1
|
Nian T, Guo K, Liu W, Deng X, Hu X, Xu M, E F, Wang Z, Song G, Yang K, Li X, Shang W. Non-pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses. BMC Med 2023; 21:378. [PMID: 37775745 PMCID: PMC10542700 DOI: 10.1186/s12916-023-03087-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Although non-pharmacological smoking cessation measures have been widely used among smokers, current research evidence on the effects of smoking cessation is inconsistent and of mixed quality. Moreover, there is a lack of comprehensive evidence synthesis. This study seeks to systematically identify, describe, and evaluate the available evidence for non-pharmacological interventions in smoking populations through evidence mapping (EM), and to search for best-practice smoking cessation programs. METHODS A comprehensive search for relevant studies published from the establishment of the library to January 8, 2023, was conducted in PubMed, Web of Science, Embase, the Cochrane Library, CNKI, CBM, Wan Fang, and VIP. Two authors independently assessed eligibility and extracted data. The PRISMA statement and AMSTAR 2 tool were used to evaluate the report quality and methodology quality of systematic reviews/meta-analyses (SRs/MAs), respectively. Bubble plots were utilized to display information, such as the study population, intervention type, evidence quality, and original study sample size. RESULTS A total of 145 SRs/MAs regarding non-pharmacological interventions for smoking cessation were investigated, with 20 types of interventions identified. The most commonly used interventions were cognitive behaviour education (n = 32, 22.07%), professional counselling (n = 20, 13.79%), and non-nicotine electronic cigarettes (e-cigarettes) (n = 13, 8.97%). Among them, counselling and behavioural support can improve smoking cessation rates, but the effect varies depending on the characteristics of the support provided. These findings are consistent with previous SRs/MAs. The general population (n = 108, 74.48%) was the main cohort included in the SRs/MAs. The total score of PRISMA for the quality of the reports ranged from 8 to 27, and 13 studies (8.97%) were rated as high confidence, and nine studies (6.21%) as moderate confidence, in the AMSTAR 2 confidence rating. CONCLUSIONS The abstinence effect of cognitive behaviour education and money incentive intervention has advantages, and non-nicotine e-cigarettes appear to help some smokers transition to less harmful replacement tools. However, the methodological shortcomings of SRs/MAs should be considered. Therefore, to better guide future practice in the field of non-pharmacological smoking cessation, it is essential to improve the methodological quality of SRs and carry out high-quality randomized controlled trials (RCTs).
Collapse
Affiliation(s)
- Tao Nian
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Kangle Guo
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wendi Liu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xinxin Deng
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Xiaoye Hu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
| | - Meng Xu
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Fenfen E
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Ziyi Wang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Guihang Song
- Gansu Provincial Medical Security Bureau, Lanzhou, 730000, People's Republic of China
| | - Kehu Yang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Xiuxia Li
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, People's Republic of China
| | - Wenru Shang
- Evidence Based Social Science Research Center/Health Technology Assessment Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, People's Republic of China.
- Vidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China.
- Collaborative Innovation Center of First Hospital, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| |
Collapse
|
2
|
Mersha AG, Bryant J, Rahman T, McGuffog R, Maddox R, Kennedy M. What Are the Effective Components of Group-Based Treatment Programs For Smoking Cessation? A Systematic Review and Meta-Analysis. Nicotine Tob Res 2023; 25:1525-1537. [PMID: 37104053 PMCID: PMC10439487 DOI: 10.1093/ntr/ntad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/12/2023] [Accepted: 04/26/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION There is significant variation in the format and delivery of group-based smoking cessation programs. To guide research and healthcare program implementation, it is important to understand the active components of interventions. AIMS AND METHODS This review aimed to (1) identify behavior change techniques (BCTs) used in effective group-based smoking cessation interventions, (2) determine the effectiveness of group-based smoking cessation interventions on smoking cessation at 6-month follow-up, and (3) identify the behavior change techniques (BCTs) related to effective group-based smoking cessation. The following databases were searched in January 2000 and March 2022: MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Library, and Web of Science. BCTs used in each study were extracted using the BCT Taxonomy. Studies that included identified BCTs were computed, and meta-analyses were conducted to evaluate smoking cessation at 6-month follow-up. RESULTS A total of 28 BCTs were identified from 19 randomized controlled trials. Studies included an average of 5.42 ± 2.0 BCTs. The most frequent BCTs were "information about health consequences" and "problem solving." The pooled 6-month smoking cessation was higher in the group-based intervention group (OR = 1.75, 95% CI = 1.12 to 2.72, p <.001). Inclusion of the following four BCTs: "Problem solving," "Information about health Consequences," "Information about social and environmental consequences," and "Reward (outcome)" were found to be significantly associated with increased rate of 6-month smoking cessation. CONCLUSIONS Group-based smoking cessation interventions doubles the rate of smoking cessation at 6-month follow-up. Implementing group-based smoking cessation programs, that incorporate multiple BCTs, is recommended for an effective smoking cessation care. IMPLICATIONS Group-based smoking cessation programs improves smoking cessation outcomes in clinical trials. There is a need to incorporate effective individual BCTs techniques to enhance smoking cessation treatment outcomes. A robust evaluation is required to assess the effectiveness of group-based cessation programs in real world settings. There is also a need to consider the differential effectiveness of group-based programs and BCT impacts on populations, for example, indigenous peoples.
