Limits...
The effectiveness of interventions to change six health behaviours: a review of reviews.

Jepson RG, Harris FM, Platt S, Tannahill C - BMC Public Health (2010)

Bottom Line: Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours.Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities.Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change.Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nursing and Midwifery, University of Stirling, Stirling FK94LA, UK. ruth.jepson@stir.ac.uk

ABSTRACT

Background: Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e.g. for drug or alcohol dependency).

Methods: The Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE) and several Ovid databases were searched for systematic reviews of interventions for the six behaviours (updated search 2008). Two reviewers applied the inclusion criteria, extracted data and assessed the quality of the reviews. The results were discussed in a narrative synthesis.

Results: We included 103 reviews published between 1995 and 2008. The focus of interventions varied, but those targeting specific individuals were generally designed to change an existing behaviour (e.g. cigarette smoking, alcohol misuse), whilst those aimed at the general population or groups such as school children were designed to promote positive behaviours (e.g. healthy eating). Almost 50% (n = 48) of the reviews focussed on smoking (either prevention or cessation). Interventions that were most effective across a range of health behaviours included physician advice or individual counselling, and workplace- and school-based activities. Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours.Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities.

Conclusions: Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change. Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.

Show MeSH

Related in: MedlinePlus

Quorum statement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2944371&req=5

Figure 1: Quorum statement.

Mentions: Titles and abstracts were independently screened by two reviewers. Any discrepancies in selections were discussed until consensus was reached. Another stage of screening consisted of a mapping exercise, where references were mapped into categories of evidence and two reviewers agreed to include or exclude further references based on the quality of the reviews and the date of publication. Since Cochrane reviews are usually the most comprehensive and of high quality, they were selected if there was more than one review in a particular topic area. Other reviews were selected on the basis of most recent publication date and quality of the review (see below for details of how we assessed quality of the reviews). The full review process is illustrated in the quorum statement (see Figure 1).


The effectiveness of interventions to change six health behaviours: a review of reviews.

Jepson RG, Harris FM, Platt S, Tannahill C - BMC Public Health (2010)

Quorum statement.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2944371&req=5

Figure 1: Quorum statement.
Mentions: Titles and abstracts were independently screened by two reviewers. Any discrepancies in selections were discussed until consensus was reached. Another stage of screening consisted of a mapping exercise, where references were mapped into categories of evidence and two reviewers agreed to include or exclude further references based on the quality of the reviews and the date of publication. Since Cochrane reviews are usually the most comprehensive and of high quality, they were selected if there was more than one review in a particular topic area. Other reviews were selected on the basis of most recent publication date and quality of the review (see below for details of how we assessed quality of the reviews). The full review process is illustrated in the quorum statement (see Figure 1).

Bottom Line: Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours.Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities.Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change.Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Nursing and Midwifery, University of Stirling, Stirling FK94LA, UK. ruth.jepson@stir.ac.uk

ABSTRACT

Background: Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e.g. for drug or alcohol dependency).

Methods: The Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE) and several Ovid databases were searched for systematic reviews of interventions for the six behaviours (updated search 2008). Two reviewers applied the inclusion criteria, extracted data and assessed the quality of the reviews. The results were discussed in a narrative synthesis.

Results: We included 103 reviews published between 1995 and 2008. The focus of interventions varied, but those targeting specific individuals were generally designed to change an existing behaviour (e.g. cigarette smoking, alcohol misuse), whilst those aimed at the general population or groups such as school children were designed to promote positive behaviours (e.g. healthy eating). Almost 50% (n = 48) of the reviews focussed on smoking (either prevention or cessation). Interventions that were most effective across a range of health behaviours included physician advice or individual counselling, and workplace- and school-based activities. Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours.Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities.

Conclusions: Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change. Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.

Show MeSH
Related in: MedlinePlus