@文章{信息:doi/10.2196/17849，作者=“Turnbull, Sophie and Cabral, Christie and Hay, Alastair and Lucas, Patricia J”，标题=“基于网络的健康干预对慢性疾病患者自我护理效果的健康公平:系统评价”，期刊=“J Med Internet Res”，年=“2020”，月=“6”，日=“5”，卷=“22”，数=“6”，页=“e17849”，关键词=“健康公平”;自理;电子健康;干预;糖尿病;哮喘;慢性阻塞性肺病;背景:基于网络的自我保健干预措施有可能通过消除获得保健的障碍来减少健康不平等现象。然而，缺乏证据表明这些干预措施对慢性疾病的平衡作用。目的:本研究探讨了基于网络的行为改变干预对高负担慢性疾病(如哮喘、慢性阻塞性肺疾病、糖尿病和骨关节炎)自我保健的效果在不同社会经济和文化群体中的差异。 Methods: A systematic review was conducted, following Cochrane review guidelines. We conducted searches in Ovid Medical Literature Analysis and Retrieval System Online and Cumulative Index to Nursing and Allied Health Literature databases. Studies with any quantitative design were included (published between January 1, 2006, and February 20, 2019) if they investigated web-based self-care interventions targeting asthma, COPD, diabetes, and osteoarthritis; were conducted in any high-income country; and reported variations in health, behavior, or psychosocial outcomes across social groups. Study outcomes were investigated for heterogeneity, and the possibility of a meta-analysis was explored. A narrative synthesis was provided together with a novel figure that was developed for this review, displaying heterogeneous outcomes. Results: Overall, 7346 records were screened and 18 studies were included, most of which had a high or critical risk of bias. Important study features and essential data were often not reported. The meta-analysis was not possible due to the heterogeneity of outcomes. There was evidence that intervention effectiveness was modified by participants' social characteristics. Minority ethnic groups were found to benefit more from interventions than majority ethnic groups. Single studies with variable quality showed that those with higher education, who were employed, and adolescents with divorced parents benefited more from interventions. The evidence for differences by age, gender, and health literacy was conflicting (eg, in some instances, older people benefited more, and in others, younger people benefited more). There was no evidence of differences in income, numeracy, or household size. Conclusions: There was evidence that web-based self-care interventions for chronic conditions can be advantageous for some social groups (ie, minority ethnic groups, adolescents with divorced parents) and disadvantageous for other (ie, low education, unemployed) social groups who have historically experienced health inequity. However, these findings should be treated with caution as most of the evidence came from a small number of low-quality studies. The findings for gender and health literacy were mixed across studies on diabetes, and the findings for age were mixed across studies on asthma, COPD, and diabetes. There was no evidence that income, numeracy, or the number of people living in the household modified intervention effectiveness. We conclude that there appear to be interaction effects, which warrant exploration in future research, and recommend a priori consideration of the predicted interaction effects. Trial Registration: PROSPERO CRD42017056163; https://www.crd.york.ac.uk/prospero/display{\_}record.php?RecordID=56163 ", issn="1438-8871", doi="10.2196/17849", url="//www.mybigtv.com/2020/6/e17849/", url="https://doi.org/10.2196/17849", url="http://www.ncbi.nlm.nih.gov/pubmed/32459632" }