Collapse
Affiliation(s)
- Amanual Getnet Mersha
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tabassum Rahman
- Centre for Epidemiology and Biostatistics, University of Melbourne, VIC, Australia
| | - Romany McGuffog
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Raglan Maddox
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| |
Collapse
|
3
|
Doğru OC, Webb TL, Norman P. Can behavior change techniques be delivered via short text messages? Transl Behav Med 2022; 12:979-986. [PMID: 36190350 DOI: 10.1093/tbm/ibac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Despite significant advancements in behavioral science it is unclear whether behavior change techniques (or BCTs) can be delivered to large numbers of people in a cost-effective and reliable way. The current study investigated whether it is possible to reliably deliver BCTs using short text messages. Short text messages were designed to deliver each of the 93 BCTs specified in the BCT taxonomy v1. Following initial coding and refinement by the team, a Delphi study with a panel of 15 experts coded which BCT each short text message was designed to deliver and also rated whether they were likely to be understood by recipients and easily converted to target different behaviors. After two iterations, the experts correctly assigned 66 of the 93 messages to the BCT that they were designed to deliver and indicated that these messages were likely to be easy to apply to a range of behaviors and understood by recipients. Experts were not able to identify which BCT 27 of the messages were designed to deliver and it was notable that some clusters of BCTs (e.g., "Goals and planning") were easier to deliver via short text messages than other clusters (e.g., "Scheduled consequences"). The findings suggest that short text messages can be a reliable way to deliver many, but not all, BCTs. The implications of the current study are discussed with respect to the delivery of specific BCTs and clusters of the taxonomy, as well as the need to test the acceptability of interventions delivered via short messages and the impact of messages on behavior.
Collapse
Affiliation(s)
- Onur Cem Doğru
- Department of Psychology, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Thomas L Webb
- Department of Psychology, The University of Sheffield, Sheffield, UK
| | - Paul Norman
- Department of Psychology, The University of Sheffield, Sheffield, UK
| |
Collapse
|
4
|
Wei X, Guo K, Shang X, Wang S, Yang C, Li J, Li Y, Yang K, Zhang X, Li X. Effects of different interventions on smoking cessation in chronic obstructive pulmonary disease patients: A systematic review and network meta-analysis. Int J Nurs Stud 2022; 136:104362. [DOI: 10.1016/j.ijnurstu.2022.104362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 07/21/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022]
|
5
|
Schmid-Mohler G, Hübsch C, Steurer-Stey C, Greco N, Schuurmans MM, Beckmann S, Chadwick P, Clarenbach C. Supporting Behavior Change After AECOPD - Development of a Hospital-Initiated Intervention Using the Behavior Change Wheel. Int J Chron Obstruct Pulmon Dis 2022; 17:1651-1669. [PMID: 35923357 PMCID: PMC9339665 DOI: 10.2147/copd.s358426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022] Open
Abstract
After hospitalization due to acute COPD exacerbations, patient-manageable behaviors influence rehospitalization frequency. This study's aim was to develop a hospital-ward-initiated Behaviour-Change-Wheel (BCW)-based intervention targeting patients' key health behaviors, with the aim to increase quality of life and reduce rehospitalization frequency. Intervention development was performed by University Hospital Zurich working groups and followed the three BCW stages for each of the three key literature-identified problems: insufficient exacerbation management, lack of physical activity and ongoing smoking. In stage one, by analyzing published evidence - including but not limited to patients' perspective - and health professionals' perspectives regarding these problems, we identified six target behaviors. In stage two, we identified six corresponding intervention functions. As our policy category, we chose developing guidelines and service provision. For stage three, we defined eighteen basic intervention packages using 46 Behaviour Change Techniques in our basic intervention. The delivery modes will be face-to-face and telephone contact. In the inpatient setting, this behavioral intervention will be delivered by a multi-professional team. For at least 3 months following discharge, an advanced nursing practice team will continue and coordinate the necessary care package via telephone. The intervention is embedded in a broader self-management intervention complemented by integrated care components. The BCW is a promising foundation upon which to develop our COPD intervention. In future, the interaction between the therapeutic care team-patient relationships and the delivery of the behavioral intervention will also be evaluated.
Collapse
Affiliation(s)
- Gabriela Schmid-Mohler
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Christine Hübsch
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Claudia Steurer-Stey
- Epidemiology, Biostatistics and Prevention Institute, University Zurich, Zurich, Switzerland
- mediX Group Practice Zurich, Zurich, Switzerland
| | - Nico Greco
- Physiotherapy Occupational Therapy, University Hospital Zurich, Zurich, Switzerland
| | - Macé M Schuurmans
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Sonja Beckmann
- Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Paul Chadwick
- Centre for Behavior Change, University College London, London, UK
| | - Christian Clarenbach
- Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| |
Collapse
|
6
|
Burke MV, Cha S, Shumaker TM, LaPlante M, McConahey L, Graham AL. Delivery of smoking cessation treatment via live chat: An analysis of client-centered coaching skills and behavior change techniques. PATIENT EDUCATION AND COUNSELING 2022; 105:2183-2189. [PMID: 34887156 DOI: 10.1016/j.pec.2021.11.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/14/2021] [Accepted: 11/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This qualitative study explored whether evidence-based tobacco cessation treatment components can be deployed via web-based live chat coaching. METHODS N = 100 randomly selected chats were coded. Researchers used a structured coding guide to note the presence of 3 Motivational Interviewing (MI) skills and 61 behavior change techniques (BCTs). RESULTS MI skills were observed in 86% of chats: 31 chats incorporated one skill, 31 incorporated two, and 24 incorporated all three. Open-ended questions were most common (76%), followed by affirmations (47%) and reflective listening statements (38%). BCTs were observed in 100% of chats: 21% involved one-five BCTs, 69% involved six-10 BCTs, and 10% involved 11 or more BCTs. Mean number of BCTs per chat was 7.25 (SD=2.5; range 2-17). The most common BCTs were Social Support (99%), Reward/Threat (95%), Natural Consequences (82%), Regulation (82%), Goals/Planning (64%), and Self Belief (42%). CONCLUSIONS Tobacco cessation coaching using MI skills and evidence-based BCTs can be delivered via live chat. This synchronous modality allows the delivery of an intervention tailored to the user's motivations and goals. PRACTICE IMPLICATIONS Web-based live chat can broaden the reach of tobacco treatment specialists to deploy evidence-based counseling skills and behavior change techniques in personalized, accessible coaching.
