基于网络干预与非基于网络干预的有效性比较[j]行为改变结果的meta分析%A Wantland,Dean J %A Portillo,Carmen J %A Holzemer,William L %A Slaughter,Rob %A McGhee,Eva M %+社区卫生系统系，加州大学旧金山分校，N531M，护理学院，San Francisco CA 94143, USA， +1 415 613 4107, dwantlan@itsa.ucsf.edu %K基于网络干预%K非基于网络干预%K基于网络治疗背景:慢性疾病自我保健干预的一个主要重点是鼓励个体的行为改变，这需要知识共享、教育和对病情的理解。利用互联网向患者提供基于网络的干预措施的情况正在迅速增加。在1996年至2003年的7年间，“基于网络的疗法”在MEDLINE上的引用量增加了12倍。与非基于网络的干预措施相比，基于网络的干预措施鼓励个人改变行为的使用和有效性尚未得到实质性的审查。目的:本荟萃分析旨在提供基于网络干预后患者/客户知识和行为改变结果的进一步信息，并与实施非基于网络干预后的结果进行比较。方法:检索MEDLINE、CINAHL、Cochrane Library、EMBASE、ERIC和PSYCHInfo数据库1996 ~ 2003年的相关文献。根据既定的质量标准和纳入/排除标准，检索、审查和评估确定的文章。22篇文章被认为适合本研究，并被选中进行分析。 Effect sizes were calculated to ascertain a standardized difference between the intervention (Web-based) and control (non-Web-based) groups by applying the appropriate meta-analytic technique. Homogeneity analysis, forest plot review, and sensitivity analyses were performed to ascertain the comparability of the studies. Results: Aggregation of participant data revealed a total of 11,754 participants (5,841 women and 5,729 men). The average age of participants was 41.5 years. In those studies reporting attrition rates, the average drop out rate was 21% for both the intervention and control groups. For the five Web-based studies that reported usage statistics, time spent/session/person ranged from 4.5 to 45 minutes. Session logons/person/week ranged from 2.6 logons/person over 32 weeks to 1008 logons/person over 36 weeks. The intervention designs included one-time Web-participant health outcome studies compared to non-Web participant health outcomes, self-paced interventions, and longitudinal, repeated measure intervention studies. Longitudinal studies ranged from 3 weeks to 78 weeks in duration. The effect sizes for the studied outcomes ranged from -.01 to .75. Broad variability in the focus of the studied outcomes precluded the calculation of an overall effect size for the compared outcome variables in the Web-based compared to the non-Web-based interventions. Homogeneity statistic estimation also revealed widely differing study parameters (Qw16 = 49.993, P ≤ .001). There was no significant difference between study length and effect size. Sixteen of the 17 studied effect outcomes revealed improved knowledge and/or improved behavioral outcomes for participants using the Web-based interventions. Five studies provided group information to compare the validity of Web-based vs. non-Web-based instruments using one-time cross-sectional studies. These studies revealed effect sizes ranging from -.25 to +.29. Homogeneity statistic estimation again revealed widely differing study parameters (Qw4 = 18.238, P ≤ .001). Conclusions: The effect size comparisons in the use of Web-based interventions compared to non-Web-based interventions showed an improvement in outcomes for individuals using Web-based interventions to achieve the specified knowledge and/or behavior change for the studied outcome variables. These outcomes included increased exercise time, increased knowledge of nutritional status, increased knowledge of asthma treatment, increased participation in healthcare, slower health decline, improved body shape perception, and 18-month weight loss maintenance. %M 15631964 %R 10.2196/jmir.6.4.e40 %U //www.mybigtv.com/2004/4/e40/ %U https://doi.org/10.2196/jmir.6.4.e40 %U http://www.ncbi.nlm.nih.gov/pubmed/15631964