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Wang JW, Zhu Z, Shuling Z, Fan J, Jin Y, Gao ZL, Chen WD, Li X. Effectiveness of mHealth App-Based Interventions for Increasing Physical Activity and Improving Physical Fitness in Children and Adolescents: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2024; 12:e51478. [PMID: 38687568 PMCID: PMC11094610 DOI: 10.2196/51478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/11/2024] [Accepted: 03/14/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has significantly reduced physical activity (PA) levels and increased sedentary behavior (SB), which can lead to worsening physical fitness (PF). Children and adolescents may benefit from mobile health (mHealth) apps to increase PA and improve PF. However, the effectiveness of mHealth app-based interventions and potential moderators in this population are not yet fully understood. OBJECTIVE This study aims to review and analyze the effectiveness of mHealth app-based interventions in promoting PA and improving PF and identify potential moderators of the efficacy of mHealth app-based interventions in children and adolescents. METHODS We searched for randomized controlled trials (RCTs) published in the PubMed, Web of Science, EBSCO, and Cochrane Library databases until December 25, 2023, to conduct this meta-analysis. We included articles with intervention groups that investigated the effects of mHealth-based apps on PA and PF among children and adolescents. Due to high heterogeneity, a meta-analysis was conducted using a random effects model. The Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias. Subgroup analysis and meta-regression analyses were performed to identify potential influences impacting effect sizes. RESULTS We included 28 RCTs with a total of 5643 participants. In general, the risk of bias of included studies was low. Our findings showed that mHealth app-based interventions significantly increased total PA (TPA; standardized mean difference [SMD] 0.29, 95% CI 0.13-0.45; P<.001), reduced SB (SMD -0.97, 95% CI -1.67 to -0.28; P=.006) and BMI (weighted mean difference -0.31 kg/m2, 95% CI -0.60 to -0.01 kg/m2; P=.12), and improved muscle strength (SMD 1.97, 95% CI 0.09-3.86; P=.04) and agility (SMD -0.35, 95% CI -0.61 to -0.10; P=.006). However, mHealth app-based interventions insignificantly affected moderate to vigorous PA (MVPA; SMD 0.11, 95% CI -0.04 to 0.25; P<.001), waist circumference (weighted mean difference 0.38 cm, 95% CI -1.28 to 2.04 cm; P=.65), muscular power (SMD 0.01, 95% CI -0.08 to 0.10; P=.81), cardiorespiratory fitness (SMD -0.20, 95% CI -0.45 to 0.05; P=.11), muscular endurance (SMD 0.47, 95% CI -0.08 to 1.02; P=.10), and flexibility (SMD 0.09, 95% CI -0.23 to 0.41; P=.58). Subgroup analyses and meta-regression showed that intervention duration was associated with TPA and MVPA, and age and types of intervention was associated with BMI. CONCLUSIONS Our meta-analysis suggests that mHealth app-based interventions may yield small-to-large beneficial effects on TPA, SB, BMI, agility, and muscle strength in children and adolescents. Furthermore, age and intervention duration may correlate with the higher effectiveness of mHealth app-based interventions. However, due to the limited number and quality of included studies, the aforementioned conclusions require validation through additional high-quality research. TRIAL REGISTRATION PROSPERO CRD42023426532; https://tinyurl.com/25jm4kmf.
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Affiliation(s)
- Jun-Wei Wang
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
- School of Sports Science, Beijing Sport University, Beijing, China
| | - Zhicheng Zhu
- Physical education institute, Xinyu University, Xinyu, China
| | - Zhang Shuling
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Jia Fan
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Yu Jin
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Zhan-Le Gao
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Wan-Di Chen
- Academic Administration, Chengdu Sport University, Chengdu, China
| | - Xue Li
- School of Sport Medicine and Health, Chengdu Sport University, Chengdu, China
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de Hosson M, De Groote K, Hecke AV, De Wolf D, Vandekerckhove K, Mosquera LM, Panzer J, Logghe K, Mels S, Demulier L, Campens L, Goossens E, De Backer J. Evaluation of a nurse-led multi-component transition program for adolescents with congenital heart disease. PATIENT EDUCATION AND COUNSELING 2024; 118:108028. [PMID: 37879284 DOI: 10.1016/j.pec.2023.108028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of the transition program for adolescents with congenital heart disease (CHD) 'Transition With a Heart' (TWAH) on disease-related knowledge, quality of life (QoL), transition experiences, and gaps in follow-up. METHODS A study with pre-posttest and control group (post-test) using consecutive sampling, including adolescents with moderate to severely complex CHD, without intellectual disability, aged≥ 12 y, and parents. After weighting, t-tests were performed. A multivariable regression analysis explored the outcomes' determinants. RESULTS In the intervention group, 28 adolescents and 25 parents were included, and 53 adolescents and 18 parents as controls. Adolescents' knowledge significantly increased after completing TWAH (from 59.8% to 75.7%;p < 0.01). Their knowledge was positively correlated with TWAH (β = +13.3;p < 0.01). Adolescents' transition experiences were also positively related to TWAH (general experience: β = +5.5;p < 0.01; transfer satisfaction: β = +0.8; p < 0.01). Adolescents' QoL was mainly determined by CHD complexity and not by TWAH. No one showed gaps in follow-up. TWAH was not associated with parents' transition experiences. CONCLUSION Implementing TWAH substantially improved adolescents' disease-related knowledge and transition experiences. PRACTICE IMPLICATIONS The results regarding transition experiences need to be confirmed by further research. The TWAH design with the person-tailored educational program, skills training, and the transition coordinator can be used in settings with other chronic diseases.