Collapse
Affiliation(s)
- Michael V Burke
- Nicotine Dependence Center, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
| | - Sarah Cha
- Innovations Center, Truth Initiative, Washington, DC, USA.
| | | | | | - Laura McConahey
- Nicotine Dependence Center, Mayo Clinic, Rochester, MN, USA.
| | - Amanda L Graham
- Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Innovations Center, Truth Initiative, Washington, DC, USA.
| |
Collapse
|
7
|
A scoping review of interventions to improve strength training participation. PLoS One 2022; 17:e0263218. [PMID: 35113954 PMCID: PMC8812857 DOI: 10.1371/journal.pone.0263218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background Low participation rates (1–31%) and unique barriers to strength training (e.g., specialized knowledge, equipment, perceived complexity) suggest effective strength training interventions may differ from effective aerobic or general physical activity interventions. The purpose of this scoping review was to examine interventions used to improve strength training participation through mapping theory, intervention characteristics, prescription parameters, and behaviour change techniques. Methods Recommendations by Levac et al. (2010) and PRISMA-ScR were followed in the conduct and reporting of this review, respectively. Patients and exercise professionals participated in developing the research question and data extraction form, interpreting the findings, and drafting the manuscript. Medline, Embase, PsycINFO, CINAHL, SPORTDiscus, and PubMed databases (inception–December 2020) were searched. The inclusion criteria were (a) original peer-reviewed articles and grey literature, (b) intervention study design, and (c) behavioural interventions targeted towards improving strength training participation. Two reviewers performed data screening, extraction, and coding. The interventions were coded using the Behaviour Change Technique Taxonomy version 1. Data were synthesized using descriptive and frequency reporting. Results Twenty-seven unique interventions met the inclusion criteria. Social cognitive theory (n = 9), the transtheoretical model (n = 4), and self-determination theory (n = 2) were the only behaviour change theories used. Almost all the interventions were delivered face-to-face (n = 25), with the majority delivered by an exercise specialist (n = 23) in community or home settings (n = 24), with high variability in exercise prescription parameters. Instructions on how to perform the behaviour, behavioural practice, graded tasks, goal setting, adding objects to the environment (e.g., providing equipment), and using a credible source (e.g., exercise specialist delivery) comprised the most common behaviour change techniques. Conclusions Our results highlight gaps in theory, intervention delivery, exercise prescription parameters, and behaviour change techniques for future interventions to examine and improve our understanding of how to most effectively influence strength training participation.
Collapse
|
8
|
de Bruin M, Black N, Javornik N, Viechtbauer W, Eisma MC, Hartman-Boyce J, Williams AJ, West R, Michie S, Johnston M. Underreporting of the active content of behavioural interventions: a systematic review and meta-analysis of randomised trials of smoking cessation interventions. Health Psychol Rev 2021; 15:195-213. [PMID: 31906781 DOI: 10.1080/17437199.2019.1709098] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
Despite its importance, underreporting of the active content of experimental and comparator interventions in published literature has not been previously examined for behavioural trials. We assessed completeness and variability in reporting in 142 randomised controlled trials of behavioural interventions for smoking cessation published between 1/1996 and 11/2015. Two coders reliably identified the potential active components of experimental and comparator interventions (activities targeting behaviours key to smoking cessation and qualifying as behaviour change techniques, BCTs) in published, and in unpublished materials obtained from study authors directly. Unpublished materials were obtained for 129/204 (63%) experimental and 93/142 (65%) comparator groups. For those, only 35% (1200/3403) of experimental and 26% (491/1891) of comparator BCTs could be identified in published materials. Reporting quality (#published BCTs/#total BCTs) varied considerably between trials and between groups within trials. Experimental (vs. comparator) interventions were better reported (B(SE) = 0.34 (0.11), p < .001). Unpublished materials were more often obtained for recent studies (B(SE) = 0.093 (0.03), p = .003) published in behavioural (vs. medical) journals (B(SE) = 1.03 (0.41), p = .012). This high variability in underreporting of active content compromises reader's ability to interpret the effects of individual trials, compare and explain intervention effects in evidence syntheses, and estimate the additional benefit of an experimental intervention in other settings.
Collapse
Affiliation(s)
- Marijn de Bruin
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Aberdeen, UK
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Nicola Black
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Aberdeen, UK
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Neza Javornik
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Aberdeen, UK
| | - Wolfgang Viechtbauer
- Department of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Maarten C Eisma
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Jamie Hartman-Boyce
- Nuffield Department of Primary Care Health Sciences and National Institute of Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - A Jess Williams
- Institute of Mental HealthSchool of Psychology, University of Birmingham, Birmingham, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Health Psychology Group, Institute of Applied Health SciencesUniversity of Aberdeen, Aberdeen, UK
| |
Collapse
|
9
|
Guerreiro MP, Strawbridge J, Cavaco AM, Félix IB, Marques MM, Cadogan C. Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease. BMC MEDICAL EDUCATION 2021; 21:287. [PMID: 34016108 PMCID: PMC8136137 DOI: 10.1186/s12909-021-02720-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/29/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. METHODS The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases. RESULTS Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists' feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases. CONCLUSIONS A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.
Collapse
Affiliation(s)
- Mara Pereira Guerreiro
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Monte de Caparica, Portugal.
| | - Judith Strawbridge
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences, Dublin, Ireland
| | | | - Isa Brito Félix
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
| | - Marta Moreira Marques
- ADAPT SFI Research Centre & Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin, Dublin, Ireland
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
| | - Cathal Cadogan
- Trinity College Dublin, School of Pharmacy and Pharmaceutical Sciences, Dublin, Ireland
| |
Collapse
|
10
|
Alcántara C, Diaz SV, Cosenzo LG, Loucks EB, Penedo FJ, Williams NJ. Social determinants as moderators of the effectiveness of health behavior change interventions: scientific gaps and opportunities. Health Psychol Rev 2021; 14:132-144. [PMID: 31957557 DOI: 10.1080/17437199.2020.1718527] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Social determinants of health (SDOH) refer to the broad range of social, economic, political, and psychosocial factors that directly or indirectly shape health outcomes and contribute to health disparities. There is a growing and concerted effort to address SDOH worldwide. However, the application of SDOH to health behavior change intervention research is unknown. We reviewed the synthesis literature on health behavior change interventions targeting self-regulation to (a) describe the sociodemographic characteristics, (b) determine which types of social determinants were tested as moderators of health behavior change interventions, (c) evaluate the methodological quality of the meta-analytic evidence, and (d) discuss scientific gaps and opportunities. Thirty (45.4%) of 66 articles examined heterogeneity of treatment effects by SDOH. There was a lack of racial/ethnic, immigrant, sexual/gender minority, and lifecourse sample diversity. Overall, 73.5% of SDOH moderator analyses tested heterogeneity of treatment effects by gender, race/ethnicity, and intervention setting; none examined neighborhood factors. Methodological quality was negatively correlated with number of SDOH analyses. Most SDOH moderator analyses were atheoretical and indicated statistically non-significant differences. We provide an integrated SDOH and science of behavior change framework and discuss scientific opportunities for intervention research on health behavior change to improve health equity.
