Equity of healthy eating and active living digital interventions for older Australians

Abstract

Purpose: Healthy eating and active living among older people contribute to healthy ageing. While health behaviour change interventions increasingly use digital technologies, there is debate about the equity of such interventions, particularly among older Australians who remain the least digitally included age group. This systematic review examined the equity of digital healthy eating and active living interventions in Australians aged 65+ years.   Methods: We searched six electronic databases and grey literature for interventions targeting community-dwelling older Australians aged 65+ years, delivered using digital technology to support healthy eating and/or active living behaviour change, with published evaluation results. Data extraction included measures of health and digital health equity, as well as digital literacy support. A narrative synthesis and meta-analysis were undertaken.   Results: Twenty-seven reports of 19 interventions were included. Primary outcomes included active living behaviours (n=13), healthy eating behaviours (n=1), or both (n=5). The only health equity factor considered in developing these interventions was geographical location (n=7). Digital self-efficacy, digital preferences and technology access were considered by four interventions, and eight provided some level of digital literacy support to participants.   Implications: Our results highlight limited reporting and consideration of equity among digital healthy ageing interventions for older Australians. To better understand engagement and outcomes of digital interventions, evaluations need to collect, analyse and report health equity and digital health equity data. It is essential that digital healthy eating and active living interventions are designed to include and support all older adults to achieve and maintain their independence and wellbeing.