveness of these interventions has not been evaluated.
This systematic review and meta-analysis aimed to evaluate the effectiveness of instant messaging-based interventions on health behavior change, addressing a gap in the literature regarding the impact of instant messaging on various health behaviors.
We conducted comprehensive searches of six electronic databases (PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus, and Web of Science) from their inception until July 2024, utilizing terms related to health behavior and instant messaging. Two authors independently screened studies and extracted data. Randomized controlled trials published in English that investigated the effects of instant messaging-based interventions on health behavior change, including physical activity, sedentary behavior, sleep, diet/nutrition, cancer screening, smoking cessation, and alcohol consumption were included. We used the revised Cochrane Risk-of-Bias Tool to assess the quality of the studies.
Fifty-seven randomized controlled trials published between 2014 and 2024 were included. The results showed that compared with the control groups, instant messaging-based interventions had statistically significant differences in physical activity (SMD = 0.52, 95% CI [0.21, 0.83], p < 0.001) and sleep (SMD = −0.93, 95% CI [−1.44, −0.42], p < 0.001). It also significantly impacted smoking cessation (OR = 1.88, 95% CI [1.28, 2.7], p < 0.001). However, it did not influence sedentary behavior (SMD = 0.25, 95% CI [−0.24, 0.74], p = 0.01) or diet/nutrition (SMD = 0.01, 95% CI [−0.31, 0.34], p < 0.001).
Instant messaging-based interventions are promising in enhancing health behavior change, including physical activity, sleep, and smoking cessation. Leveraging real-time communication and multimedia content can improve patient engagement and intervention effectiveness.
Optimal glycemic control is known to be challenging for people with type 2 diabetes (T2D) due to the maintenance of long-term self-management behavior. Incorporating the transtheoretical model (TTM) components into motivational interviewing (MI) has been applied to promote self-management behaviors such as physical activity in T2D patients. However, the effectiveness of the TTM-based MI intervention in improving glycemic control, self-management, and self-efficacy in adults with T2D remains unclear.
This systematic review and meta-analysis of randomized controlled trials aimed to estimate the effect of a TTM-based MI intervention on glycemic control, self-management, and self-efficacy in adults with T2D patients.
We searched five electronic databases up to September 13, 2023. Two researchers independently screened records, extracted data, and assessed study quality using the Cochrane Risk of Bias Tool 2.0. Pooled effects were estimated in standardized mean differences (SMDs) or mean differences (MDs) using fixed- and random-effects models. Sensitivity analysis and meta-regression explored the reasons for heterogeneity.
Thirty trials with 4214 participants were identified. The TTM-based MI intervention significantly reduced HbA1c (MD = −0.92, 95% CI [−1.08, −0.75], p < 0.001, I 2 = 65%), FPG (SMD = −1.06, 95% CI [−1.38, −0.73], p < 0.001, I 2 = 93%), and 2hPG (MD = −1.42 mmol/L, 95% CI [−1.83, −1.00], p < 0.001, I 2 = 89%), with high, moderate, and low certainty of evidence, respectively. The intervention also improved self-management (SMD = 1.47, 95% CI [1.16, 1.78], p < 0.001, I 2 = 80%) and self-efficacy (SMD = 1.53, 95% CI [1.04, 2.02], p < 0.001, I 2 = 92%). Meta-analysis revealed that MI treatment dose and initial glycemic status contributed to the high heterogeneity.
The TTM-based MI intervention can be a promising intervention for understanding patients' stage of change with tailored strategies and MI techniques to facilitate behavior change, resulting in improved glycemic control, self-management, and self-efficacy in T2D patients. Nevertheless, given the moderate to high risk of bias in the included studies, further rigorous randomized controlled trials should be conducted to examine the effectiveness of TTM-based MI interventions. Short and multiple sessions that comply with the fidelity of MI in the intervention plans are suggested in daily nursing routine for diabetes self-management education.
Motivational interviewing is a client-centered counseling technique widely applied as a behavior change strategy. It has been adopted to help cancer patients modify health behaviors. The effectiveness of motivational interviewing on physical activity behavior and its associated outcomes in cancer patients is unclear.
The aim of this review was to determine the effect of motivational interviewing with other motivational strategies on physical activity behavior and associated outcomes in cancer patients.
This is a systematic review and meta-analysis of randomized controlled trials, following PRISMA guidelines. Eight English databases were searched from inception to October 2022. The outcomes were evaluated using standardized mean differences (SMDs) with fixed- and random-effects models. Methodological quality of the studies was assessed by Cochrane Risk of Bias Tool 2.0.
Eight trials with 450 participants were identified, with sample sizes ranging from 25 to 87. The number of motivational interviewing sessions ranged from one to 12. The types of motivational strategy intervention varied. Apart from motivational interviewing, pedometers were frequently used as a strategy. The quality of the included studies differed, with one out of eight scoring low in the overall risk of bias. Our meta-analysis indicated that motivational interviewing with other motivational strategies significantly promoted the total physical activity level (SMD = 0.34, 95% confidence interval [0.10, 0.58], p = .005; low certainty), but not did not affect other physical and psychosocial outcomes.
The combination of motivational interviewing with other motivational strategies was beneficial in increasing the total physical activity level of cancer patients.
Motivational interviewing can be a clinical communication skill that healthcare professionals, especially nurses, can acquire to motivate patients to change their behaviors to promote health. Future studies adopting motivational interviewing interventions could consider additional motivational strategies, such as pedometers, to maximize the benefits on physical activity behaviors.
Primary dysmenorrhea (PD) is a global public health concern affecting women's health and quality of life, leading to productivity loss and increased medical expenses. As a non-pharmacological intervention, auricular acupoint therapy (AAT) has been increasingly applied to treat PD, but the overall effectiveness remains unclear.
The aim of this review was to synthesize the effects of AAT targeting menstrual pain among females with PD.
Eight databases (PubMed, EMBASE, AMED, CINAHL Plus, Cochrane Library, Web of Science, China National Knowledge Infrastructure and Wanfang Data) and three registries (ClinicalTrials.gov, ISRCTN Registry and the Chinese Clinical Trial Registry) were searched to identify existing randomized controlled trials (RCTs) from inception to 21 August 2022. Two reviewers independently screened, extracted the data, and appraised the methodological quality and the evidence strength using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and the GRADE approach.
A total of 793 participants from 11 RCTs were included. Despite substantial heterogeneity, AAT was more effective in reducing menstrual pain and related symptoms than placebo and nonsteroidal anti-inflammatory medications (NSAIDs). No significant subgroup differences were found between study locations as well as invasiveness, duration, type, acupoints number, ear selection and provider of AAT. Only minor adverse effects of AAT were reported.
AAT can help women with PD, particularly those who are refrained from pharmaceuticals. Primary healthcare professionals, including nurses, can be well-equipped to provide evidence-based and effective AAT for people with PD. AAT can be used in a broader global clinical community. To provide an optimal effect and have wider usability, a unified practice standard is required, which would necessitate further adaptation of clinical care of people with PD. AAT effectively decreased menstrual pain and other accompanying symptoms of PD. More research is needed to identify effective AAT features and explore optimal therapy regimes for PD.
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