Collapse
Affiliation(s)
| | | | | | - Eric B Loucks
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | |
Collapse
|
11
|
Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer. Nutrients 2021; 13:nu13020612. [PMID: 33668596 PMCID: PMC7917689 DOI: 10.3390/nu13020612] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 12/26/2022] Open
Abstract
Background: An increasing number of dietary interventions for cancer survivors have been based on the behaviour change theory framework. The purpose of this study is to review the use and implementation of behaviour change theories in dietary interventions for people after cancer and assess their effects on the reported outcomes. Methods: The search strategy from a Cochrane review on dietary interventions for cancer survivors was expanded to incorporate an additional criterion on the use of behaviour change theory and updated to September 2020. Randomised controlled trials (RCT) testing a dietary intervention compared to the control were included. Standard Cochrane methodological procedures were used. Results: Nineteen RCTs, with 6261 participants (age range 44.6 to 73.1 years), were included in the review. The Social Cognitive Theory was the most frequently used theory (15 studies, 79%). Studies included between 4 to 17 behaviour change techniques. Due to limited information on the mediators of intervention and large heterogeneity between studies, no meta-analyses was conducted to assess which theoretical components of the interventions are effective. Conclusions: Whilst researchers have incorporated behaviour change theories into dietary interventions for cancer survivors, due to inconsistencies in design, evaluation and reporting, the effect of theories on survivors’ outcomes remains unclear.
Collapse
|
12
|
van der Velde M, Valkenet K, Geleijn E, Kruisselbrink M, Marsman M, Janssen LM, Ruurda JP, van der Peet DL, Aarden JJ, Veenhof C, van der Leeden M. Usability and Preliminary Effectiveness of a Preoperative mHealth App for People Undergoing Major Surgery: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e23402. [PMID: 33410758 PMCID: PMC7819776 DOI: 10.2196/23402] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 11/03/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Major surgery is associated with negative postoperative outcomes such as complications and delayed or poor recovery. Multimodal prehabilitation can help to reduce the negative effects of major surgery. Offering prehabilitation by means of mobile health (mHealth) could be an effective new approach. OBJECTIVE The objectives of this pilot study were to (1) evaluate the usability of the Be Prepared mHealth app prototype for people undergoing major surgery, (2) explore whether the app was capable of bringing about a change in risk behaviors, and (3) estimate a preliminary effect of the app on functional recovery after major surgery. METHODS A mixed-methods pilot randomized controlled trial was conducted in two Dutch academic hospitals. In total, 86 people undergoing major surgery participated. Participants in the intervention group received access to the Be Prepared app, a smartphone app using behavior change techniques to address risk behavior prior to surgery. Both groups received care as usual. Usability (System Usability Scale), change in risk behaviors 3 days prior to surgery, and functional recovery 30 days after discharge from hospital (Patient-Reported Outcomes Measurement Information System physical functioning 8-item short form) were assessed using online questionnaires. Quantitative data were analyzed using descriptive statistics, chi-square tests, and multivariable linear regression. Semistructured interviews about the usability of the app were conducted with 12 participants in the intervention group. Thematic analysis was used to analyze qualitative data. RESULTS Seventy-nine people-40 in the intervention group and 39 in the control group-were available for further analysis. Participants had a median age of 61 (interquartile range 51.0-68.0) years. The System Usability Scale showed that patients considered the Be Prepared app to have acceptable usability (mean 68.2 [SD 18.4]). Interviews supported the usability of the app. The major point of improvement identified was further personalization of the app. Compared with the control group, the intervention group showed an increase in self-reported physical activity and muscle strengthening activities prior to surgery. Also, 2 of 2 frequent alcohol users in the intervention group versus 1 of 9 in the control group drank less alcohol in the run-up to surgery. No difference was found in change of smoking cessation. Between-group analysis showed no meaningful differences in functional recovery after correction for baseline values (β=-2.4 [95% CI -5.9 to 1.1]). CONCLUSIONS The Be Prepared app prototype shows potential in terms of usability and changing risk behavior prior to major surgery. No preliminary effect of the app on functional recovery was found. Points of improvement have been identified with which the app and future research can be optimized. TRIAL REGISTRATION Netherlands Trial Registry NL8623; https://www.trialregister.nl/trial/8623.
