Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews

Abstract

BackgroundThe assessment and communication of disease risk that is personalised to the individual is widespread in healthcare contexts. Despite several systematic reviews of RCTs, it is unclear under what circumstances that personalised risk estimates promotes change in four key health-related behaviours: smoking, physical activity, diet and alcohol consumption.PurposeThe present research aims to systematically identify, evaluate and synthesise the findings of existing systematic reviews.MethodsThis systematic review of systematic reviews followed published guidance. A search of four databases and two-stage screening procedure with good reliability identified nine eligible systematic reviews.ResultsThe nine reviews each included between three and 15 primary studies, containing 36 unique studies. Methods of personalising risk feedback included imaging/visual feedback, genetic testing, and numerical estimation from risk algorithms. The reviews were generally high quality. For a broad range of methods of estimating and communicating risk, the reviews found no evidence that risk information had strong or consistent effects on health-related behaviours. The most promising effects came from interventions using visual or imaging techniques and with smoking cessation and dietary behaviour as outcomes, but with inconsistent results. Few interventions explicitly used theory, few targeted self-efficacy or response efficacy, and a limited range of Behaviour Change Techniques were used.ConclusionsPresenting risk information on its own, even when highly personalised, does not produce strong effects on health-related behaviours or changes which are sustained. Future research in this area should build on the existing knowledge base about increasing the effects of risk communication on behaviour.Electronic supplementary materialThe online version of this article (doi:10.1007/s12160-017-9895-z) contains supplementary material, which is available to authorized users.

Laypeople Are Strategic Essentialists, Not Genetic Essentialists

“…Others have reviewed the literature relating to the impact of genetics on health behaviors in some detail. As perhaps will not be surprising given the small effect sizes of genetic information on racism that I just reviewed, meta‐reviews indicate that messages about genetics typically produce low or no effect sizes on health behaviors, although there is some variability across diseases and populations . For those who hoped genetic information would promote a revolution in behavior, this is a disappointment.…”

“…As perhaps will not be surprising given the small effect sizes of genetic information on racism that I just reviewed, metareviews indicate that messages about genetics typically produce low or no effect sizes on health behaviors, although there is some variability across diseases and populations. 36 For those who hoped genetic information would promote a revolution in behavior, this is a disappointment. But had we thought about people as strategic essentialists rather than as genetic essentialists, we would have predicted that the technical precision of genetics would add only incrementally to people's already-existing cognitive resources regarding heredity.…”

A Systematic Review of Genetic Testing and Lifestyle Behaviour Change: Are We Using High-Quality Genetic Interventions and Considering Behaviour Change Theory?

“…When it comes to systematic reviews assessing behaviour change as a result of genetic testing interventions, a simple risk-of-bias assessment is not sufficient to develop the most meaningful conclusions; yet it is often the only quality assessment conducted in this type of work [3, 5, 6]. It is further important to consider the delivery of a health/genetic intervention (such as considering the provision of disease risk estimates vs. actionable behaviour change recommendations) and to consider behaviour change theories [18].…”

Do interventions containing risk messages increase risk appraisal and the subsequent vaccination intentions and uptake? – A systematic review and meta‐analysis

“…This may be because risk information communicated verbally is more difficult to absorb and understand. This concurs with other work which has found that interventions utilizing images or visual components have been found to be successful predictors of changing risk appraisal (French et al ., ). Accordingly, it is advised that future interventions aiming to communicate risk incorporate images into their design.…”