How to promote healthy behaviours in patients? An overview of evidence for behaviour change techniques

To identify the evidence for the effectiveness of behaviour change techniques, when used by health-care professionals, in accomplishing health-promoting behaviours in patients. Reviews were used to extract data at a study level. A taxonomy was used to classify behaviour change techniques. We included 23 systematic reviews: 14 on smoking cessation, 6 on physical exercise, and 2 on healthy diets and 1 on both exercise and diets. None of the behaviour change techniques demonstrated clear effects in a convincing majority of the studies in which they were evaluated. Techniques targeting knowledge (n = 210 studies) and facilitation of behaviour (n = 172) were evaluated most frequently. However, self-monitoring of behaviour (positive effects in 56% of the studies), risk communication (52%) and use of social support (50%) were most often identified as effective. Insufficient insight into appropriateness of technique choice and quality of technique delivery hinder precise conclusions. Relatively, however, self-monitoring of behaviour, risk communication and use of social support are most effective. Health professionals should avoid thinking that providing knowledge, materials and professional support will be sufficient for patients to accomplish change and consider alternative strategies which may be more effective.

[1]  Havelaar Ah,et al.  Ons eten gemeten. Gezonde voeding en veilig voedsel in Nederland , 2004 .

[2]  G. Latham,et al.  Goal Setting as a Strategy for Health Behavior Change , 1995, Health education quarterly.

[3]  M. Carrillo,et al.  Moderate Long-Term Physical Activity Improves the Age-Related Decline in Bile Formation and Bile Salt Secretion in Rats , 1994, Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine.

[4]  R. Fullilove,et al.  Do Nurse Practitioners Make a Difference in Provision of Health Counseling in Hospital Outpatient Departments? , 2004, Journal of the American Academy of Nurse Practitioners.

[5]  C. Mulrow,et al.  Does Counseling by Clinicians Improve Physical Activity? A Summary of the Evidence for the U.S. Preventive Services Task Force , 2002, Annals of Internal Medicine.

[6]  L. Stead,et al.  Physician advice for smoking cessation. , 2004, The Cochrane database of systematic reviews.

[7]  Charles Abraham,et al.  Standard care impact on effects of highly active antiretroviral therapy adherence interventions: A meta-analysis of randomized controlled trials. , 2010, Archives of internal medicine.

[8]  F. Chung,et al.  Interventions in the preoperative clinic for long term smoking cessation: A quantitative systematic review , 2008, Canadian Journal of Anaesthesia-journal Canadien D Anesthesie.

[9]  C. Summerbell,et al.  Interventions for treating obesity in children. , 2009, The Cochrane database of systematic reviews.

[10]  I. Ajzen Attitudes, Personality and Behavior , 1988 .

[11]  D. Revere,et al.  Review of Computer-generated Outpatient Health Behavior Interventions: , 2001 .

[12]  E. A. Locke,et al.  New developments in and directions for goal-setting research. , 2007 .

[13]  R. Windsor,et al.  A meta-evaluation of smoking cessation intervention research among pregnant women: improving the science and art. , 1998, Health education research.

[14]  M. Lindström,et al.  Increasing prevalence of overweight, obesity and physical inactivity: two population-based studies 1986 and 1994. , 2003, European journal of public health.

[15]  Steven Prentice-Dunn,et al.  Protection motivation theory. , 1997 .

[16]  R. Murray,et al.  Smoking cessation in chronic obstructive pulmonary disease. , 2009, Respiratory medicine.

[17]  M. Conner,et al.  Predicting health behaviour : research and practice with social cognition models , 2005 .

[18]  Gerjo Kok,et al.  Intervention Mapping: Protocol for Applying Health Psychology Theory to Prevention Programmes , 2004, Journal of health psychology.

[19]  D. Druckman,et al.  Theory, research, and practice , 2003 .

[20]  A. Blenkinsopp,et al.  Systematic review of the effectiveness of community pharmacy-based interventions to reduce risk behaviours and risk factors for coronary heart disease. , 2003, Journal of public health medicine.

[21]  C. Juzwiak,et al.  [Nutrition and physical activity] , 2000, Jornal de pediatria.

[22]  L. Stead,et al.  Community pharmacy personnel interventions for smoking cessation. , 2004, The Cochrane database of systematic reviews.

[23]  A D Oxman,et al.  Systematic Reviews: Checklists for review articles , 1994 .

[24]  J. Higgins,et al.  Dietary advice given by a dietitian versus other health professional or self-help resources to reduce blood cholesterol. , 2003, The Cochrane database of systematic reviews.

[25]  M. Weatherall,et al.  Is goal planning in rehabilitation effective? A systematic review , 2006, Clinical rehabilitation.

[26]  E KoplanKate,et al.  Smoking Cessation , 2000 .

[27]  M. Thorogood,et al.  Interventions for promoting physical activity. , 2005, The Cochrane database of systematic reviews.