Collapse
Affiliation(s)
- Miriam van der Velde
- Innovation of Human Movement Care Research Group, HU University of Applied Sciences, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Karin Valkenet
- Innovation of Human Movement Care Research Group, HU University of Applied Sciences, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Edwin Geleijn
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marjoke Kruisselbrink
- Clinical Health Sciences, Program Physiotherapy Sciences, Utrecht University, Utrecht, Netherlands
| | - Marije Marsman
- Department of Anesthesiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Liedewij Mj Janssen
- Department of Anesthesiology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jelle P Ruurda
- Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Donald L van der Peet
- Department of Surgery, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jesse J Aarden
- European School of Physiotherapy, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Cindy Veenhof
- Innovation of Human Movement Care Research Group, HU University of Applied Sciences, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
13
|
Thacker J, Bosello F, Ridehalgh C. Do behaviour change techniques increase adherence to home exercises in those with upper extremity musculoskeletal disorders? A systematic review. Musculoskeletal Care 2020; 19:340-362. [PMID: 33331093 DOI: 10.1002/msc.1532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To investigate whether behaviour change techniques (BCTs) can influence adherence to home exercise in people with upper extremity musculoskeletal disorders (UEMD). DESIGN A systematic review of randomised control trials, non-randomised control trials, case-control studies and cohort studies. Results were presented narratively. Participants were those with UEMD. The intervention was any home exercise programme, alongside a BCT designed to increase exercise adherence. Any duration of intervention was accepted. The main outcome sought was adherence to home exercise. A systematic search was performed on four online databases. Grey literature was searched. RESULTS The search resulted in 28,755 titles. 77 full-text articles were assessed for eligibility. Six studies were included in the qualitative synthesis. Four studies had Some Concern of Bias, whilst two studies had High Risk of Bias. Three studies found statistically significant differences in exercise adherence (p < 0.05) between the Intervention group and Control group. The BCT 'Social Support (unspecified)' was used within all studies that found significant differences in adherence levels at outcome. However, multiple BCTs were received by the Intervention groups within all studies, making it impossible to identify the effects of any single BCT upon adherence levels. CONCLUSION Social support may be relevant in patients' adherence levels to HEPs. However, confidence in the results is uncertain given the small number of studies found, and their High RoB. Future studies should validate their measurement and definition of adherence, as well as the number of BCTs they use, to provide reproducible evidence.
Collapse
Affiliation(s)
| | - Francesca Bosello
- European School of Physiotherapy, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | | |
Collapse
|
14
|
Black N, Johnston M, Michie S, Hartmann-Boyce J, West R, Viechtbauer W, Eisma MC, Scott C, de Bruin M. Behaviour change techniques associated with smoking cessation in intervention and comparator groups of randomized controlled trials: a systematic review and meta-regression. Addiction 2020; 115:2008-2020. [PMID: 32196796 DOI: 10.1111/add.15056] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/22/2019] [Accepted: 03/18/2020] [Indexed: 02/06/2023]
Abstract
AIMS To estimate the strengths of associations between use of behaviour change techniques (BCTs) and clusters of BCTs in behavioural smoking cessation interventions and comparators with smoking cessation rates. METHOD Systematic review and meta-regression of biochemically verified smoking cessation rates on BCTs in interventions and comparators in randomized controlled trials, adjusting for a priori-defined potential confounding variables, together with moderation analyses. Studies were drawn from the Cochrane Tobacco Addiction Group Specialised Register. Data were extracted from published and unpublished (i.e. obtained from study authors) study materials by two independent coders. Adequately described intervention (k = 143) and comparator (k = 92) groups were included in the analyses (n = 43 992 participants). Using bivariate mixed-effects meta-regressions, while controlling for key a priori confounders, we regressed smoking cessation on (a) three BCT groupings consistent with dual-process theory (i.e. associative, reflective motivational and self-regulatory), (b) 17 expert-derived BCT groupings (i.e. BCT taxonomy version 1 clusters) and (c) individual BCTs from the BCT taxonomy version 1. RESULTS Among person-delivered interventions, higher smoking cessation rates were predicted by BCTs targeting associative and self-regulatory processes (B = 0.034, 0.041, P < 0.05), and by three individual BCTs (prompting commitment, social reward, identity associated with changed behaviour). Among written interventions, BCTs targeting taxonomy cluster 10a (rewards) predicted higher smoking cessation (B = 0.394, P < 0.05). Moderation effects were observed for nicotine dependence, mental health status and mode of delivery. CONCLUSIONS Among person-delivered behavioural smoking cessation interventions, specific behaviour change techniques and clusters of techniques are associated with higher success rates.
Collapse
Affiliation(s)
- Nicola Black
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Aberdeen, UK.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Marie Johnston
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Aberdeen, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford and United Kingdom and National Institute of Health Research, Oxford Biomedical Research Centre, University of Oxford, Unipart House Business Centre, Oxford, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Maarten C Eisma
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Aberdeen, UK.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| | - Claire Scott
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Aberdeen, UK.,Scottish Dental Clinical Effectiveness Programme, NHS Education for Scotland, Dundee Dental Education Centre, Dundee, UK
| | - Marijn de Bruin
- Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Aberdeen, UK.,Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| |
Collapse
|
15
|
Smartphone App and Carbon Monoxide Self-Monitoring Support for Smoking Cessation: A Randomized Controlled Trial Nested into the Swiss HIV Cohort Study. J Acquir Immune Defic Syndr 2020; 85:e8-e11. [DOI: 10.1097/qai.0000000000002396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Minian N, Corrin T, Lingam M, deRuiter WK, Rodak T, Taylor VH, Manson H, Dragonetti R, Zawertailo L, Melamed OC, Hahn M, Selby P. Identifying contexts and mechanisms in multiple behavior change interventions affecting smoking cessation success: a rapid realist review. BMC Public Health 2020; 20:918. [PMID: 32532233 PMCID: PMC7291527 DOI: 10.1186/s12889-020-08973-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome. Methods This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis. Results Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.’s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant’s capability or motivation to make a behaviour change was only successful within certain contexts. Conclusion In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from ‘individualistic epidemiology’ and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment). Trial registration PROSPERO registration number: CRD42017064430
Collapse
Affiliation(s)
- Nadia Minian
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Tricia Corrin
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Mathangee Lingam
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Wayne K deRuiter
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Calgary, 1403 - 29 Street NW, Calgary, Alberta, T2N 2T9, Canada
| | - Heather Manson
- Public Health Ontario, 480 University Avenue, Toronto, Ontario, M5G 1V2, Canada
| | - Rosa Dragonetti
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Laurie Zawertailo
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
| | - Osnat C Melamed
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada
| | - Margaret Hahn
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, 175 College St, Toronto, Ontario, M5T 1P7, Canada. .,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada. .,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario, M5T 1R8, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
| |
Collapse
|
17
|
Hennessy EA, Johnson BT, Acabchuk RL, McCloskey K, Stewart-James J. Self-regulation mechanisms in health behavior change: a systematic meta-review of meta-analyses, 2006-2017. Health Psychol Rev 2020; 14:6-42. [PMID: 31662031 PMCID: PMC7571594 DOI: 10.1080/17437199.2019.1679654] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 10/09/2019] [Indexed: 12/28/2022]
Abstract
Self-regulation is one primary mechanism in interventions for health behavior change and has been examined in numerous recent meta-analyses. This pre-registered meta-review (PROSPERO CRD42017074018) examined Mmeta-analyses of any intervention and health behavior/outcome were eligible if they quantitatively assessed self-regulation and appeared between January 2006 and August 2017. In total, 66 meta-analyses were ultimately eligible; 27% reported a protocol, 11% used GRADE; 58% focused on RCTs. Reviews satisfied only a moderate number of items on the AMSTAR 2 (M = 45.45%, SD = 29.57%). Only 6% of meta-analyses directly examined whether changes in self-regulation predicted the behavior change (i.e., self-efficacy and physical activity, l = 2; frequency of self-monitoring and goal attainment, l = 1; cognitive bias modification and addiction, l = 1). Meta-analyses more routinely assessed self-regulation by comparing the efficacy of intervention components (97%), such as those from behavior change taxonomies. Meta-analyses that focused on intervention components identified several as successful, including personalized feedback, goal setting, and self-monitoring; however, none were consistently successful in that each worked only for some health behaviors and with particular populations. Some components had inconclusive evidence, given that they were only examined in low- quality reviews. Future reviewers should utilize advanced methods to assess mechanisms, and study authors should report hypothesized mechanisms to facilitate synthesis.
