Computer-tailored weight reduction interventions targeting adults: a narrative systematic review.

ISSUE ADDRESSED: Potentially modifiable risk factors such as high body mass, physical inactivity and poor nutrition are, when combined, the largest contributors to the preventable burden of disease in Australia. Computer-tailoring has shown promise in modifying lifestyle risk factors. This paper describes a narrative systematic review examining the evidence for 'second' generation computer-tailored primary prevention weight reduction interventions. METHOD: Studies published from January 1996-2008 were identified through electronic databases and searches of reference lists of relevant articles. Only randomised controlled trials or quasi-experimental designs with pretest and post-test weight reduction outcome data were included. RESULTS: Six articles were identified, three of which reported significant positive effects. The intervention intensity and duration, method of tailoring and theory used differed. The internal validity was good but external validity poor for the majority of studies. CONCLUSIONS: The evidence of effectiveness for computer-tailored primary prevention interventions for weight reduction is limited to a small number of heterogeneous studies. There is uncertainty whether reported effects are generalisable and sustained. The relative success of different components of efficacious interventions and the optimal intervention intensity and tailoring methods are unclear.

Computer-tailored dietary behaviour change interventions: a systematic review.

Improving dietary behaviours such as increasing fruit and vegetable consumption and reducing saturated fat intake are important in the promotion of better health. Computer tailoring has shown promise as a strategy to promote such behaviours. A narrative systematic review was conducted to describe the available evidence on 'second'-generation computer-tailored primary prevention interventions for dietary behaviour change and to determine their effectiveness and key characteristics of success. Systematic literature searches were conducted through five databases: Medline, Embase, PsycINFO, CINAHL and All EBM Reviews and by examining the reference lists of relevant articles to identify studies published in English from January 1996 to 2008. Randomized controlled trials or quasi-experimental designs with pre-test and post-test behavioural outcome data were included. A total of 13 articles were reviewed, describing the evaluation of 12 interventions, seven of which found significant positive effects of the computer-tailored interventions for dietary behaviour outcomes, one also for weight reduction outcomes. Although the evidence of short-term efficacy for computer-tailored dietary behaviour change interventions is fairly strong, the uncertainty lies in whether the reported effects are generalizable and sustained long term. Further research is required to address these limitations of the evidence.

Rapid versus intermediate health impact assessment of foreshore development plans.

OBJECTIVE: To describe the main differences between conducting a rapid health impact assessment (HIA) and an intermediate HIA on foreshore development plans and their feasibility from a health service perspective. METHODS: A rapid HIA and an intermediate HIA were undertaken on two foreshore development plans. RESULTS: The main differences between the two HIAs were in the identification, assessment and decision-making stages of the HIA. CONCLUSION: While the rapid HIA was less resource intensive than the intermediate HIA, there are several factors that affect the feasibility of conducting this type of HIA within a short time period.