21. Norman, G. J & Zabinski, M. F 2007 No Yes Yes Yes Yes 22. Perry, K. J & Hickson, M 2011 No Yes Yes No Yes 23. Reed, V. A & Schifferdecker, K. E 2011 No Yes Yes Yes Yes 24. Saperstein, S. L & Atkinson, N. L 2007 No Yes Yes Yes Yes 25. Shaw, K. A & Gennat, H. C 2006 No Yes Yes No No 26. Shaw, K. A & O’Rourke, P 2005 No Yes Yes No Yes 27. Tuah, N. A & Amiel, C 2011 No Yes Yes Yes Yes 28. Turk, M. W & Yang, K 2009 No Yes Yes Yes Yes
Multimedia Appendix 2. Review Characteristics First Author, Year Type of review, intervention mode, search period & OQAQ score Aim Selection criteria No of interventions, participants & sample type Key outcomes Reported intervention content and interactive components Results and conclusions Arem (2011) Descriptive Internet-based 2001 to Jan 2009 OQAQ=10 To examine the strengths and weaknesses of internet-based interventions Inclusion: RCT; overweight or obese adults; weight loss or maintenance; web-based interventions Interventions = 9 N= 4282 Sample = community; 79% female; predominately white Weight loss and maintenance Online tailoring; personalized emails on progress; diaries; individual feedback; structured weight loss lessons 8/9 relevant studies. No statistical pooling. High attrition rate. Effectiveness of internet interventions remains unclear Cole-Lewis (2011) Descriptive Text messaging (mobile phones) May and June 2009 OQAQ=14 To investigate the effectiveness of text messaging for disease prevention and management Inclusion: Randomized or controlled trials; text messaging for disease prevention or management; measures in health behavior, health outcomes, and/or clinical outcomes using pre post-tests; peer reviewed Interventions = 12 N= 2365 Sample = predominately community; in 3 studies, women were greatly Weight change. Most studies targeted other health behaviors Text messaging; automated messaging; tailored messages 2/12 relevant studies. Weight loss of 2.9 and 4.5kg. Text messaging effective in weight loss and diabetes management experimental
Enwald (2010) Descriptive E-health Not restricted by publication date OQAQ=12 Evaluation of second generation interventions to prevent obesity and its associated problems Inclusion: RCT or second generation technology; health behavior associated to nutrition; weight management and physical activity assessed using physiological or behavioral outcomes Interventions = 23 N= 12417 Sample = unclear; gender NS; predominately white Weight change Personalized feedback as the tailoring mechanism used in most studies 5/23 relevant studies. Only two studies reporting weight loss of 4.1 and 5.3kg. Nutrition interventions more effective than PA promotion programs. Tailoring more effective in nutrition interventions than physical activity and weight management Gordon (2011) Descriptive Community pharmacy-based Jan 1999 to June 2009 OQAQ=10 To assess the cost-effectiveness and effectiveness of community pharmacy weight management interventions Inclusion: Community pharmacy setting; weight management as primary focus Interventions = 10 N= 2583 Sample = service users Weight change Self-monitoring and goal setting; questionnaires; diaries; information sheets 2/10 relevant studies. Did not synthesize quantitative data. Weight loss in one study at 3 and 6 months. Effectiveness remains unclear Harris (2011) Meta-analysis E-health Jan 1990 to Nov 2009 OQAQ=17 To assess the effectiveness and cost-effectiveness of e-health interventions for dietary behavior change and to determine the effective components and mechanisms Inclusion: RCT; adolescents and adults; interactive and tailored software; dietary behaviors and clinical outcomes Interventions = 43 N= Not stated Sample = unclear; Dietary behavior and clinical outcomes Tailored software with goal setting and feedback components; personalized emails; diaries; personal digital assistant and automated telephone service; computer; kiosks; minitel 22/43 relevant studies. Effectiveness and cost-effectiveness of e-health interventions inconclusive
Hemmingsson (2001) Descriptive Internet-based 1966 to 2001 OQAQ=8 A summary of physical activity behavior change adherence influences Inclusion: Overweight and obese adults; contain PA behavior change adherence information Interventions = 7 N= 651 Sample = unclear Physical activity levels and weight/fat loss Insufficient description of intervention content; peer support; telephone social support and logins described in two relevant studies 2/7 relevant studies. Did not synthesize quantitative data. Various factors influencing PA behavior change. Evidence not conclusive and warrants further research Keller (2008) Descriptive Home/gym based exercises for postpartum women May 2007 OQAQ=9 A description of intervention studies for guiding weight management interventions Inclusion: Weight loss or body composition outcome; PA interventions; postpartum women; RCT Interventions = 6 N= 298 Sample = community; 100% female; predominately white Weight and fat loss Food and activity diaries for and goal setting; Harris-benedict equation; target heart rate percentage; motivational interviewing; informational brochure; written lessons; telephone contact 3/6 relevant studies. Weight loss range of 1.6 to 7.8kg. Significant changes in body composition in women found in relevant studies. No significant