Collapse
Affiliation(s)
- Emily A Hennessy
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Blair T Johnson
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Rebecca L Acabchuk
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Kiran McCloskey
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Jania Stewart-James
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| |
Collapse
|
18
|
Protogerou C, McHugh RK, Johnson BT. How best to reduce unhealthy risk-taking behaviours? A meta-review of evidence syntheses of interventions using self-regulation principles. Health Psychol Rev 2020; 14:86-115. [DOI: 10.1080/17437199.2019.1707104] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Cleo Protogerou
- School of Social Sciences, Humanities and Arts (SSHA) and Health Sciences Research Institute (HSRI), University of California, Merced, USA
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - R. Kathryn McHugh
- Department of Psychiatry, Harvard Medical School, and Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, USA
| | - Blair T. Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
19
|
Lüscher J, Berli C, Schwaninger P, Scholz U. Smoking cessation with smartphone applications (SWAPP): study protocol for a randomized controlled trial. BMC Public Health 2019; 19:1400. [PMID: 31664959 PMCID: PMC6819348 DOI: 10.1186/s12889-019-7723-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/09/2019] [Indexed: 12/27/2022] Open
Abstract
Background Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. The social context of smokers has, however, been neglected in smartphone apps promoting smoking cessation. This randomized controlled trial investigates the effectiveness of a smartphone app in which smokers quit smoking with the help of a social network member. Methods This protocol describes the design of a single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Participants of this study are adult smokers who smoke at least one cigarette per day and intend to quit smoking at a self-set quit date. Blocking as means of group-balanced randomization is used to allocate participants to intervention or control conditions. Both intervention and control group use a smartphone-compatible device for measuring their daily smoking behavior objectively via exhaled carbon monoxide. In addition, the intervention group is instructed to use the SmokeFree Buddy app, a multicomponent app that also facilitates smoking-cessation specific social support from a buddy over a smartphone application. All participants fill out a baseline diary for three consecutive days and are invited to the lab for a background assessment. They subsequently participate in an end-of-day diary phase from 7 days before and until 20 days after a self-set quit date. Six months after the self-set quit date a follow-up diary for three consecutive days takes place. The primary outcome measures are daily self-reported and objectively-assessed smoking abstinence and secondary outcome measures are daily self-reported number of cigarettes smoked. Discussion This is the first study examining the effectiveness of a smoking cessation mobile intervention using the SmokeFree Buddy app compared to a control group in a real-life setting around a self-set quit date using a portable objective measure to assess smoking abstinence. Opportunities and challenges with running studies with smoking participants and certain design-related decisions are discussed. Trial registration This trial was prospectively registered on 04/04/2018 at ISRCTNregistry: ISRCTN11154315.
Collapse
Affiliation(s)
- Janina Lüscher
- Applied Social and Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland.
| | - Corina Berli
- Applied Social and Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland
| | - Philipp Schwaninger
- Applied Social and Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland
| | - Urte Scholz
- Applied Social and Health Psychology and University Research Priority Program "Dynamics of Healthy Aging", Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland
| |
Collapse
|
20
|
O'Neill N, Dogar O, Jawad M, Kellar I, Kanaan M, Siddiqi K. Which Behavior Change Techniques May Help Waterpipe Smokers to Quit? An Expert Consensus Using a Modified Delphi Technique. Nicotine Tob Res 2019; 20:154-160. [PMID: 27798091 DOI: 10.1093/ntr/ntw297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 10/24/2016] [Indexed: 11/13/2022]
Abstract
Introduction Waterpipe smoking is addictive and harmful. The determinants of waterpipe smoking may differ from those of cigarette smoking; therefore, behavioral approaches to support quitting may also differ between these two tobacco products. While some evidence exists on effective behavioral change techniques (BCTs) to facilitate cigarette smoking cessation, there is little research on waterpipe smoking cessation. Methods Twenty-four experts were selected from the author lists of peer-reviewed, randomized controlled trials on waterpipe smoking cessation. They were invited to two rounds of a consensus development exercise using modified Delphi technique. Experts ranked 55 BCTs categorized further into those that promote; "awareness of harms of waterpipe smoking and advantages of quitting" (14), "preparation and planning to quit" (29), and "relapse prevention and sustaining an ex-smoker identity" (12) on their potential effectiveness. Kendall's W statistics was used to assess agreement. Results Fifteen experts responded in round 1 and 14 completed both rounds. A strong consensus was achieved for BCTs that help in "relapse prevention and sustaining ex-smoker identity" (w = 0.7; p < .001) and a moderate for those that promote "awareness of harms of waterpipe smoking and advantages of quitting" (w = 0.6; p < .001) and "preparation and planning to quit" (w = 0.6; p < .001). Providing information on the consequences of waterpipe smoking and its cessation, assessing readiness and ability to quit, and making people aware of the withdrawal symptoms, were the three highest-ranking BCTs. Conclusion Based on expert consensus, an inventory of BCTs ordered for their potential effectiveness can be useful for health professionals offering cessation support to waterpipe smokers. Implications Waterpipe smoking is addictive, harmful, and gaining global popularity, particularly among youth. An expert consensus on behavior change techniques, likely to be effective in supporting waterpipe smokers to quit, has practice and research implications. Smoking cessation advisors can use these techniques to counsel waterpipe smokers who wish to quit. Behavioral and public health scientists can also use these to develop and evaluate behavioral support interventions for this client group.
