Electronic screening and brief interventions promoting healthy diet and physical activity among adult patients in medical settings: A systematic review

Background & aims: Electronic screening and brief interventions (eSBIs) are promising health promoting approaches but their utilization towards nutrition outcomes has been little documented so far. The aim of this systematic review is to examine the nature and findings of eSBIs targeting diet and/or physical activity (PA) among adult patients in healthcare settings since smartphone technologies emerged.

Methods: Three systematic searches in PubMed, ScienceDirect and PsycINFO were conducted from January 2010 to May 2023. We include all studies assessing eSBI towards lifestyle habits (dietary habits and/or PA at least), implemented in healthcare settings and targeting adult participants.

Results: Of 1981 articles identified, 15 studies met inclusion criteria. Most of them documented eSBIs implemented in primary care (n=11), targeting PA (n=11) and diet (n=9) alone or combined (n=5). Some eSBIs targeted additional behaviors (e.g. smoking, drinking). Delivery modes included computer (n=8), printed documents (n=8) or phone (n=2) but only four eSBIs were interactive (or partially automated). In addition to personalized feedback, most common behavior change techniques were "information about social and environmental consequences" (n=9), "goal setting" (n=7), and "information about health consequences" (n=7). Most studies assessing behavior change had a control group (8 in 10), and eight studies found positive changes in behavior.

Conclusions: Although implementing eSBIs towards PA/diet among adult patients in medical settings seems promising for primary, secondary and tertiary prevention, common conceptual framework, intervention and outcomes are severely lacking, and the extent to which they follow existing SBI guidelines remains unclear. Demonstrating their effectiveness requires fixing these issues before conducting prospective assessment studies in medical settings.