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• W2893510375 abstract "Digital health interventions (mobile-/internet-based) are endorsed by cardiovascular societies in North America and Europe as a promising strategy to improve self-care behaviour for exercise and cardiovascular outcomes. Nevertheless, heterogeneity of treatment effects across clinical trials is widely reported. The objective of this study was to isolate the components of these trials that were associated with significant treatment effects and to explore potential sources of heterogeneity in trials that have played a prominent role in scientific statements and systematic reviews. We conducted a systematic review of randomized controlled trials (RCTs) of digital health interventions for prevention and management of cardiovascular disease (CVD). 96 RCTs were systematically selected from 10 scientific statements, task force guidelines as well as notable systematic reviews published in English journals from 2010 to present. This substudy examined 29 RCTs from these sources that promoted exercise or cardiovascular fitness for individuals with elevated CVD risk factors or established CVD. Data was gathered on trial characteristics, significance of results, and individual therapeutic components of the digital intervention (i.e patient education, self-monitoring, intervention tailoring, and use of additional services). Meta-analysis indicated a significant improvement in exercise and cardiovascular fitness for digital interventions vs. Control: standardized mean difference (SMD) = 0.44, 95% CI [0.16, 0.64]. Subgroup analyses indicated significant effects when interventions included at least four therapeutic strategies (SMD = 0.67, 95%CI [0.27, 1.08]) and when they specified an organized theoretical framework or clinical model to guide their intervention (SMD = 0.43, 95% CI [0.25, 0.62]). Clinical trials of digital health interventions to promote exercise were efficacious for patients with elevated risk factors or established CVD, however, we also observed significant heterogeneity. Subgroup analysis revealed that differences in the magnitude of treatment effects was partially explained by the use of an organizing clinical/theoretical framework for the intervention. Moreover, clinical outcomes were enhanced when an intervention employed multiple therapeutic components, as noted above. This review highlights foundational features for a digital strategy to promote exercise for cardiovascular health. It also reinforces the need for future trials to explicitly examine how outcomes are mediated by the design and components of their digital intervention." @default.
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• W2893510375 date "2018-10-01" @default.
• W2893510375 modified "2023-09-26" @default.
• W2893510375 title "WHAT MAKES DIGITAL INTERVENTIONS EFFECTIVE FOR EXERCISE PROMOTION: A SYSTEMATIC REVIEW OF REVIEWS AND META-ANALYSIS" @default.
• W2893510375 doi "https://doi.org/10.1016/j.cjca.2018.07.372" @default.
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