Weight Management in Young Adults: Systematic Review of Electronic Health Intervention Components and Outcomes

Abstract

Background Young adulthood is a vulnerable period for unhealthy lifestyle adoption and excess weight gain. Scant attention has been focused on developing and evaluating effective weight gain prevention strategies for this age group. Electronic health (eHealth) offers potential as a cost-effective means of delivering convenient, individually-tailored, and contextually-meaningful interventions at scale. Objective The primary aim of this systematic review was to locate and synthesize the evidence on eHealth weight management interventions targeting young adults, with a particular focus on (eHealth) intervention components and outcomes. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy was executed across the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EBSCO, EMBASE, Emerald, Education Resources Information Center, Medical Literature Analysis and Retrieval System Online, Ovid, ProQuest, PsycINFO, PubMed, Science Direct, Scopus, and Web of Science. Furthermore, 2 reviewers independently assessed records for eligibility: peer-reviewed, published in English, and report evaluations of eHealth weight management interventions targeting healthy young adults (aged 18-35 years). Data were then extracted from studies that met the criteria for inclusion. The methodological quality of studies was independently assessed by 2 reviewers using the Effective Public Health Practice Project’s (EPHPP) quality assessment tool. A comprehensive narrative evidence synthesis was then completed. Results Out of the 1301 studies assessed for eligibility, 24 met the criteria for inclusion. According to the EPHPP quality assessment tool, overall, 19 studies were as rated weak, 5 as moderate, and none as strong. The narrative synthesis of intervention outcomes found 8 studies reported positive weight-related outcomes, 4 reported mixed outcomes, and 12 did not report any significant changes in weight-related outcomes. The narrative synthesis of (eHealth) intervention components led to 3 levels of classification. A total of 14 studies were classified as Web-based , 3 as mobile-based , and 7 as multicomponent interventions. Following the narrative synthesis, 5 key strategies were thematically identified: self-regulation (goal setting and self-monitoring), tailored or personalized feedback, contact with an interventionist, social support, and behavioral prompts (nudges and reminders) and booster messages. Conclusions Findings highlight the limited evidence base for eHealth weight management interventions targeting young adults. The complex nature of weight management presents an ongoing challenge for interventionists to identify what works, for whom, ho...

Effectiveness of gender-targeted versus gender-neutral interventions aimed at improving dietary intake, physical activity and/or overweight/obesity in young adults (aged 17–35 years): a systematic review and meta-analysis

“…For example, in a review of 21 weight gain prevention randomised controlled trials (RCTs) in young adults, significant changes in weight and/or body mass index (BMI) were reported for half of the studies, more commonly those with a theoretical underpinning [14]. Further, in a recent review of eHealth weight management interventions for young adults, eight of 24 studies were found to have positive weight-related outcomes, most commonly web-based and multicomponent intervention approaches [12]. While the reviews to date provide important insight into effective intervention approaches for improving young adults' health behaviours, it is not yet clear which approaches are most effective.…”

“…To synthesise the evidence for effective interventions targeting nutrition, physical activity and/or obesity for young adults, several systematic reviews have been conducted [ 12 – 15 ]. For example, in a review of 21 weight gain prevention randomised controlled trials (RCTs) in young adults, significant changes in weight and/or body mass index (BMI) were reported for half of the studies, more commonly those with a theoretical underpinning [ 14 ].…”

Which behaviour change techniques within interventions to prevent weight gain and/or initiate weight loss improve adiposity outcomes in young adults? A systematic review and meta‐analysis of randomized controlled trials

“…The effectiveness of these self‐regulation strategies are comparable to a systematic review of 24 e Health interventions in young adults, which reported self‐regulation skills (goal setting and self‐monitoring) as key strategies for weight management. Notably, all studies in that review which had positive weight‐related outcomes implemented some form of self‐monitoring . Goal setting requires the participant to set or agree on a goal defined in terms of a positive outcome of wanted behaviour, while self‐monitoring requires deliberate attention to the participant's own actions, as well as the conditions under which they occur, and their immediate and long‐term effects .…”

“…However, there has been a sharp increase in interventions to prevent weight gain and/or initiate weight loss among young adults since the most recent systematic reviews on weight gain prevention (end search date: June 2014) and weight reduction in this group (end search date: March 2008) . In particular, there has been a substantial increase in electronic health (eHealth) interventions (defined as use of information and communication technologies for health) in the last decade . For example, this includes the consortium of seven Early Adult Reduction of weight through LifestYle intervention (EARLY) trials from the United States .…”

Application and effectiveness of eHealth strategies for metabolic and bariatric surgery patients: A systematic review

“…Reviews in young adults have not reported such strong supportive findings. Willmott et al 9 found a limited evidence base for eHealth weight management interventions targeting young adults but this was largely due to weak study designs.…”