changes in weight loss. Effectiveness remain unclear Kroeze (2006) Descriptive Computer-based 1965 to Sep 2004 OQAQ=12 A review of the efficacy of nutrition education and expert-driven computer-tailored physical activity interventions Inclusion: Computer tailored interventions targeting PA or diet; RCT with pre and post-test; adults; studies in English; delivered in a “nonpersonal” way without person-to-person counselling Interventions = 31 N= 84-1,317 Sample = unclear Change in health behavior (PA and diet) and weight loss Tailored and interactive feedback; computer-tailored letters; pamphlets; brochures; multimedia (text and video); computer-tailored print materials 2/31 relevant studies. Did not synthesize quantitative data. Evidence for computer-tailored interventions is strong. However, small effect size in most studies. Follow up periods only up to 6 months
Lemmens (2008) Descriptive Home-based; group; face to face; written materials and emails 1998 to 2008 OQAQ=9 To examine the efficacy of obesity prevention interventions and to identify the effective components for intervention development Inclusion: Dietary intake; PA or both; overweight individuals; RCT; non-RCT or interrupted time series designs; minimum 3 months follow up Interventions = 9 N= not stated Sample = community; predominately white; 20-79 years old BMI and weight loss Emailed exercise and dietary programmes; 3/9 relevant studies. Only one study targeting diet and PA demonstrated significant weight loss of 1.6kg. Inconclusive findings for the effectiveness of home-based interventions Lombard (2009) Descriptive Includes a range of delivery including face to face; groups; mail; newsletters and phone 1998 to 2008 OQAQ=10 To summarize weight gain prevention interventions to identify the key elements contributing to intervention success Inclusion: Adults; weight gain prevention; comparison group; duration of 3 months or over; follow-up < 3 months; family studies targeting adults Interventions = 8 N= 2282 Sample = unclear Weight loss Self-monitoring; tailored advice; social support; problem solving; goal setting; stress and time management; relapse prevention; cognitive and behavior change strategies; personalized contact; newsletters; email and phone contact; incentives; booklet; pedometer 7/9 relevant studies. Small differences in weight lost between treatment groups. Weight loss range of 1 to 1.9 kg. Five studies reported significant weight loss. Few trials on weight gain prevention. Low intensity multicomponent interventions identified as most effective Loveman (2011) Descriptive Multicomponent No restrictions (from inception to 2009) To evaluate the long-term cost and clinical effectiveness of multicomponent weight management Inclusion: RCT; adults (≥ 18 years); overweight or obese; structured multicomponent weight Interventions = 12 N= 59-1191 Sample = predominately white females. Weight loss Self-monitoring; goal setting; individual problem solving; incentives; stages of change; rewards; stress 10/12 relevant studies. Did not synthesize quantitative data. Weight lost in overweight and obese adults, but not
OQAQ=18 interventions for weight loss and maintenance management programmes; diet, PA or both; lifestyle behavior change strategy However, some studies did not mention participant characteristics management; modelling; assertiveness training; cognitive behavioral strategies; relapse prevention model; pocket diaries; lotteries to encourage attendance; questionnaires clinically significant. Effectiveness remains unclear. No UK RCT studies in review Manzoni (2011) Descriptive Internet-based 18 studies from previous review (Neve et al. 2010) and 2008 to 2011 for own review OQAQ=13 To examine the effectiveness of web-based interventions for weight loss and maintenance Inclusion: RCT; publication in a peer reviewed journal; overweight or obese adults; internet-based; weight loss or maintenance outcomes Interventions = 26 N= 8324 Sample = community; 77% female Weight loss and maintenance Individual e-mail feedback; of weight and diet; exercise diaries 25/25 relevant studies. Heterogeneity found in most studies including duration of intervention, type of feedback, and social support tools. Findings inconclusive Neve (2010) Meta-analysis Web-based 1995 to 2010 OQAQ=15 To examine the effectiveness of internet-based interventions for weight loss and weight maintenance and to identify the underlying components influencing weight control Inclusion: RCT with one intervention study arm; targets weight loss or maintenance; dietary or PA behavior change; 18 years or over; overweight or obese Interventions = 20 N= 5700 Sample = 77% female (3.7% unclear) Percentage change in body weight Behavioral therapy; individually tailored programme; email feedback; motivational interviewing; telephone human email counselling 18/18 relevant studies. Three of six studies reported 5% or greater weight lost. Heterogeneity between studies. Effectiveness remains unclear. Require studies providing detailed descriptions of intervention content for
