wow-inequalities/02-data/intermediate/wos_sample/25af938cfa4cf0fa921ef5ae68500484-harris-j.-and-felix/info.yaml

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abstract: 'Background: UK public health policy strongly advocates dietary change
for the improvement of population health and emphasises the importance
of individual empowerment to improve health. A new and evolving area in
the promotion of dietary behavioural change is `e-learning'', the use of
interactive electronic media to facilitate teaching and learning on a
range of issues including health. The high level of accessibility,
combined with emerging advances in computer processing power, data
transmission and data storage, makes interactive e-learning a
potentially powerful and cost-effective medium for improving dietary
behaviour.
Objective: This review aims to assess the effectiveness and
cost-effectiveness of adaptive e-learning interventions for dietary
behaviour change, and also to explore potential psychological mechanisms
of action and components of effective interventions.
Data sources: Electronic bibliographic databases (Cumulative Index to
Nursing and Allied Health Literature, The Cochrane Library, Dissertation
Abstracts, EMBASE, Education Resources Information Center, Global
Health, Health Economic Evaluations Database, Health Management
Information Consortium, MEDLINE, PsycINFO and Web of Science) were
searched for the period January 1990 to November 2009. Reference lists
of included studies and previous reviews were also screened; authors
were contacted and trial registers were searched.
Review methods: Studies were included if they were randomised controlled
trials, involving participants aged >= 13 years, which evaluated the
effectiveness of interactive software programs for improving dietary
behaviour. Primary outcomes were measures of dietary behaviours,
including estimated intakes or changes in intake of energy, nutrients,
dietary fibre, foods or food groups. Secondary outcome measures were
clinical outcomes such as anthropometry or blood biochemistry.
Psychological mediators of dietary behaviour change were also
investigated. Two review authors independently screened results and
extracted data from included studies, with any discrepancies settled by
a third author. Where studies reported the same outcome, the results
were pooled using a random-effects model, with weighted mean differences
(WMDs), and 95\% confidence intervals (CIs) were calculated.
Cost-effectiveness was assessed in two ways: through a systematic
literature review and by building a de novo decision model to assess the
cost-effectiveness of a `generic'' e-learning device compared with
dietary advice delivered by a health-care professional.
Results: A total of 36,379 titles were initially identified by the
electronic searches, of which 43 studies were eligible for inclusion in
the review. All e-learning interventions were delivered in high-income
countries. The most commonly used behavioural change techniques reported
to have been used were goal setting; feedback on performance;
information on consequences of behaviour in general; barrier
identification/problem solving; prompting self-monitoring of behaviour;
and instruction on how to perform the behaviour. There was substantial
heterogeneity in the estimates of effect. E-learning interventions were
associated with a WMD of +0.24 (95\% CI 0.04 to 0.44) servings of fruit
and vegetables per day; -0.78g (95\% CI -2.5g to 0.95g) total fat
consumed per day; -0.24g (95\% CI -1.44g to 0.96g) saturated fat intake
per day; -1.4\% (95\% CI -2.5\% to -0.3\%) of total energy consumed from
fat per day; +1.45g (95\% CI -0.02g to 2.92g) dietary fibre per day; +4
kcal (95\% CI -85 kcal to 93 kcal) daily energy intake; -0.1 kg/m(2)
(95\% CI -0.7 kg/m(2) to 0.4 kg/m(2)) change in body mass index. The
base-case results from the E-Learning Economic Evaluation Model
suggested that the incremental cost-effectiveness ratio was
approximately 102,112 per quality-adjusted life-year (QALY). Expected
value of perfect information (EVPI) analysis showed that although the
individual-level EVPI was arguably negligible, the population-level
value was between 37M pound and 170M pound at a willingness to pay of
20,000-30,000 pound per additional QALY.
Limitations: The limitations of this review include potential reporting
bias, incomplete retrieval of completed research studies and data
extraction errors.
Conclusion: The current clinical and economic evidence base suggests
that e-learning devices designed to promote dietary behaviour change
will not produce clinically significant changes in dietary behaviour and
are at least as expensive as other individual behaviour change
interventions.
Future work recommendations: Despite the relatively high EVPI results
from the cost-effectiveness modelling, further clinical trials of
individual e-learning interventions should not be undertaken until
theoretically informed work that addresses the question of which
characteristics of the target population, target behaviour, content and
delivery of the intervention are likely to lead to positive results, is
completed.'
affiliation: 'Edwards, P (Corresponding Author), London Sch Hyg \& Trop Med, Fac Epidemiol
\& Populat Hlth, London WC1, England.
Harris, J.; Felix, L.; Ferguson, E.; Free, C.; Edwards, P., London Sch Hyg \& Trop
Med, Fac Epidemiol \& Populat Hlth, London WC1, England.
Miners, A.; Lock, K., London Sch Hyg \& Trop Med, Fac Publ Hlth \& Policy, London
WC1, England.
Murray, E., UCL, Res Dept Primary Care \& Populat Hlth, London, England.
Michie, S., UCL, Res Dept Clin Educ \& Hlth Psychol, London, England.
Landon, J., Natl Heart Forum, London, England.'
author: Harris, J. and Felix, L. and Miners, A. and Murray, E. and Michie, S. and
Ferguson, E. and Free, C. and Lock, K. and Landon, J. and Edwards, P.
author_list:
- family: Harris
given: J.
- family: Felix
given: L.
- family: Miners
given: A.
- family: Murray
given: E.
- family: Michie
given: S.
- family: Ferguson
given: E.
- family: Free
given: C.
- family: Lock
given: K.
- family: Landon
given: J.
- family: Edwards
given: P.
da: '2023-09-28'
doi: 10.3310/hta15370
eissn: 2046-4924
files: []
issn: 1366-5278
journal: HEALTH TECHNOLOGY ASSESSMENT
keywords-plus: 'TAILORED NUTRITION INTERVENTION; FAT INTAKE INTERVENTION; REDUCING
RISK-FACTORS; PHYSICAL-ACTIVITY; RANDOMIZED-TRIAL; WEIGHT-LOSS;
VEGETABLE CONSUMPTION; CARDIOVASCULAR RISK; SMOKING-CESSATION;
SELF-EFFICACY'
language: English
month: OCT
number: '37'
number-of-cited-references: '122'
orcid-numbers: 'Michie, Susan/0000-0003-0063-6378
Edwards, Phil/0000-0003-4431-8822
Murray, Elizabeth/0000-0002-8932-3695
Harris, Jody/0000-0002-3369-1253
Felix, Lambert/0000-0001-6517-9089
Free, Caroline/0000-0003-1711-0006'
pages: 1+
papis_id: ebc10dbd9ee3d9e0fb30bb6cdb58f96e
ref: Harris2011adaptiveelearning
researcherid-numbers: 'Michie, Susan/A-1745-2010
'
times-cited: '56'
title: 'Adaptive e-learning to improve dietary behaviour: a systematic review and
cost-effectiveness analysis'
2023-10-01 08:15:07 +00:00
type: article
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unique-id: WOS:000300462800001
usage-count-last-180-days: '0'
usage-count-since-2013: '77'
volume: '15'
web-of-science-categories: Health Care Sciences \& Services
year: '2011'