Multiple Risk Behavior Interventions: Meta-analyses of RCTs

Meader, Nick; King, Kristelle; Wright, Kath; Graham, Hilary; Petticrew, Mark; Power, Chris; White, Martin; Sowden, Amanda

doi:10.1016/j.amepre.2017.01.032

Cited by 99 publications

(102 citation statements)

References 57 publications

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“…Despite important improvements in lifestyle, changes in body weight were relatively modest in the general population (−0.16 kg) and individuals with overweight (−0.55 kg). This is in accordance with the minimal reductions in weight (−0.59 kg, 95% CI: −1.02 to −0.16) found in a previous meta-analysis examining the efficacy of multiple risk behavior interventions (7). Notwithstanding, individuals with obesity responded with significant reductions in body weight (−1.60 kg), further supporting the beneficial role of the intervention in this at-risk group.…”

Section: Discussionsupporting

confidence: 89%

“…A recent meta-analysis showed that interventions mainly consisting of education and skills training resulted in modest improvements in diet (e.g., fruit and vegetable intake) and physical activity levels, leading the authors to conclude that such small reductions in risk behaviors fail to translate into meaningful reductions in mortality risk (7). The authors also suggested that the large number of studies and consistency of findings argue against further trials focusing on the use of education and skills training to target risky behaviors (7). A similar conclusion was reached by a comprehensive systematic review, which showed noticeable absence of reporting of benefit in physical activity for communitywide interventions (6).…”

Section: Discussionmentioning

confidence: 99%

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Impact of a Real‐World Lifestyle Intervention in an Entire Latin American City with More Than 50,000 People

Atalla

Pinto

Mielke

et al. 2019

Obesity

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Objective The aim of this study was to assess the impact of a real‐world citywide intervention on physical activity and eating habits in a Latin American city with more than 50,000 inhabitants. Methods This was a plausibility assessment of a real‐life intervention. A probabilistic sample (n = 1,424) from Jaguariuna (Sao Paulo, Brazil) was assessed before and after a 7‐month intervention aimed at increasing physical activity levels and improving eating habits at a city level. Primary outcomes were physical activity, sedentary behavior, and eating habits assessed by a valid telephone inquiry. The secondary outcome was body weight. Results The proportion of individuals achieving the recommended intake of fruits and vegetables increased (18%; 95% CI: 2% to 36%; P = 0.031), whereas the number of individuals consuming soft drinks and exchanging main meals for snacks or junk food decreased (−35%; 95% CI: −45% to −22%; P < 0.001 and −16%; 95% CI: −29% to −1%; P = 0.037). The number of active individuals increased during leisure time (37%; 95% CI: 19% to 58%; P < 0.001), at work (17%; 95% CI: 4% to 32%; P = 0.009), and in the household (14%; 95% CI: 0% to 31%; P = 0.047). Body weight decreased among individuals with overweight or obesity. Conclusions This intervention promoted pronounced lifestyle changes (i.e., increased physical activity and healthier food choices) in the entire city, providing scientific‐based evidence on which to build effective public health policies in Latin America.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Impact of a Real‐World Lifestyle Intervention in an Entire Latin American City with More Than 50,000 People

Atalla

Pinto

Mielke

et al. 2019

Obesity

View full text Add to dashboard Cite

show abstract

“…As little is known about how to address multiple health risks in an efficient manner (Meader et al, ; J. J. Prochaska & Prochaska, ) more research is needed on intervention strategies for patients presenting multiple health risks. Further, it is known that tailoring intervention content to the needs of participants can enhance intervention impact (Kreuter, Strecher, & Glassman, ).…”

Section: Discussionmentioning

confidence: 99%

“…As little is known about how to address multiple health risks in an efficient manner (Meader et al, 2017;J. J. Prochaska & Prochaska, 2011) more research is needed on intervention strategies for patients presenting multiple health risks.…”

Section: Screening Levelmentioning

confidence: 99%

Proactive multipurpose health risk screening in health care settings: Methods, design, and reach

Guertler

Moehring

Krause

et al. 2019

Int J Methods Psych Res

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Objectives Real world implementation of proactive screening and brief intervention in health care is threatened by high cost. Using e‐health interventions and screening for multiple health risk factors may provide more efficiency. We describe methodological details of a proactive multipurpose health risk screening in health care settings and report on participation rates, participants' characteristics, and participation factors. Methods Patients between 18 and 64 years from ambulatory practices and hospitals were proactively approached by study assistants at three sites for a computerized screening on harmful alcohol and tobacco consumption, depressive symptoms, insufficient fruit/vegetable consumption, physical inactivity and overweight. On the basis of their health risk pattern, a computerized algorithm allocated patients to one of five studies each of them addressing a psychiatric research question. Results Among all eligible patients, 13,763 (86.5%) were screened. Younger age and being female predicted screening participation. Of those with complete data (n = 12,828), 82.9% reported at least two health risks and 34.0% were eligible for a study. Study participation ranged between 35.2% and 50.8%, and was associated with socio‐demographics and problem severity. Conclusions This study supports the use of systematic proactive screening for multiple health risks in health care settings as it is more resource‐saving than single focused screening.

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“…It is noted that these risk factors usually occur simultaneously 3 and evidence shows that involvement in multiple risk behaviors is associated with increased risk of chronic disease and mortality compared to involvement in one or no risk behavior 4 .…”

Section: Introductionmentioning

confidence: 99%

Simultaneity and aggregation of risk factors for noncommunicable diseases among brazilian adolescents

Rocha

Velasquez-Melendez

2019

Esc. Anna Nery

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Objective: To estimate the prevalence of concurrency of risk factors for Noncommunicable Diseases and non-random aggregation of these in Brazilian school adolescents. Method: Descriptive study, with data from the National School Health Survey (Pesquisa Nacional de Saúde do Escolar), 2015. The prevalence of concurrent risk factors was estimated: smoking, alcohol use, physical inactivity and low consumption of fruits and vegetables. Aggregation was verified when the observed-expected prevalence ratio was greater than 1. The analyses were performed in Stata 15.0 software. Results: The proportion of concurrent risk factors was higher for those who had two risk factors (56.1%; 95%CI: 55.5-56.6). The most prevalent risk factors combination was “Low consumption of fruits and vegetables + Physical inactivity” (66%; 95% CI: 65.8-66.9). There was an aggregation of risk factors, and the highest ratio between observed and expected prevalence was: “Smoking + Alcohol” (79.0%; 95%CI: 73.8-84.2). Conclusion and implications for practice: The findings show a high prevalence of concurrent risk factors, with aggregation of these in adolescents. Identifying these risk groups may favor early interventions by minimizing exposure and targeting primary prevention strategies in early exposure to risk factors.

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Multiple Risk Behavior Interventions: Meta-analyses of RCTs

Cited by 99 publications

References 57 publications

Impact of a Real‐World Lifestyle Intervention in an Entire Latin American City with More Than 50,000 People

Impact of a Real‐World Lifestyle Intervention in an Entire Latin American City with More Than 50,000 People

Proactive multipurpose health risk screening in health care settings: Methods, design, and reach

Simultaneity and aggregation of risk factors for noncommunicable diseases among brazilian adolescents

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