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Affiliation(s)
- Michèle de Hosson
- Ghent University Hospital, Department of Adult Congenital Heart Disease, Ghent, Belgium.
| | - Katya De Groote
- Ghent University Hospital, Department of Pedicatric Cardiology, Ghent, Belgium
| | - Ann Van Hecke
- Ghent University - Faculty of Medicine and Health Sciences - Department of Public Health and Primary Care - University Center for Nursing and Midwifery, Ghent, Belgium; Ghent University Hospital, Staff nursing department, Ghent, Belgium
| | - Daniël De Wolf
- Ghent University Hospital, Department of Pedicatric Cardiology, Ghent, Belgium
| | | | | | - Joseph Panzer
- Ghent University Hospital, Department of Pedicatric Cardiology, Ghent, Belgium
| | - Karen Logghe
- Ghent University Hospital, Department of Pedicatric Cardiology, Ghent, Belgium
| | - Saskia Mels
- Ghent University Hospital, Department of Pediatric Psychology, Ghent, Belgium
| | - Laurent Demulier
- Ghent University Hospital, Department of Adult Congenital Heart Disease, Ghent, Belgium
| | - Laurence Campens
- Ghent University Hospital, Department of Adult Congenital Heart Disease, Ghent, Belgium
| | - Eva Goossens
- University of Antwerp - Centre for Research and Innovation in Care (CRIC), Department of Nursing and Midwifery Sciences, Antwerp, Belgium; KU Leuven - Department of Public Health and Primary Care, Leuven, Belgium
| | - Julie De Backer
- Ghent University Hospital, Department of Adult Congenital Heart Disease, Ghent, Belgium
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Venna A, Deshpande S, Downing T, John A, d'Udekem Y. Are dynamic measurements of central venous pressure in Fontan circulation during exercise or volume loading superior to resting measurements? Cardiol Young 2023:1-12. [PMID: 37981897 DOI: 10.1017/s1047951123003797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND The main objective measure to assess the health of the Fontan circulation is the pressure measurement of the superior vena cava or pulmonary arteries. We reviewed the literature for benefits of measuring resting pressure in the Fontan circuit and explored whether dynamic measurement by volume loading or exercise has the potential to refine this diagnostic tool. METHODS PubMed was searched for articles showing a relationship between resting post-operative central venous pressure or pulmonary artery pressure and Fontan failure. Relationships between post-operative central venous pressure or pulmonary artery pressure and volume loading changes, such as during exercise or volume loading during cardiac catheterization, were also queried. RESULTS A total of 44 articles mentioned relationships between resting central venous pressure or pulmonary artery pressure and Fontan failure. Only 26 included an analysis between the variables and only seven of those articles found pressure to be predictive of Fontan failure. Ten articles examined the relationship between exercise or volume loading and outcomes and demonstrated a large individual variation of pressures under these dynamic conditions. CONCLUSIONS Based on current literature, there is not a lot of strong evidence to show that elevated resting central venous pressure or pulmonary artery pressure is predictive of Fontan failure. Some individuals experience dramatic increases in central venous pressure or pulmonary artery pressure under increased loading conditions with exercise or bolus fluid infusion, while others experience increases closer to that of a healthy control population. Further studies are needed to examine whether more dynamic and continuous monitoring of systemic venous pressures might better predict outcomes in patients with Fontan circulation.
