BackgroundThe prevelance of depression in older people is high, treatment is inadequate, it creates a substantial burden and is a public health priority for which exercise has been proposed as a therapeutic strategy.AimsTo estimate the effect of exercise on depressive symptoms among older people, and assess whether treatment effect varies depending on the depression criteria used to determine participant eligibility.MethodSystematic review and meta-analysis of randomised controlled trials of exercise for depression in older people.ResultsNine trials met the inclusion criteria and seven were meta-analysed. Exercise was associated with significantly lower depression severity (standardised mean difference (SMD) =–0.34, 95% CI –0.52 to –0.17), irrespective of whether participant eligibility was determined by clinical diagnosis (SMD =–0.38, 95% CI –0.67 to –0.10) or symptom checklist (SMD =–0.34, 95% CI –0.62 to –0.06). Results remained significant in sensitivity analyses.ConclusionsOur findings suggest that, for older people who present with clinically meaningful symptoms of depression, prescribing structured exercise tailored to individual ability will reduce depression severity.

Background: Interventions to change health-related behaviours have potential to increase health inequalities. Methods: This review investigated the effectiveness of interventions targeting low-income groups to reduce smoking or increase physical activity and/or healthy eating. Of 9766 papers identified by the search strategy, 13 met the inclusion criteria. Intervention content was coded into component technique and theoretical basis, and examined as a potential source of effect heterogeneity. Results: Interventions were heterogeneous, comprising 4-19 techniques. Nine interventions had positive effects, seven resulted in no change and one had an adverse effect. Effective interventions had a tendency to have fewer techniques than ineffective interventions, with no evidence for any technique being generally effective or ineffective. Only six studies cited theory relative to intervention development, with little information about how theory was used and no obvious association with intervention content or effect. Conclusion: This review shows that behaviour change interventions, particularly those with fewer techniques, can be effective in low-income groups, but highlights the lack of evidence to draw on in informing the design of interventions for disadvantaged groups.Chronic diseases, such as cardiovascular disease, diabetes, cancer and respiratory disease, are a major cause of death and disability worldwide. There is considerable evidence showing that quitting smoking, eating a healthier diet, not consuming excessive amounts of alcohol and exercising regularly can have a major impact on reducing rates of chronic illness 1 2 Lower socioeconomic status (SES) and lower social status is associated with poorer health outcomes and less healthy behaviours.3-6 For example, in Great Britain, although smoking prevalence has declined across all socioeconomic groups, 15% of managerial and professional groups smoked compared with 29% of manual occupational groups in 2006.7 While 30% of adults in managerial and professional groups eat the recommended five portions of fruit and vegetable a day, just 18% of adults in the routine and manual groups do so.8 Only 25% of people in lower socioeconomic groups participate in sports and exercise compared with about 50% of higher socioeconomic groups (although when occupational activity is controlled for, activity levels are similar).8 9 The adult routine and manual group is estimated at about 15 million people; about 4.3 million smoke, 12.3 million eat less than five fruit and vegetable portions a day, and 7.5 million are not physically active.10 Even a small percentage change in behaviour in lower socioeconomic groups could have a large impact on the health profile of the general population and on health costs.The health promotion literature offers many theories and techniques on behaviour change, but thus far there has been little research analysing the effectiveness of particular component techniques, or of the effectiveness of techniques across different groups. Literature re...

The Transtheoretical Model (TTM) has gained widespread popularity and acceptance, yet little is known about its effectiveness as a basis for health behavior intervention. A systematic review was conducted in order to evaluate the effectiveness of TTM interventions in facilitating health-related behavior change. Thirty-five electronic databases, catalogues, and internet resources were searched for relevant studies. In addition, the bibliographies of retrieved references were scanned for further relevant publications and authors were contacted for further information where necessary. Thirty-seven randomized controlled trials, targeting seven health-related behaviors, satisfied the inclusion criteria. Overall, the methodological quality of trials was variable, and there was limited evidence for the effectiveness of stage-based interventions as a basis for behavior change or for facilitating stage progression, irrespective of whether those interventions were compared with other types of intervention or with no intervention or usual care controls. The theoretical and practical implications of these findings are discussed. © 2005 Taylor & Francis Group Ltd

Objective To evaluate the effectiveness of interventions using a stage based approach in bringing about positive changes in smoking behaviour. Design Systematic review.

BackgroundYouth comprise 40% of the world’s unemployed, a status associated with adverse wellbeing and social, health, and economic costs. This systematic review and meta-analysis review synthesises the literature on the effectiveness of interventions targeting young people not in employment, education, or training (NEET).MethodsRandomised and quasi-randomised trials with a concurrent or counterfactual control group and baseline equivalence are included. Cochrane collaboration tools are used to assess quality, and a narrative synthesis was undertaken. The primary outcome is employment; secondary outcomes were health, earnings, welfare receipt, and education.ResultsEighteen trials are included (9 experimental and 9 quasi-experimental), sample sizes range from 32 to 54,923. Interventions include social skills, vocational, or educational classroom-based training, counselling or one-to-one support, internships, placements, on-the-job or occupational training, financial incentives, case management, and individual support. Meta-analysis of three high-quality trials demonstrates a 4% (CI 0.0–0.7) difference between intervention and control groups on employment. Evidence for other outcomes lacks consistency; however, more intensive programmes increase employment and wages over the longer term.ConclusionsThere is some evidence that intensive multi-component interventions effectively decrease unemployment amongst NEETs. The quality of current evidence is limited, leaving policy makers under-served when designing and implementing new programmes, and a vulnerable population neglected.Systematic review registrationPROSPERO CRD42014007535Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0394-2) contains supplementary material, which is available to authorized users.