Abstract
BackgroundPromoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries.MethodsMajor databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies.ResultsA total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets.ConclusionsThe majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers.Trial registrationThe review protocol can be retrieved from the PROSPERO database (Registration ID: CRD42015029240).Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0434-2) contains supplementary material, which is available to authorized users.
Highlights
Promoting physical activity and healthy eating is important to combat the unprecedented rise in Non-communicable disease (NCD) in many developing countries
In 2012, about 38 million global deaths were attributed to non-communicable diseases (NCDs) such as diabetes, cardiovascular diseases and cancer, and it is expected that NCD death rates will increase further, reaching 52 million by 2030
A 25 % reduction in physical inactivity is estimated to prevent about 1.3 million NCD-related deaths annually [9] while a healthy diet and increased physical activity can prevent a significant proportion of the 18 million deaths caused by high blood pressure, high body mass index, high fasting blood glucose and high total cholesterol [10]
Summary
Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries. There is extensive evidence on the preventive effects of regular physical activity and healthy eating on the risk of developing a NCD [7, 8]. A 25 % reduction in physical inactivity is estimated to prevent about 1.3 million NCD-related deaths annually [9] while a healthy diet and increased physical activity can prevent a significant proportion of the 18 million deaths caused by high blood pressure, high body mass index, high fasting blood glucose and high total cholesterol [10]. Decreasing physical activity levels were observed in most Asian [15, 16], Latin-and South American [17–19] and some African countries [13, 20] as urbanization increased
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