Abstract
INTRODUCTION: Digital health interventions are effective for weight management and improving dietary intake, but studies in culturally and linguistically diverse (CALD) and Indigenous populations are limited. The aim of this systematic review is to evaluate the effectiveness of digital health interventions on body weight and dietary intake outcomes in CALD and Indigenous populations. METHODS: MEDLINE, Embase, Scopus, and Cochrane databases were searched on December 28, 2022 (PROSPERO: CRD42023394058). Inclusion criteria were randomized controlled trials (RCTs) conducted in high-income English-speaking countries with free-living adults ≥ 18 years. Trials had to report both weight and dietary outcomes, with ≥ 50% participants from CALD/Indigenous backgrounds or outcomes reported by race/ethnicity. Two reviewers independently screened records. Risk of bias was assessed using the Cochrane RoB 2 tool. Results were synthesized descriptively and presented in graphs and tables. RESULTS: From the 1984 records identified, nine RCTs were included, which involved a total of 2716 participants. Eight trials were conducted in the United States, and only one trial included Indigenous participants. Significant body weight changes occurred in three trials. Significant diet quality changes occurred in three trials. Most trials had high retention rates (≥ 80%) but low intervention adherence (< 50%). Risk of bias was low for most trials. CONCLUSION: Limited evidence supports the effectiveness of digital health interventions for improving body weight and dietary intake outcomes in CALD and Indigenous populations. The predominance of US-based trials, female-dominated samples, and hybrid intervention designs limits generalizability. Future research should prioritize inclusive practices and standalone digital designs to establish effectiveness in these populations.