Counseling for health behavior change in people with COPD: systematic review

Abstract

Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term “counseling” as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD.

Effectiveness of Workplace Interventions for Improving Absenteeism, Productivity, and Work Ability of Employees: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Particularly, counseling interventions, which enable individuals to evaluate behavioral choices [69], can be defined as coaching, advising, mentoring, or motivational interviewing [70]. These types of interventions have demonstrated their effectiveness in reducing smoking and a tendency to increase physical activity in people with chronic obstructive pulmonary disease [71]. Another important characteristic of effective absenteeism reduction interventions was the individualization of the interventions instead of group sessions, a typical characteristic of counseling interventions.…”

Changing health behaviour with rehabilitation in thoracic cancer: A systematic review and synthesis

“…We used robust systematic search methods and collated findings from a large body of studies meeting the WHO definition of rehabilitation conducted in populations with lung cancer or mesothelioma. We carefully extracted and coded behaviour change findings using established behavioural science tools, methods that have been conducted in other recent reviews characterising behavioural components of complex health interventions . Extracting data using the TIDieR checklist revealed limitations in the quality of intervention reporting on the training and supervision of providers, how well the intervention was actually delivered, and how well participants understood and enacted intervention components away from the clinical setting.…”

Improving physical activity, sedentary behaviour and sleep in COPD: perspectives of people with COPD and experts via a Delphi approach

“…Counselling added to pulmonary rehabilitation has shown some promise for improving PA in people with COPD ( Lahham, McDonald & Holland, 2016 ; Mantoani et al, 2016 ). However, there is currently no universally accepted approach for health counselling with interventions commonly comprised of various combinations of different behaviour change techniques ( Wilson et al, 2015 ; Williams et al, 2017 ). As such, it is not clear which exact intervention components have led to the often small, positive effects on PA.…”

“…Interventions aiming to change behaviour in people with COPD have previously been developed by healthcare providers and/or researchers, with little or no input from the intended participants. The lack of consistent, long-term positive effects of many behaviour change interventions in this population ( Soler, Diaz-Piedra & Ries, 2013 ; McDonnell et al, 2014 ; Lahham, McDonald & Holland, 2016 ; Mantoani et al, 2016 ; Mesquita et al, 2017a ; Mesquita et al, 2017b ; Williams et al, 2017 ) may in part be due to intervention designers and intervention participants having different ideas about what is important. This notion has recently been demonstrated where people with COPD and experts managing COPD were asked about different aspects of the disease ( Celli et al, 2017 ).…”