Collapse
Affiliation(s)
- Nancy O'Neill
- Department of Health Sciences, University of York, York, UK
| | - Omara Dogar
- Department of Health Sciences, University of York, York, UK
| | - Mohammed Jawad
- Department of Primary Care and Public Health, Imperial College London, London, UK.,Department of Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Ian Kellar
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
| | - Mona Kanaan
- Department of Health Sciences, University of York, York, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| |
Collapse
|
21
|
Marck CH, das Nair R, Grech LB, Borland R, Constantinescu CS. Modifiable risk factors for poor health outcomes in multiple sclerosis: The urgent need for research to maximise smoking cessation success. Mult Scler 2019; 26:266-271. [PMID: 31219393 PMCID: PMC7065446 DOI: 10.1177/1352458519858730] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tobacco smoking is a well-established risk factor for multiple sclerosis (MS) onset, progression and poor health outcomes in people with MS. Despite smoking being a modifiable risk factor, no research has been undertaken to understand how, or who is best placed, to assess or understand smoking behaviour in people with MS, or how healthcare professionals can best assist people with MS to quit. People with MS may have unique motivators to continue smoking, or unique barriers to smoking cessation, that are not addressed by existing cessation tools. Research is urgently needed in this area if the aim is to maximise health outcomes for all people with MS.
Collapse
Affiliation(s)
- Claudia H Marck
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Roshan das Nair
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK/Institute of Mental Health, Nottingham, UK
| | - Lisa B Grech
- School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia/Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia/Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia/Cancer Council Victoria, Melbourne, VIC, Australia/Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Cris S Constantinescu
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
22
|
Rajani NB, Weth D, Mastellos N, Filippidis FT. Use of gamification strategies and tactics in mobile applications for smoking cessation: a review of the UK mobile app market. BMJ Open 2019; 9:e027883. [PMID: 31213452 PMCID: PMC6596969 DOI: 10.1136/bmjopen-2018-027883] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Mobile phone-based interventions have been proven to be effective tools for smoking cessation, at least in the short term. Gamification, that is, the use of game-design elements in a non-game context, has been associated with increased engagement and motivation, critical success factors for long-term success of mobile Health solutions. However, to date, no app review has examined the use of gamification in smoking cessation mobile apps. Our review aims to examine and quantify the use of gamification strategies (broad principles) and tactics (on-screen features) among existing mobile apps for smoking cessation in the UK. METHODS The UK Android and iOS markets were searched in February 2018 to identify smoking cessation apps. 125 Android and 15 iOS apps were tested independently by two reviewers for primary functionalities, adherence to Five A smoking cessation guidelines, and adoption of gamification strategies and tactics. We examined differences between platforms with χ2 tests. Correlation coefficients were calculated to explore the relationship between adherence to guidelines and gamification. RESULTS The most common functionality of the 140 mobile apps we reviewed allowed users to track the days since/until the quit date (86.4%). The most popular gamification strategy across both platforms was performance feedback (91.4%). The majority of apps adopted a medium level of gamification strategies (55.0%) and tactics (64.3%). Few adopted high levels of gamification strategies (6.4%) or tactics (5.0%). No statistically significant differences between the two platforms were found regarding level of gamification (p>0.05) and weak correlations were found between adherence to Five A's and gamification strategies (r=0.38) and tactics (r=0.26). CONCLUSION The findings of this review show that a high level of gamification is adopted by a small minority of smoking cessation apps in the UK. Further exploration of the use of gamification in smoking cessation apps may provide insights into its role in smoking cessation.
Collapse
Affiliation(s)
- Nikita B Rajani
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Dominik Weth
- Department of Strategy and Innovation, MSU Consulting GmbH, Bad Homburg, Germany
| | - Nikolaos Mastellos
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
23
|
Abstract
Tobacco cigarette smoking is a serious epidemic that kills several million people each year. Nevertheless, a significant percentage of patients with respiratory diseases continue to smoke after diagnosis, despite the assistance offered, thus reducing the efficacy of the treatments prescribed by the health providers and dramatically increasing the mortality rate. International guidelines have advocated the importance of including smoking cessation protocols in the management of patients' respiratory conditions and pointed out the need to deliver integrated and tailored interventions. Consistently with this framework, the commentary proposes a new clinical approach to smoking cessation in patients with respiratory diseases. This approach integrates, according to P5 personalized medicine, pharmacological and psychological aspects affecting smoking behaviors, overcoming the traditional approach mainly based on the pharmacological interventions.
