护理SCI晨读:mHealth干预对成年初期性健康和生殖健康的影响:随机对照试验的系统评价和荟萃分析
mHealth干预对新兴成人期性健康和生殖健康的影响:随机对照试验的系统评价和荟萃分析
分享智慧
共同成长
摘要
背景
年轻人的性健康和生殖健康是国际关注的焦点,人们对健康的怀孕和分娩越来越感兴趣。mHealth干预措施涉及使用移动技术提供健康支持,在临床护理实践中得到广泛应用,并且在成年初期传播与性健康和生殖健康相关的信息方面发挥着越来越重要的作用。但是,缺乏关于移动医疗干预计划效果的证据。
目标
这项荟萃分析系统地评估了mHealth干预措施在成年初期对避孕药具使用和妊娠发生的影响,从而确定了成功的mHealth干预计划的特征。
设计
我们对随机对照试验进行了系统的回顾和荟萃分析。
数据源
检索了四个电子数据库(PubMed,Embase,CINAHL和Cochrane图书馆),查找从建库到2020年5月相关文章。
审查方法
数据提取和质量评估由两名审核员独立进行。选择了11篇有关mHealth干预措施对新兴成年人性健康和生殖健康影响的论文。使用偏倚风险2(RoB 2)工具评估了纳入研究的偏倚风险。使用STATA 16.0进行总体和亚组荟萃分析。使用I 2计算研究中的异质性。
结果
我们测试了mHealth干预措施对避孕药具使用和怀孕发生的影响,以确定性健康和生殖健康的影响。 尽管对怀孕发生的影响不显著(OR 0.80,95%CI:0.61-1.05,I 2 = 0.0%,p = 0.950。),mHealth干预措施改善了避孕方法的使用(OR 1.21;95%CI:1.02-1.43,I 2 = 20.7%;p = 0.234)。在亚组分析中,mHealth干预措施尤其改善了口服避孕药的使用(OR 1.43,95%CI:1.15-1.77,I 2 = 0.0%,p = 0.784)。在交流类型方面,实验组的mHealth干预显示双向交流具有统计学意义(OR 1.28,95%CI:1.06-1.54,I 2 = 0.0%,p = 0.872)。
结论
这项荟萃分析发现,mHealth干预对避孕有积极作用,而对怀孕发生的影响是有限的。我们还从我们的审查结果中确认了有效的mHealth干预的潜在因素。我们的研究结果表明,mHealth干预可能被建议为促进成年初期性健康和生殖健康的有用策略。
Abstract
Background
Sexual and reproductive health of young people is an international concern with the increasing interest in healthy pregnancy and childbirth. mHealth interventions involve the use of mobile technologies for health support, have wide applications in clinical nursing practice, and play an increasingly important role in disseminating sexual and reproductive health-related information in emerging adulthood. However, there is a lack of evidence on the effects of mHealth intervention programs.
Objectives
This meta-analysis systematically assessed the effects of mHealth interventions on contraceptive use and pregnancy occurrence in emerging adulthood to identify the characteristics of a successful mHealth intervention program.
Design
We conducted a systematic review and meta-analysis of randomized controlled trials.
Data sources
Four central electronic databases (PubMed, Embase, CINAHL complete, and the Cochrane Library) were searched for relevant articles published from inception to May 2020.
Review methods
Data extraction and quality appraisal were performed independently by two reviewers. Eleven papers on the effects of mHealth interventions on sexual and reproductive health in emerging adulthood were selected. The included studies were assessed for the risk of bias with the Risk of Bias 2 (RoB 2) tool. Overall and subgroup meta-analyses were conducted using STATA 16.0. Heterogeneity within studies was calculated using I2.
Results
We tested the effect of mHealth interventions on contraceptive use and pregnancy occurrence to identify the impact of sexual and reproductive health. mHealth interventions improved the use of contraception (OR 1.21; 95% CI: 1.02–1.43, I2 = 20.7%; p = 0.234) although the effect on pregnancy occurrence was not significant (OR 0.80, 95% CI: 0.61–1.05, I2 = 0.0%, p = 0.950). In subgroup analysis, mHealth interventions especially improved oral contraceptive use (OR 1.43, 95% CI: 1.15–1.77, I2 = 0.0%, p = 0.784). Regarding the communication type, two-way communication showed statistically significant results with the mHealth intervention in the experimental group (OR 1.28, 95% CI: 1.06–1.54, I2 = 0.0%, p = 0.872).
Conclusion
This meta-analysis found a positive effect of mHealth intervention on contraception, whereas the impact on pregnancy occurrences was limited. We also confirmed the factors underlying effective mHealth interventions from the results of our review. Our findings demonstrate that mHealth interventions may be suggested as a useful strategy to promote sexual and reproductive health in emerging adulthood.
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