Multidisciplinary management of obesity through digital-health: a scoping review.
Creators: name: Sosa Fernandez Del Campo, Sofia
name: Brito, Alex
name: Meyers, Guilherme
name: Fagherazzi, Guy
name: Leners, Bernadette
name: Schmitz, Susanne
name: Lefebvre, Bertrand
name: Bohn, Torsten
name: Samouda, Hanen
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Digital health
subject: Obesity digital management
subject: Obesity management
subject: Obesity multidisciplinary management

description: A scoping review will be conducted in order to summarise the available evidence on digital health and multidisciplinary management of obesity including overweight. Studies will be selected if the obesity management is based on nutrition education, promotion of regular physical activity and/or psychological support through digital health. The PRISMA-ScR checklist (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review) will be followed. - Hypotheses and objectives: Obesity is a multifactorial disease. Multidisciplinary approaches based on nutrition education, promotion of regular physical activity and/or psychological support provide an optimal management of obesity (1-4). As digital health enables people to manage their own health, digital health technologies might sustainably help to take charge of obesity (5, 6). The objective of the scoping review is to summarise the available evidence on multidisciplinary management of obesity through digital health, based on nutritional, exercise and/or psychological support. - Design Plan: +Study type: Scoping review. +Study design: Scoping review based on a systematic search of evidence. The evidence will include observational (i.e. cross-sectional, case-control studies and cohorts) and experimental (i.e. randomised controlled trials or non-randomised trials) studies. - Sampling Plan: +Existing Data: The present study corresponds to the first research conducted by our group in this domain. +Explanation of existing data: Understanding on the existing data has been limited to exploratory non-systematic searches of reviews and studies using PubMed. - Data collection procedures: +Eligibility criteria: Studies published in English since January 1st 2000 will be considered. Studies will be selected if they consider the management of obesity as a disease through digital health in humans. Eligible studies will have information on the multidisciplinary management of obesity, including overweight, through nutrition education, physical activity promotion and/or psychological support through digital health technologies. Original research will be eligible. Brief reports, reviews and commentaries will be considered as a potential source of references not found in our systematic search. The age range of inclusion will be between 6 and 64 years old: children (6-12 years), adolescents (13-18 years), adults (19-44 years) and people at middle age (45-64 years) having overweight or obesity. +Exclusion criteria: Children and adults with normal weight (without overweight or obesity), Children &lt; 6 years, Elderly people (≥ 65 years), Studies targeting the management of other chronic diseases than obesity as primary outcome (e.g. cardiovascular disease, diabetes, cancer, hypertension…). In these studies, obesity is not considered as a disease, but as a risk factor of the other chronic diseases, Pregnancy, Articles published languages other than English, “Grey” literature (reports, doctoral theses, conference contributions, book chapters, editorials), unless they will be used to identify potential references. - Systematic search: 1. An exhaustive systematic search of the literature will be performed through the following selected databases: +PubMed covering all records from Medline, as well as in-processing publications, + Scopus covering all records from PsycINFO and Web of Science, in addition to Medline records. + If needed we will contact colleagues working on the topic of interest to ask to them for potential relevant material. 2. Joanna Briggs Manual: The scoping review will be performed according to the Joanna Briggs Manual: + Identification of key words An initial limited search in 20 previously published papers will be performed. This will enable us to identify the main keywords and synonyms associated with the topic. These keywords will be extracted from the title, abstract and the main text of the selected articles. A snowball search will be performed, based on the references cited in the selected papers. The 20 most significant studies will be selected from the snowball search. A MeSH (Medical Subject Headings) terms search will also be conducted. + Execution of systematic search: The systematic final search will be conducted, in the selected databases, based on the combination of the selected keywords. The search strategy will have the following structure: “keywords for obesity” AND “keywords for digital health” AND “keywords for nutritional education OR promotion of physical activity OR psychological support”. The full electronic search strategy will be