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eHealth interventions for reducing cardiovascular disease risk in men: A systematic review and meta-analysis
James McMahon1, David R Thompson1, Michaela C Pascoe2
1School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK.
Insights
eHealth interventions show promise in reducing cardiovascular disease (CVD) risk factors in men, improving metrics like BMI and blood pressure. However, adherence remains a challenge for these digital health tools.
Area of Science:
- Cardiovascular Health
- Digital Health Interventions
- Behavioral Science
Background:
- Men face a higher risk of cardiovascular disease (CVD) compared to women.
- Modifying behavioral risk factors is crucial for CVD prevention in men.
- Engaging men in behavior change interventions presents significant challenges, with limited gender-specific support available.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of eHealth interventions for reducing CVD risk factors specifically in men.
- To evaluate the impact of digital health strategies on men's cardiovascular health outcomes.
Main Methods:
- A comprehensive search of randomized controlled trials (RCTs) was conducted up to July 2020, with no date restrictions.
- Nine RCTs targeting at least two major CVD risk factors were identified and reviewed.
- Study quality varied, with several trials assessed as low or unclear risk of bias.
Main Results:
- eHealth interventions led to statistically significant improvements in Body Mass Index (BMI), body weight, waist circumference, and both systolic and diastolic blood pressure compared to control or printed materials.
- Modest improvements were observed in physical activity and dietary habits favoring the eHealth intervention group.
- Participant adherence to eHealth interventions was generally poor across the reviewed studies.
Conclusions:
- eHealth interventions demonstrate potential for reducing cardiovascular disease risk in adult men through promoting behavior change.
- Further research is needed to understand the relationship between specific intervention characteristics and their impact on outcomes.
- Addressing poor participant adherence is critical for optimizing the effectiveness of future eHealth CVD prevention programs for men.
Abstract:
Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. Although men often indicate a preference for gender-specific information and support, this rarely occurs. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Therefore, the aim of this systematic review and meta-analysis was to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. A search of published randomised controlled trials with no date restrictions up to July 2020 was conducted to identify those targeting at least two major CVD risk factors. Nine trials were identified and reviewed. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p=0.01), body weight (Z=-3.25, p=0.01), waist circumference (Z=-2.30, p=0.02) and systolic (Z=-3.57, p=0.01) and diastolic (Z=-3.56, p=0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.
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