Norman (2007) Descriptive E-health technology No restrictions (from inception to 2007) OQAQ=13 To provide a descriptive evaluation of interactive second generation interventions to promote weight loss Inclusion: RCT and published in scientific journal; PA; dietary behavior or a combination of both; baseline and follow-up measures; intervention feasibility or effectiveness; Interventions = 47 N= PA = 28-655; diet = 72-1578; combination = Sample = unclear but female participants PA = 64-100%; diet = 70-100%; combination = predominately white females Weight loss and BMI Motivational tips; educational information; internet tailored newsletters; computerized assessment and feedback; electronic forms; diet analysis; chat room; bulletin board; internet video sessions; online meetings and support; buddy program; animated fitness instructor; 24- hour help desk; reminders; goal setting; interactive (IMM); CD-ROM; interactive phone technology 12/49 relevant studies. Did not synthesize quantitative data. Small to medium effect sizes reported across e-health studies. Findings inconclusive. Require further studies to understand underlying mechanisms promoting dietary and physical activity behavior change Reed (2011) Meta-analysis Internet-based No restriction date reported OQAQ=17 To investigate the influence of computer technology on weight loss interventions Inclusion: RCT; computer-based education or support; comparison group; overweight or obese adults; weight or BMI outcomes Interventions = 13 N= 1866 Sample = means age = 49; 67% female; predominately white Weight loss and BMI Paper diary; booklet; workbook; group therapy; in-person sessions; and phone counselling 7/11 relevant studies. Computer-based interventions effective in weight loss but only when used in addition to standard weight loss programs. Sustaining weight loss over time remains unclear
Saperstein (2007) Descriptive Internet-based Not reported OQAQ=9 To investigate the efficacy of the internet as a mode of delivery to facilitate weight loss. Inclusion: RCT; internet-based weight lost programs; overweight or obese adults Interventions = 6 N= NS Sample = unclear Weight and waist circumference Online logins; food diaries; online programs targeting dietary and PA changes, through cognitive and behavior strategies; personalized feedback and support 6/6 relevant studies. Did not synthesize quantitative data. Internet-based tools could be effective for weight loss. Particularly, structured, personalized programs that include cognitive behavioral strategies Tuah (2011) Descriptive Range of methods incorporating the Transtheoretical Model and Stages of Change TTM SOC No restriction (from inception to 2011) OQAQ=18 To examine the effectiveness of PA and dietary programs that use the transtheoretical model (TTM) to facilitate weight loss Inclusion: RCT; 18 years or over; overweight or obese; healthy adults; including diabetes, heart diseases and hypertension; use of TTM SOC model; tailored lifestyle modification strategies Interventions = 5 N= 3910 Sample = age range from 25-75, predominately white Weight loss TTM SOC; feedback; personalized assessment report quarterly telephone; newsletters; manuals; pedometers; face to face counselling 2/5 relevant studies. Interventions utilising TTM SOC induced small weight change, but weight lost unsustainable over time. Heterogeneity across outcomes and interventions with small to medium samples. TTM SOC ineffective for weight loss Turk (2009) Descriptive Clinical, therapy and modality 1984 to 2007 OQAQ=11 To summarize the findings of RCT interventions that assess strategies for maintenance of weight and the viability of these programs Inclusion: RCT; weight maintenance; adult population; English language; true design; randomly assigned at maintenance Interventions = 40 N= unclear Sample = predominately white Weight maintenance Self-monitoring; self-weighing; chatroom; weekly weights online; food diaries; healthy diet educational materials; pedometers 8/40 relevant studies. Mixed results. No difference in weight maintenance when compared to in-person interventions in two relevant studies
Weinstein (2006) Descriptive Internet-based 1995 to 2006 OQAQ=12 To investigate the efficacy of weight loss programs delivered via the internet Inclusion: RCT; publication in peer reviewed journal; overweight or obese adults; internet-based interventions; weight loss Interventions = 8 N= 418 Sample = age range from 30-62; 55% female; predominately white Weight loss and maintenance Weekly feedback; email; bulletin board support; email from therapist; food diaries; tailored health information and phone support 8/8 relevant studies. No quantitative synthesis. Weight loss range of 0.8 to 2.2kg across 5 studies. Internet weight-loss effectiveness similar to standard weight loss programs Wieland (2012) Meta-analysis Computer-based From inception to 2011 OQAQ=18 To examine the effectiveness of interactive computer-based interventions for weight loss or weight maintenance Inclusion: RCT and trials; computer-based interventions; interactive programs; overweight or obese adults Interventions = 18 N = 4140 Sample = predominately white Weight loss and maintenance Interactive; weekly online chats; weekly email feedback; electronic bulletin board; e-mailed individualized feedback; e-mail counselling; online online education or online behavior therapy; message boards 18/18 relevant studies. Interactive computer-based interventions are more effective than minimal (usual care, pamphlets) or no interventions