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☐ ☆ ✇ Worldviews on Evidence-Based Nursing

The Effectiveness of Instant Messaging‐Based Interventions on Health Behavior Change: A Systematic Review and Meta‐Analysis

Por: Tianxue Hou · Mu‐Hsing Ho · Huangqianyu Li · Chia‐Chin Lin — Julio 28th 2025 at 04:03

ABSTRACT

Background

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.

Aims

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.

Methods

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.

Results

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).

Linking Evidence to Action

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.

☐ ☆ ✇ Worldviews on Evidence-Based Nursing

The Effectiveness of Mind–Body Exercise on Health‐Related Quality of Life and Mental Health During and After Breast Cancer Treatment: An Umbrella Review of Meta‐Analyses for Randomized Controlled Trials

ABSTRACT

Background

Previous studies regarding mind–body exercise among people with breast cancer mostly focused on one type of mind–body exercise and provided conflicting results.

Aims

This paper aims to systematically synthesize the evidence hierarchy and examine the credibility of previous meta-analyses of different types of mind–body exercises.

Methods

We searched PubMed, Embase, Cochrane Library, Web of Science, and Epitemonikos from database inception to February 2nd, 2024, for meta-analyses of randomized controlled trials. Included meta-analyses examined the effects of mind–body exercises on at least one outcome of health-related quality of life, cancer-related fatigue, depression, anxiety, and sleep quality in breast cancer patients. The random effects estimates (Hedges'G), 95% prediction interval, small study effect, and excess significance bias were calculated. Furthermore, we categorized meta-analyses based on the evidence credibility criteria and assessed quality using A Measurement Tool to Assess Systematic Reviews 2.

Results

The umbrella review included a re-analysis of 16 meta-analyses of 9 articles including 134 randomized controlled trials involving 9469 breast cancer patients and survivors. We identified 3 articles as “low” quality and 6 articles as “critically low” quality. Convincing evidence supported the effectiveness of Yoga intervention in reducing depression symptoms (G = −0.77, 95% Confidence Interval [−0.93, −0.61]). However, 11 meta-analyses were supported by weak evidence (1 for Qigong alleviated depression, 4 for Qigong, Baduanjin, Tai Chi Chuan, and Yoga improved health-related quality of life, 3 for multiple mind–body exercises, Tai Chi Chuan, and Yoga reduced cancer-related fatigue, 2 of Baduanjin and Yoga reduced anxiety, as well as 1 of Yoga improved sleep quality).

Linking Evidence to Action

Mind–body exercises, especially yoga, may be beneficial for improving health-related quality of life and mental health for breast cancer patients. Further high-quality interventions investigating diverse mind–body exercise interventions are warranted to ascertain the effectiveness of health-related quality of life and mental health outcomes.

☐ ☆ ✇ Worldviews on Evidence-Based Nursing

Effectiveness of motivational strategies on physical activity behavior and associated outcomes in patients with cancer: A systematic review and meta‐analysis

Por: Naomi Takemura · Mu‐Hsing Ho · Denise Shuk Ting Cheung · Chia‐Chin Lin — Noviembre 9th 2023 at 04:31

Abstract

Background

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.

Aim

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.

Methods

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.

Results

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.

Conclusion

The combination of motivational interviewing with other motivational strategies was beneficial in increasing the total physical activity level of cancer patients.

Linking Evidence to Action

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.

☐ ☆ ✇ Worldviews on Evidence-Based Nursing

The effectiveness of technology‐based cognitive behavioral therapy on perinatal depression and anxiety: A systematic review and meta‐analysis

Por: Hannie Ching · Joelle Yan Xin Chua · Jing Shi Chua · Shefaly Shorey — Agosto 10th 2023 at 08:33

Abstract

Background

Extensive literature has shown the effectiveness of cognitive behavioral therapy in treating perinatal depression, but little is known about the effectiveness of its technology-based version.

Aim

The aim of this review was to examine the effectiveness of technology-based cognitive behavioral therapy in reducing depressive and anxiety symptoms in women suffering from or at risk of experiencing perinatal depression.

Methods

Six electronic databases were searched until February 2023 for articles published in English. Random-effect meta-analyses were conducted. Heterogeneity was assessed using the I 2 statistics and Cochran's Q chi-squared test. Sensitivity analyses and subgroup analyses were also performed, and quality appraisals at the study and outcome levels were conducted.

Results

A total of 16 randomized controlled trials were included in the review. Results from meta-analyses suggest that technology-based cognitive behavioral therapy has a medium effect in reducing perinatal depressive symptoms and a small effect in reducing perinatal anxiety symptoms. Overall, women suffering from or at risk of perinatal depression may benefit from technology-based cognitive behavioral therapy.

Linking Evidence to Action

Future interventions can be improved by addressing both perinatal depression and anxiety, paying more attention to antenatal women to prevent postnatal mental health issues, and using self-guided mobile applications for accessibility.

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