[28]  Canadian journal of anaesthesia , 1987 .

[29]  K. Hartmann,et al.  Smoking cessation in pregnancy: a review of postpartum relapse prevention strategies. , 2004, The Journal of the American Board of Family Practice.

[30]  Henry L. Tosi A Theory of Goal Setting and Task Performance , 1991 .

[31]  B. Hanratty,et al.  The effect of physical activity advice given in routine primary care consultations: a systematic review. , 2001, Journal of Public Health Medicine.

[32]  C. Tufanaru,et al.  Health Belief Model , 2009 .

[33]  Lina Balluz,et al.  Prevalence of selected risk behaviors and chronic diseases--Behavioral Risk Factor Surveillance System (BRFSS), 39 steps communities, United States, 2005. , 2008, Morbidity and mortality weekly report. Surveillance summaries.

[34]  M. Munafo,et al.  Interventions for smoking cessation in hospitalised patients. , 2003, The Cochrane database of systematic reviews.

[35]  N. Mutrie,et al.  Interventions to promote walking: systematic review , 2007, BMJ : British Medical Journal.

[36]  J. Critchley,et al.  Efficacy of psychosocial interventions for smoking cessation in patients with coronary heart disease: a systematic review and meta-analysis , 2006, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[37]  M. Fortin,et al.  Single risk factor interventions to promote physical activity among patients with chronic diseases: systematic review. , 2008, Canadian family physician Medecin de famille canadien.

[38]  M. Mäkelä,et al.  Effectiveness of individual lifestyle interventions in reducing cardiovascular disease and risk factors , 2000, Annals of medicine.

[39]  H. Moore,et al.  Dietary advice for the prevention of type 2 diabetes mellitus in adults. , 2016, The Cochrane database of systematic reviews.

[40]  A Tremblay,et al.  [Nutrition and physical activity]. , 1980, L'union medicale du Canada.

[41]  I. Ajzen,et al.  Predicting and Changing Behavior: The Reasoned Action Approach , 2009 .

[42]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[43]  K. Lovell,et al.  Healthy living interventions and schizophrenia: a systematic review. , 2005, Journal of advanced nursing.

[44]  C. Skinner,et al.  The health belief model. , 2008 .

[45]  F. Naughton,et al.  Self-help smoking cessation interventions in pregnancy: a systematic review and meta-analysis. , 2008, Addiction.

[46]  E. Waters,et al.  Interventions for promoting smoking cessation during pregnancy. , 2000, The Cochrane database of systematic reviews.

[47]  E. A. Locke,et al.  Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. , 2002, The American psychologist.

[48]  M. H. Jager-Geurts,et al.  Hart- en vaatziekten in Nederland, 2006. Cijfers over leefstijl- en ricicofactoren, ziekte en sterfte , 2006 .

[49]  Charles Abraham,et al.  The UK national institute for health and clinical excellence public health guidance on behaviour change: A brief introduction , 2009, Psychology, health & medicine.

[50]  C. Abraham,et al.  A taxonomy of behavior change techniques used in interventions. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[51]  B. Pinto,et al.  Health behavior changes after a cancer diagnosis: What do we know and where do we go from here? , 2000, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[52]  E. Waters,et al.  Interventions for preventing obesity in children. , 2001, The Cochrane database of systematic reviews.

[53]  T. Thomsen,et al.  Interventions for preoperative smoking cessation. , 2014, The Cochrane database of systematic reviews.

[54]  C. V. van Schayck,et al.  Smoking cessation for chronic obstructive pulmonary disease. , 2003, The Cochrane database of systematic reviews.

[55]  Lora E. Burke,et al.  Compliance with cardiovascular disease prevention strategies: A review of the research , 1997, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[56]  E. Seydel,et al.  Protection Motivation Theory , 2022 .

[57]  K. Chad,et al.  Home versus center based physical activity programs in older adults. , 2005, The Cochrane database of systematic reviews.

[58]  S. Brophy,et al.  Interventions for latent autoimmune diabetes (LADA) in adults. , 2011, The Cochrane database of systematic reviews.

[59]  A. Avenell,et al.  What are the long-term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. , 2004, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[60]  K. Glanz,et al.  Health Behavior and Health Education , 1990 .

[61]  L. Stead,et al.  Nursing intervention and smoking cessation: meta-analysis update. , 2006, Heart & lung : the journal of critical care.

[62]  S. Wilcox,et al.  Nutrition and physical activity interventions to reduce cardiovascular disease risk in health care settings: a quantitative review with a focus on women. , 2009, Nutrition reviews.

[63]  R. Glasgow,et al.  Review of primary care-based physical activity intervention studies: effectiveness and implications for practice and future research. , 2000, The Journal of family practice.

[64]  H. Leino‐Kilpi,et al.  A review of outcomes of individualised nursing interventions on adult patients. , 2008, Journal of clinical nursing.