Background: Noncommunicable diseases (NCDs) are associated with the burden of premature deaths and huge medical costs globally. There is an increasing number of studies combining a multiple health behavior change (MHBC) intervention paradigm with eHealth approaches to jointly promote weight-related health behaviors among people with NCD; yet, a comprehensive summary of these studies is lacking. Objective: This review aims to meta-analyze the effectiveness and systematically summarize the characteristics of the relevant intervention studies for improving the outcomes of physical activity, healthy diet, and weight among people with NCD. Methods: Following PRISMA guidelines, 4 electronic databases (PsycINFO, PubMed, Scopus, SPORTDiscus) were systematically searched to identify eligible articles based on a series of inclusion and exclusion criteria. Article selection, quality assessment, and data extraction were independently performed by 2 authors. The standardized mean difference (SMD) was calculated to evaluate the effectiveness of interventions for 3 intervention outcomes (physical activity, healthy diet, and weight), and subsequent subgroup analyses were performed for gender, age, intervention duration, channel, and theory. Calculations were conducted, and figures were produced in SPSS 22 and Review Manager 5.3. Results: Of the 664 original hits generated by the systematic searches, 15 eligible studies with moderate to high quality were included. No potential publication bias was detected using statistical analyses. Studies varied in intervention channel, intensity, and content. The meta-analysis revealed that the eHealth MHBC interventions significantly promoted physical activity (SMD 0.85, 95% CI 0.23 to 1.47, P=.008) and healthy diet (SMD 0.78, 95% CI 0.13 to 1.43, P=.02), but did not contribute to a healthy weight status (SMD –0.13, 95% CI= –0.47 to 0.20, P=.43) among people with NCDs, compared to the control conditions. Results from subgroup analysis indicated that theory-based interventions achieved greater effect than nontheory-based interventions in promoting physical activity, and interventions with traditional approaches (SMS, telephone) were more effective than those with modern internet-based approaches in promoting healthy diet. Conclusions: The results of this review indicates that eHealth MHBC interventions achieve preliminary success in promoting physical activity and healthy diet behaviors among people with NCD. Future studies could improve the intervention design to achieve better intervention effectiveness. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019118629; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=118629

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中文翻译：

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基于电子卫生保健的多种健康行为改变干预措施对非传染性疾病患者身体活动，健康饮食和体重的影响：系统评价和荟萃分析

背景：非传染性疾病（NCD）与全球过早死亡的负担和巨大的医疗费用相关。越来越多的研究将多种健康行为改变（MHBC）干预范例与eHealth方法结合起来，共同在NCD患者中促进体重相关的健康行为。然而，这些研究缺乏全面的总结。目的：本综述旨在荟萃分析有效性，并系统总结相关干预研究的特征，以改善非传染性疾病患者的体育锻炼，健康饮食和体重的结局。方法：按照PRISMA指南，系统地搜索了4个电子数据库（PsycINFO，PubMed，Scopus，SPORTDiscus），以根据一系列纳入和排除标准来鉴定合格的文章。文章的选择，质量评估和数据提取均由2位作者独立完成。计算标准均值差（SMD）以评估3种干预结果（体力活动，健康饮食和体重）的干预效果，然后对性别，年龄，干预时间，渠道和理论进行亚组分析。进行了计算，并在SPSS 22和Review Manager 5.3中生成了数字。结果：在系统搜索产生的664个原始匹配中，包括了15项中到高质量的合格研究。使用统计分析未检测到潜在的出版偏倚。研究的干预渠道，强度和内容各不相同。荟萃分析显示，eHealth MHBC干预措施显着促进了体育锻炼（SMD 0.85，95％CI 0.23至1.47，P = .008）和健康饮食（SMD 0.78，95％CI 0.13至1.43，P = .02），但与对照组相比，NCD患者没有健康的体重状况（SMD –0.13，95％CI = –0.47至0.20，P = .43）。亚组分析的结果表明，基于理论的干预在促进身体活动方面比基于非理论的干预效果更大，而采用传统方法（SMS，电话）的干预比基于互联网的现代方法在促进健康饮食方面的效果更好。结论：审查的结果表明，eHealth MHBC干预措施在促进非传染性疾病患者的体育锻炼和健康饮食行为方面取得了初步成功。未来的研究可能会改善干预设计，以达到更好的干预效果。试用注册：PROSPERO国际系统评价前瞻性注册CRD42019118629；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=118629

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