Online tools help people improve their health but need more study

(Reuters Health) - Mobile apps and web-based programs do help people reach health goals like exercising more, losing weight and quitting smoking, but studies need to follow-up longer to see how sustainable these interventions are, according to a recent review of existing research.

Lifestyle choices like poor diet and smoking are a major cause of death and disease worldwide, the researchers write in the Journal of the American Heart Association, and digital tools may be a low-cost and more accessible option for people looking to improve their health.

“Our results suggest internet-based and mobile-based interventions can be effective tools for behavioral modification,” said lead author Dr. Ashkan Afshin, the Assistant Professor of Global Health at the University of Washington in Seattle.

“We also found these programs were more effective if they included some interactions with healthcare providers,” Afshin added by email.

Afshin and his team reviewed 224 studies of the effectiveness of programs targeting improved diet, exercise, weight loss, smoking cessation or reducing alcohol use and employing web, mobile, personal sensors or stand-alone software technologies.

The studies were published between 1990 and 2013 and most were done in high-income countries, including the U.S., Australia and European nations.

The majority of interventions lasted less than six months and nearly all ran for less than one year. The researchers note that more research is needed to determine how well the programs work over the long term.

Overall, interventions using web-based programs did produce results with regard to improved diet, physical activity, body fat loss and reducing or quitting tobacco and alcohol.

Mobile interventions, including apps and text-message reminders, helped people improve their physical activity and lose excess body fat, but didn’t show improvements in other areas.

For web-based programs targeting weight loss, the researchers looked at 35 studies, 24 of which showed significant improvements after the intervention. Most studies lasted between six weeks and six months and only 10 studies followed participants for more than a year to see if the results were sustained.

Similarly, there were 24 studies targeting diet, such as increasing daily fruit or vegetable intake, and 14 found substantial improvements. Out of five studies that compared an online program to a conventional intervention, two found the online intervention was more effective, two found equal effects and one found no significant effect from either.

Afshin’s team also found that web-based programs to help people become more physically active were highly effective, with 88 percent helping people exercise more.

Among web-based programs for quitting smoking, 77 percent increased people’s success. Mobile texting programs were less helpful, and only two out of seven helped people stop smoking for at least one week.

Among web-based programs to cut down alcohol use, about 83 percent were shown to be helpful.

“Programs that have components such as goal-setting and self-monitoring and use multiple modes of communication and tailored messages tended to be more effective,” Afshin said.

Brie Turner-McGrievy, a behavioral researcher at the University of South Carolina in Columbia, noted that participants in many traditional, in-person interventions may not have much support in between meetings.

With technology, however, real-time feedback is possible, she said by email. “We are able to adapt our interventions as participants are engaging in healthy or unhealthy behaviors throughout the day.”

Though traditional methods may still have some advantages, this is changing as technology changes, said Turner-McGrievy, who was not involved in the new study.

Afshin noted that tech interventions can be combined with in-person care as well. “Clinicians . . . can use such programs to help their patients improve their lifestyle behaviors and reduce the risk of chronic disease such as cardiovascular disease and diabetes,” he said.