presented in the appendix of the final manuscript. + Data charting process: The open access online software CADIMA (JKI—Julius Kühn-Institut, vers. 2.1.3 - Feb 2020) will be used to conduct the systematic search. ++ Papers selection: The literature search will be uploaded from the PubMed and Scopus databases into the software CADIMA as a bibliographic citation file that will be registered in RIS (Research Information Systems) format. The search results will then be combined. The duplicated studies will be detected and eliminated. In order to select the papers that will be included in the scoping review, the recorded papers will be screened. The screening of the identified references will be performed at the level of the title, abstract and the full text. Two independent researchers will work on the pre-selection and selection of the studies and a third researcher will act as a mediator for agreement of the selection. The titles, abstracts and texts should mention the multidisciplinary management of obesity through digital health, based on nutrition education, promotion of regular physical activity and/or psychological support. ++The following selection criteria will be applied to define the eligibility of a study: Population: Human 6-64 years, having overweight or obesity, no pregnant. Intervention/Exposure: Digital technologies to manage obesity including overweight, based on a multidisciplinary approach including nutrition education, promotion of physical activity and/or psychological support. - Study Design: Observational studies (cross sectional studies, case-control, and cohorts) or interventional studies (randomized controlled trials and non-randomized controlled trials). A consistency check will be performed on a random sample of the selected references in order to assess the inter reviewer agreement, following the application of the selection criteria. -. Data extraction: The following information will be extracted from the selected papers: +Study information ++ Specific Objective of the study (feasibility, efficacy or efficiency) ++ Study design ++ Study location and country (school, workplace…) ++ Study duration (weeks) ++ Study / Weight management program's name ++ Type of digital health technology used (internet-based weight loss program, mobile application…) ++ Name of the digital health technology used (MyFitnessPal, Lose it!....) ++ Target population: Adults / Children / Parent-child dyad (yes, no) ++ Sample size ++ Gender (N, %) ++ Age (minimum, maximum) ++ Dropout (N, %) ++ Interventions: Nutritional education, physical activity, psychological support without and with digital health. + Study outcomes ++ Feasibility, efficacy and/or efficiency ++ Anthropometric, clinical, biological and nutrition-physical activity-psychology related outcomes. - Data presentation: The presentation of the data and the results will include the description of the study selection process through a flow diagram based on the PRISMA for scoping review checklist, as well as a bibliographic reference list for each database after elimination of the duplicates, the results of the consistency check. The main findings will be presented in tables and supplementary material. - Co-authors contributions: HS conceptualized the study and coordinated the review. AB and SSFDC performed the systematic search. SSFDC, GRM and B Leners performed the papers selection and data extraction. HS acted as a mediator for agreement of the studies selection and data extraction. SS advised the team on the scoping review process. SSFDC and HS drafted the manuscript. AB, GF, SS, B Lefebvre and TB provided further input to the manuscript. All authors critically revised the manuscript for important intellectual content, and approved the final version. - Acknowledgement: We acknowledge Coralie Dessenne, Documentation Officer at the Luxembourg Institute of Health, for her support, especially her advice advising on the literature search. - References: 1. Bischoff SC, Damms-Machado A, Betz C, Herpertz S, Legenbauer T, Low T, et al. Multicenter evaluation of an interdisciplinary 52-week weight loss program for obesity with regard to body weight, comorbidities and quality of life--a prospective study. Int J Obes (Lond). 2012; 36: 614-24. 2. Yumuk V, Tsigos C, Fried M, Schindler K, Busetto L, Micic D, et al. European Guidelines for Obesity Management in Adults. Obesity facts. 2015; 8: 402-24. 3. Yumuk V, Fruhbeck G, Oppert JM, Woodward E, Toplak H. An EASO position statement on multidisciplinary obesity management in adults. Obesity facts. 2014; 7: 96-101. 4. Ross MM, Kolbash S, Cohen GM, Skelton JA. Multidisciplinary treatment of pediatric obesity: nutrition evaluation and management. Nutr Clin Pract. 2010; 25: 327-34. 5. World Health Organisation. WHO Guideline: recommendations on digital interventions for health system strengthening. 2019. 6. Castelnuovo G, Simpson S. Ebesity - e-health for obesity - new technologies for the treatment of obesity in clinical psychology and medicine. Clin Pract Epidemiol Ment Health. 2011; 7: 5-8.