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

Abstract

BackgroundSeveral 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).MethodsThe 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.ResultsWe 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.ConclusionsDespite 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.

Quality assessment of a sample of mobile app-based health behavior change interventions using a tool based on the National Institute of Health and Care Excellence behavior change guidance

“…It is beyond the scope of this paper to discuss these in detail here, but reviews of the evidence [10] formed the basis of the National Institute for Health and Care Excellence (NICE) guidelines on approaches to health behavior change [11,12]. NICE is an independent organization, set up by the UK government in 1999 to help reduce variation in the availability and quality of NHS treatments and care.…”

Risk factors for noncommunicable chronic diseases in women in China: surveillance efforts

“…38 Risky behaviours related to lifestyle, always hard to change without suitable interventions, are usually established in childhood and often persist in adulthood. [39][40][41] Appropriate public health interventions should be implemented in China to reduce these risky behaviours and thereby lower the prevalence of the biological NCD risk factors to which they can lead, such as hypertension, raised blood glucose and hypercholesterolemia.…”

The differences in selected health-related behaviour indicators among women with different educational attainment in Slovenia / Razlike v izbranih kazalnikih vedenj, povezanih z zdravjem, med različno izobraženimi ženskami v Sloveniji

“…One of the consequences of this research practice is maintaining the impression that gender is a homogenous category. Numerous studies have found significant gender differences in behaviour (9)(10), while a lower number analyse these differences within the gender (11). Our study focuses precisely on this aspect.…”