Behavior change techniques in physical activity interventions for adults with substance use disorders: A systematic review.

Abstract

Objective: Increasing regular physical activity (PA) behavior may be an effective adjunct intervention for substance use disorder (SUD) treatment. This systematic review aims to identify promising behavior change techniques (BCTs), namely, BCTs present in the design of interventions evidencing significant short-term and/or long-term (d ≥ 0.15 for objective measures and d ≥ 0.36 for self-report measures) increase in PA and/or reduction of substance use, secondary psychological measures, and retention in the PA intervention. Method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the search was performed on March 11, 2021 across databases including MEDLINE, PsycINFO, SPORTDiscus, Cochrane Library, CINAHL, ProQuest, Web of Science Core Collection, Google Scholar, Open Grey, and ProQuest Dissertations & Theses. Studies were included if they measured PA, included participants aged ≥18 years, were randomized control trials, and if participants were diagnosed with SUDs. The Cochrane RoB 2.0 Tool was used to assess risk of bias. BCTs from eligible studies were extracted, coded, and ranked according to their proportional presence across studies. Results: The final synthesis included k = 61 studies with N = 12,887 participants. High heterogeneity across outcome measures, interventions, and control conditions was found. In total, 477 applications of BCTs were identified. Instruction on how to perform the behavior, social support (unspecified), behavioral practice/rehearsal, problem-solving, pharmacological support, goal setting (behavior), self-monitoring (behavior), and biofeedback were the eight most frequently used promising BCTs across studies. Conclusions: Incorporating the eight most promising BCTs identified in this review in future PA interventions in SUD populations may improve SUD outcomes.

Behaviour change techniques in physical activity‐focused interventions for young people at risk of problematic substance use: A systematic review and meta‐analysis

“…Compared to a review investigating the use of BCTs in physical activity interventions for adults with substance use disorder (Thal et al, 2022), our review found differences in commonly reported BCTs in the included studies. While there was an overlap in identified F I G U R E 1 Prisma flow diagram of study selection (see also Klamert et al, 2023).…”

“…Further, while analyses based on extracted BCTs explain part of the observed variance in outcomes, the heterogeneity in the established subgroups based on the number of BCTs remains significant, indicating the presence of other confounding or moderating variables which have not been identified. This may partly be explained by the general large heterogeneity in the included studies regarding intervention design, setting, outcome measures and physical activity promotion, as noted previously by Thal et al (2022).…”

“…reduction in alcohol, opiate and stimulant use) in adult populations for the application of the following BCTs with physical activity interventions targeting substance use: instruction on how to perform the behaviour , social support ( unspecified ), behavioural practice/rehearsal , problem‐solving , pharmacological support (i.e. for smoking cessation, as detailed by Hartmann‐Boyce et al (2018)), goal setting (behaviour), self‐monitoring (behaviour) and biofeedback (Thal et al, 2022). A meta‐analysis was not performed in this review, and it remains unclear if the use of these BCTs in interventions has an effect on younger populations.…”

“…BCTs (instruction on how to perform behaviour, goal setting (behaviour), self-monitoring (behaviour)),Thal et al (2022) additionally highlighted social support (unspecified), behavioural practice/rehearsal, problem-solving and pharmacological support as promising techniques for adults.Our review found social comparison, providing normative information and information about behavioural consequences and modelling the goal behaviour as additional commonly reported BCTs to increase physical activity behaviour. The differences in identified BCTs can be explained by the different target populations (adults versus young people), intervention type and taxonomy used (general BCT taxonomy versus taxonomy of BCTs aiming to specifically increase physical activity).…”

The health of people attending residential treatment for alcohol and other drug use: Prevalence of and risks for major lifestyle diseases

“…Although some reviews suggest behaviour change techniques may be helpful at increasing physical activity in the short-term, results showing long-term benefits are lacking [45] and the quality of reviews assessing the effectiveness of exercise-based interventions in AOD services have a wide range of methodological limitations [46]. This limits the ability to make specific recommendations about appropriate physical activity interventions in these contexts.…”