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Affiliation(s)
- Alyssia Venna
- Division of Cardiac Surgery, Children's National Hospital, Washington, DC, USA
| | | | - Tacy Downing
- Division of Cardiology, Children's National Health System, Washington, DC, USA
| | - Anitha John
- Division of Cardiology, Children's National Health System, Washington, DC, USA
| | - Yves d'Udekem
- Division of Cardiac Surgery, Children's National Hospital, Washington, DC, USA
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Su JJ, Liu JYW, Cheung DSK, Wang S, Christensen M, Kor PPK, Tyrovolas S, Leung AYM. Long-term effects of e-Health secondary prevention on cardiovascular health: a systematic review and meta-analysis. Eur J Cardiovasc Nurs 2023; 22:562-574. [PMID: 36695341 DOI: 10.1093/eurjcn/zvac116] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/06/2022] [Accepted: 12/08/2023] [Indexed: 01/26/2023]
Abstract
AIMS Despite the well-documented short-to-medium-term effectiveness of e-Health (electronic health) secondary prevention interventions on patients with cardiovascular disease (CVD), there is limited empirical evidence regarding long-term effectiveness. This review aims to evaluate the long-term effects of e-Health secondary prevention interventions on the health outcomes of patients with CVD. METHODS AND RESULTS This systematic review and meta-analysis followed Cochrane Handbook for Systematic Reviews of Interventions. EMBASE, Medline, Web of Science, and Scopus were searched from 1990 to May 2022. Randomized controlled trials investigating the effects of e-Health secondary prevention on health outcomes of CVD patients that collected endpoint data at ≥ 12 months were included. RevMan 5.3 was used for risk of bias assessment and meta-analysis. Ten trials with 1559 participants were included. Data pooling suggested that e-Health programmes have significantly reduced LDL cholesterol [n = 6; SMD = -0.26, 95% confidence interval (CI): (-0.38, -0.14), I2 = 17%, P < 0.001]; systolic blood pressure [n = 5; SMD = -0.46, 95% CI: (-0.84, -0.08), I2 = 90%, P = 0.02]; and re-hospitalization, reoccurrence, and mortality [risk ratio = 0.36, 95% CI: (0.17, 0.77), I2 = 0%, P = 0.009]. Effects on behavioural modification, physiological outcomes of body weight and blood glucose, and quality of life were inconclusive. CONCLUSION e-Health secondary prevention is effective in improving long-term management of risk factors and reducing the reoccurrence of cardiac events in patients with CVD. Results are inconclusive for behaviour modification and quality of life. Exploring, implementing, and strengthening strategies in e-Health secondary prevention programmes that focus on maintaining behaviour changes and enhancing psychosocial elements should be undertaken. REGISTRATION PROSPERO CRD42022300551.
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Affiliation(s)
- Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- World Health Organization for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR 999077, China
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR 999077, China
| | - Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- World Health Organization for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Martin Christensen
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Patrick Pui Kin Kor
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- World Health Organization for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
| | - Stefanos Tyrovolas
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- World Health Organization for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain
| | - Angela Yee Man Leung
- School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon 999077, Hong Kong
- World Health Organization for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Hong Kong SAR 999077, China
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Zhang S, Xu X, Yu M, Wang M, Jin P. Efficacy and Safety of Minimally Invasive Transcatheter Closure of Congenital Heart Disease under the Guidance of Transesophageal Ultrasound: A Randomized Controlled Trial. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2969979. [PMID: 35872962 PMCID: PMC9303110 DOI: 10.1155/2022/2969979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Abstract
Objective To investigate the efficacy of minimally invasive transcatheter closure of congenital heart disease (CHD) under the guidance of transesophageal ultrasound. Methods A total of 100 patients with CHD treated in our hospital from February 2019 to April 2020 were enrolled in the group. The patients were randomly divided into control group and research group. The control group received minimally invasive transcatheter closure under the guidance of X-ray, and the research group received minimally invasive transcatheter closure under the guidance of transesophageal ultrasound. The operative results, the intraoperative- and postoperative-related indexes, and the incidence of early postoperative complications and follow-up results were compared. Results First of all, we compared the results of the two groups: 48 cases of success, 2 cases of difficulty in the research group, 35 cases of success, 11 cases of difficulty, and 4 cases of failure in the control group. The success rate in the research group was higher than that in the control group (P < 0.05). Secondly, we compare the relevant indicators in the process of operation. The operation time, cardiopulmonary bypass time, upper and lower cavity obstruction time, and blood transfusion volume in the research group were lower than those in the control group (P < 0.05). In terms of postoperative-related indexes, the ventilator-assisted time, 24 h postoperative drainage, ICU time, and postoperative hospital stay in the research group were all lower than those in the control group (P < 0.05). The incidence of early postoperative complications in the research group was significantly lower than that in the control group such as secondary pleural hemostasis, pulmonary infection, pleural effusion, subcutaneous emphysema, poor incision healing, phrenic nerve loss, and right lower limb numbness (P < 0.05). All patients were followed up for 6 months, and the cardiac function of both groups returned to normal. There was no significant difference in the incidence of postoperative residual shunt and new tricuspid regurgitation. There was no significant difference in the data (P > 0.05). Considering abnormal ECG events, the incidence of abnormal ECG events (complete right bundle branch block, incomplete right bundle branch block, second- and third-degree block, left anterior branch block) in the research group was significantly lower than that in the control group (P < 0.05). Conclusion Minimally invasive transcatheter closure of CHD under the guidance of transesophageal ultrasound has the advantages of less trauma, less blood loss, short hospital stay, simple operation, less postoperative complications, and remarkable therapeutic effect. Minimally invasive transcatheter closure under the guidance of transesophageal ultrasound has the advantage of adapting to a wide range of syndromes and can be used for the closure of CHD in children. According to different types of CHD, registering the corresponding occlusive pathway can improve the success rate of operation. Through postoperative reexamination and regular follow-up, it is proved that minimally invasive transcatheter closure under the guidance of transesophageal ultrasound is safe, effective, and feasible.
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Affiliation(s)
- Shuangyin Zhang
- Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Xu Xu
- Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Min Yu
- Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Min Wang
- Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou 730030, China
| | - Ping Jin
- Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou 730030, China
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