E化健康管理對青少年體重控制成效探討－－系統性文獻回顧

The Efficacy of E-Health Management on Weight Control in Adolescents: A Systematic Review

背景：E化健康管理已成為現今便利的慢性病管理模式，陸續有學者以實證研究探討E化健康管理應用在體重控制之成效，但目前應用E化健康管理於青少年體重控制仍有待實證性探討。目的：透過系統性文獻回顧，統整E化健康管理運用於青少年體重控制之成效。方法：搜尋六個電子資料庫，年份自1995年至2013年4月，依納入及排除條件篩選後，以modified Jadadscale評價文獻品質。結果：共有七篇文獻符合篩選標準，共有3,728位青少年及1,394位父母參與。研究對象大多是體重過重青少女，平均年齡自12.52（SD = 3.15）至15.31（SD = 0.69）歲。研究結果呈現E化健康管理可顯著降低BMI（body mass index）及體脂肪，其中四篇顯示可顯著提升身體活動知識及技巧，但在飲食控制成效呈現差異性。結論／實務應用：E化健康管理介入對青少年體重控制有顯著效果，但網站登錄次數與主要結果指標成效較分歧。未來研究應考量運用激勵措施、增加警示提醒系統或其他策略提升網站使用率，並針對青少年特質，量身打造網路介入工具，建置合適的照護模式。

Background: Advances during the past decade have made it feasible to apply e-health methods to chronic disease management. Researchers have recently begun applying these methods to weight control. The application of e-health management methods to weight control in adolescents has yet to be investigated empirically.Purpose: This study conducted a systematic review of reports discussing the weight-control effects of e-health management in adolescents.Method: Researchers searched 6 electronic databases for relevant articles published between 1995 and April 2013. Data were collected using inclusion and exclusion criteria. A modified Jadad Scale was used to evaluate the quality of the identified articles.Results: Seven studies met the inclusion criterion of targeting adolescent subject populations. A total of 3728 adolescents and 1394 parents participated in these studies. The majority of participants were overweight girls and median participant ages ranged from 12.52 (SD = 3.15) to 15.31 (SD = 0.69). All studies reported that e-health management reduced body mass index and body fat percentage. Four studies indicate that e-health management may improve physical activity knowledge and skills. However, diet control outcomes among the seven studies varied.Conclusion: Empirical results demonstrate that e-health management significantly affects weight control. However, the effectiveness of log-in versus primary outcome indicators was inconclusive. Future studies should consider the use of incentives, reminder systems, and other strategies to enhance website usage. The development of an Internet-based, computer-tailored weight-management intervention for overweight adolescents and the development of an appropriate care model are recommended.