Effectiveness of eHealth Interventions on Moderate-to-Vigorous Intensity Physical Activity Among Patients in Cardiac Rehabilitation: Systematic Review and Meta-analysis.

BACKGROUND: Cardiac rehabilitation is a class IA recommendation for patients with cardiovascular diseases. Physical activity is the core component and core competency of a cardiac rehabilitation program. However, many patients with cardiovascular diseases are failing to meet cardiac rehabilitation guidelines that recommend moderate-to-vigorous intensity physical activity. OBJECTIVE: The major objective of this study was to review the evidence of the effectiveness of eHealth interventions in increasing moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation. The secondary objective was to examine the effectiveness of eHealth interventions in improving cardiovascular-related outcomes, that is, cardiorespiratory fitness, waist circumference, and systolic blood pressure. METHODS: A comprehensive search strategy was developed, and a systematic search of 4 electronic databases (PubMed, Web of Science, Embase, and Cochrane Library) was conducted for papers published from the start of the creation of the database until November 27, 2022. Experimental studies reporting on eHealth interventions designed to increase moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation were included. Multiple unblinded reviewers determined the study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Collaboration Tool for randomized controlled trials and the Cochrane Effective Practice and Organization of Care group methods for nonrandomized controlled trials. A random-effect model was used to provide the summary measures of effect (ie, standardized mean difference and 95% CI). All statistical analyses were performed using Stata 17. RESULTS: We screened 3636 studies, but only 29 studies were included in the final review, of which 18 were included in the meta-analysis. The meta-analysis demonstrated that eHealth interventions improved moderate-to-vigorous intensity physical activity (standardized mean difference=0.18, 95% CI 0.07-0.28; P=.001) and vigorous-intensity physical activity (standardized mean difference=0.2, 95% CI 0.00-0.39; P=.048) but did not improve moderate-intensity physical activity (standardized mean difference=0.19, 95% CI -0.12 to 0.51; P=.23). No changes were observed in the cardiovascular-related outcomes. Post hoc subgroup analyses identified that wearable-based, web-based, and communication-based eHealth intervention delivery methods were effective. CONCLUSIONS: eHealth interventions are effective at increasing minutes per week of moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation. There was no difference in the effectiveness of the major eHealth intervention delivery methods, thereby providing evidence that in the future, health care professionals and researchers can personalize convenient and affordable interventions tailored to patient characteristics and needs to eliminate the inconvenience of visiting center-based cardiac rehabilitation programs during the COVID-19 pandemic and to provide better support for home-based maintenance of cardiac rehabilitation. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021278029; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=278029.

A comparative analysis on risk communication between international and Chinese literature from the perspective of knowledge domain visualization.

BACKGROUND: The outbreak of coronavirus disease (COVID-19) severely damaged and endangered people's lives at the end of 2019. Risk communication plays an important role in the response to it successfully, which has been appreciated by the World Health Organization. Therefore, a comprehensive analysis of risk communication research is necessary, which can understand current research hotspots and reveal new trends. METHODS: In this study, we collected 1134 international articles from the Web of Science database and 3983 Chinese articles from the China National Knowledge Infrastructure database. Bibliometric and mapping knowledge domain analysis methods were used for temporal distribution analysis, cooperation network analysis, co-word network analysis, and burst detection analysis. RESULTS: The first article in this field was published by western scholars earlier, while the first Chinese article in 2002. Research institutions mainly come from universities. The USA plays a key role in this field. Chinese scholars had a closer cooperation network, but there was less cooperation among domestic institutions. Risk perception, trust, risk management, and risk information had always been the research hotspots in this academic. Trust, sentiment research, and public risk events were essential directions for the future. There are 25 burst words for international articles, while 11 burst words for Chinese articles from 2000 to 2020. CONCLUSIONS: In summary, both domestic and international researchers are concerned about risk communication, risk perception, trust, and risk information. International research on risk communication is systematic and comprehensive relatively. However, Chinese scholars take severe acute respiratory syndrome as the research background and reviewing foreign knowledge as the research starting point. With the purpose of practical and applied research based on a public emergency, the risk communication research lacks continuity in Chinese academy in the past years.