Effectiveness of Human-Supported and Self-Help eHealth Lifestyle Interventions for Patients With Cardiometabolic Risk Factors:
A Meta-Analysis
Talia R. Cohen Rodrigues (Universiteit Leiden)
Linda D. Breeman (Universiteit Leiden)
Asena Kinik (Universiteit Leiden)
Thomas Reijnders (Universiteit Leiden)
Elise Dusseldorp (Universiteit Leiden)
Veronica R. Janssen (Universiteit Leiden)
R. A. Kraaijenhagen (Universiteit Leiden, Vital10, Amsterdam, NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam)
Douwe E. Atsma (Universiteit Leiden)
A.W.M. Evers (Leiden University Medical Center, Erasmus Universiteit Rotterdam, Universiteit Leiden, TU Delft - Human Factors)
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Abstract
Objective eHealth is a useful tool to deliver lifestyle interventions for patients with cardiometabolic diseases. However, there are inconsistent findings about whether these eHealth interventions should be supported by a human professional, or whether self-help interventions are equally effective. Methods Databases were searched between January 1995 and October 2021 for randomized controlled trials on cardiometabolic diseases (cardiovascular disease, chronic kidney disease, type 1 and 2 diabetes mellitus) and eHealth lifestyle interventions. A multilevel meta-analysis was used to pool clinical and behavioral health outcomes. Moderator analyses assessed the effect of intervention type (self-help versus human-supported), dose of human support (minor versus major part of intervention), and delivery mode of human support (remote versus blended). One hundred seven articles fulfilled eligibility criteria and 102 unique (N = 20,781) studies were included. Results The analysis showed a positive effect of eHealth lifestyle interventions on clinical and behavioral health outcomes (p <.001). However, these effects were not moderated by intervention type (p =.169), dose (p =.698), or delivery mode of human support (p =.557). Conclusions This shows that self-help eHealth interventions are equally effective as human-supported ones in improving health outcomes among patients with cardiometabolic disease. Future studies could investigate whether higher-quality eHealth interventions compensate for a lack of human support. Meta-analysis registration: PROSPERO CRD42021269263.
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