7 research outputs found

    Web- and text-based interventions for smoking cessation: Meta-analysis and meta-regression

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    <p><i>Background</i>: In the past decade, several smoking cessation interventions have been developed and implemented through information and communication technology (ICT). Evidence suggests that they might be suitable for large-scale public health interventions, based on updated communication media characteristics in terms of interplay between technology and graphical user interface, reaching high numbers of individuals.</p> <p><i>Objectives</i>: We aimed at estimating web/text-based interventions effectiveness as compared with approaches routinely used for general population, that is smoking assessment or non-electronic self-help materials.</p> <p><i>Methods</i>: A systematic review and meta-analysis was performed searching through PubMed, Embase and PsycInfo databases, as well as references of relevant papers. Heterogeneity and risk of bias were evaluated following standard methods. In addition, we performed meta-regression analyses testing if candidate covariates moderate the overall effect.</p> <p><i>Results</i>: Slight but significant effectiveness was found for eHealth interventions over control conditions (RR = 1.28, 95% CI: 1.14–1.45). Meta-regressions showed similar findings for web- and text-based interventions. The effect seemed moderated by the follow-up period, being higher at 3 months and lower at 6/7 months follow-up.</p> <p><i>Conclusions</i>: Our results outline moderate effectiveness of web/text-based interventions. However, a paucity of properly controlled studies and lack of information on several effect modifiers still hamper the development and implementation of smoking cessation interventions through ICT.</p

    The Effectiveness and Cost-Effectiveness of Screening for HIV in Migrants in the EU/EEA: A Systematic Review.

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    Migrants, defined as individuals who move from their country of origin to another, account for 40% of newly-diagnosed cases of human immunodeficiency virus (HIV) in the European Union/European Economic Area (EU/EEA). Populations at high risk for HIV include migrants, from countries or living in neighbourhoods where HIV is prevalent, and those participating in high risk behaviour. These migrants are at risk of low CD4 counts at diagnosis, increased morbidity, mortality, and onward transmission. The aim of this systematic review is to evaluate the effectiveness and cost-effectiveness of HIV testing strategies in migrant populations and to estimate their effect on testing uptake, mortality, and resource requirements. Following a systematic overview, we included four systematic reviews on the effectiveness of strategies in non-migrant populations and inferred their effect on migrant populations, as well as eight individual studies on cost-effectiveness/resource requirements. We assessed the certainty of our results using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The systematic reviews reported that HIV tests are highly accurate (rapid test >90% sensitivity, Western blot and ELISA >99% sensitivity). A meta-analysis showed that rapid testing approaches improve the access and uptake of testing (risk ratio = 2.95, 95% CI: 1.69 to 5.16), and were associated with a lower incidence of HIV in the middle-aged women subgroup among marginalised populations at a high risk of HIV exposure and HIV related stigma. Economic evidence on rapid counselling and testing identified strategic advantages with rapid tests. In conclusion, community-based rapid testing programmes may have the potential to improve uptake of HIV testing among migrant populations across a range of EU/EEA settings
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