Collapse
|
24
|
Hosseinzadeh H, Shnaigat M. Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: a systematic review. Aust J Prim Health 2019; 25:PY18181. [PMID: 31203839 DOI: 10.1071/py18181] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/26/2019] [Indexed: 11/23/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the more disabling diseases and the third cause of mortality worldwide. Self-management is considered an effective strategy for controlling and managing COPD. This review aims to summarise the available evidence on the effectiveness of COPD self-management in primary care settings. Social Sciences, Citation Index, MEDLINE, CINAHL, Academic Search Complete and Scopus were searched for randomised controlled trials of COPD self-management in general practice between 2001 and 2018. Ten randomised controlled trials of COPD self-management trials conducted in primary care settings were included in this review. The identified trials have recruited stable patients; a majority having mild to moderate COPD. The trials implemented different types of interventions and measured improvements in knowledge, skills and behaviours of self-management, mental health, self-efficacy and endpoint outcomes such as hospitalisation and quality of life. The findings showed that COPD self-management trials had positive effects on COPD knowledge and improved self-management behaviours such as adherence to medication, physical activities and smoking cessation in some cases; however, the effect of trials on hospitalisation rate, quality of life and healthcare utilisation were not conclusive. There was also not enough evidence to suggest that the trials were efficient in improving self-efficacy, a major driver of self-management behaviours. Primary care COPD self-management trials are efficient in improving surrogate outcomes such as knowledge of and adherence to self-management behaviours; however, such improvements are less likely to be sustainable in the absence of self-efficacy. Future studies should also focus on improving endpoint self-management outcomes like hospitalisation rate and quality of life to benefit both patient and healthcare system.
Collapse
Affiliation(s)
- Hassan Hosseinzadeh
- School of Health & Society, Building 15, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Mahmmoud Shnaigat
- School of Health & Society, Building 15, University of Wollongong, Wollongong, NSW 2522, Australia; and Corresponding author
| |
Collapse
|
25
|
Mathew AR, Guzman M, Bridges C, Yount S, Kalhan R, Hitsman B. Assessment of Self-Management Treatment Needs Among COPD Helpline Callers. COPD 2019; 16:82-88. [PMID: 30789041 PMCID: PMC7135910 DOI: 10.1080/15412555.2019.1575350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 02/01/2023]
Abstract
Telephone quitlines are an effective population-based strategy for smoking cessation, particularly among individuals with tobacco-related diseases such as chronic obstructive pulmonary disease (COPD). Expanding quitline services to provide COPD-focused self-management interventions is potentially beneficial; however, data are needed to identify specific treatment needs in this population. We conducted a telephone-based survey (N = 5,772) to examine educational needs, behavioral health characteristics, and disease-related interference among individuals with COPD who received services from the American Lung Association (ALA) Lung Helpline. Most participants (73.7%) were interested in COPD-focused information, and few had received prior instruction in breathing exercises (33.9%), energy conservation (26.5%), or airway clearing (32.1%). About one-third of participants engaged in regular exercise, 16.3% followed a special diet, and 81.4% were current smokers. Most participants (78.2%) reported COPD-related interference in daily activities and 30.8% had been hospitalized within the past six months for their breathing. Nearly half of participants (45.4%) reported current symptoms of anxiety or depression. Those with vs. without anxiety/depression had higher rates of COPD-related interference (83.9% vs. 73.5%, p < .001) and past six-month hospitalization (33.4% vs. 28.3%, p < .001). In conclusion, this survey identified strong interest in disease-focused education; a lack of prior instruction in specific self-management strategies for COPD; and behavioral health needs in the areas of exercise, diet, and smoking cessation. Anxiety and depression symptoms were common and associated with greater disease burden, underscoring the importance of addressing coping with negative emotions. Implications for self-management treatments that target multiple behavioral needs of COPD patients are discussed.
Collapse
Affiliation(s)
- Amanda R. Mathew
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Miriam Guzman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Susan Yount
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ravi Kalhan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
26
|
Jódar-Sánchez F, Carrasco Hernández L, Núñez-Benjumea FJ, Mesa González MA, Moreno Conde J, Parra Calderón CL, Fernandez-Luque L, Hors-Fraile S, Civit A, Bamidis P, Ortega-Ruiz F. Using the Social-Local-Mobile App for Smoking Cessation in the SmokeFreeBrain Project: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e12464. [PMID: 30522992 PMCID: PMC6302230 DOI: 10.2196/12464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 01/12/2023] Open
Abstract
Background Smoking is considered the main cause of preventable illness and early deaths worldwide. The treatment usually prescribed to people who wish to quit smoking is a multidisciplinary intervention, combining both psychological advice and pharmacological therapy, since the application of both strategies significantly increases the chance of success in a quit attempt. Objective We present a study protocol of a 12-month randomized open-label parallel-group trial whose primary objective is to analyze the efficacy and efficiency of usual psychopharmacological therapy plus the Social-Local-Mobile app (intervention group) applied to the smoking cessation process compared with usual psychopharmacological therapy alone (control group). Methods The target population consists of adult smokers (both male and female) attending the Smoking Cessation Unit at Virgen del Rocío University Hospital, Seville, Spain. Social-Local-Mobile is an innovative intervention based on mobile technologies and their capacity to trigger behavioral changes. The app is a complement to pharmacological therapies to quit smoking by providing personalized motivational messages, physical activity monitoring, lifestyle advice, and distractions (minigames) to help overcome cravings. Usual pharmacological therapy consists of bupropion (Zyntabac 150 mg) or varenicline (Champix 0.5 mg or 1 mg). The main outcomes will be (1) the smoking abstinence rate at 1 year measured by means of exhaled carbon monoxide and urinary cotinine tests, and (2) the result of the cost-effectiveness analysis, which will be expressed in terms of an incremental cost-effectiveness ratio. Secondary outcome measures will be (1) analysis of the safety of pharmacological therapy, (2) analysis of the health-related quality of life of patients, and (3) monitoring of healthy lifestyle and physical exercise habits. Results Of 548 patients identified using the hospital’s electronic records system, we excluded 308 patients: 188 declined to participate and 120 did not meet the inclusion criteria. A total of 240 patients were enrolled: the control group (n=120) will receive usual psychopharmacological therapy, while the intervention group (n=120) will receive usual psychopharmacological therapy plus the So-Lo-Mo app. The project was approved for funding in June 2015. Enrollment started in October 2016 and was completed in October 2017. Data gathering was completed in November 2018, and data analysis is under way. The first results are expected to be submitted for publication in early 2019. Conclusions Social networks and mobile technologies influence our daily lives and, therefore, may influence our smoking habits as well. As part of the SmokeFreeBrain H2020 European Commission project, this study aims at elucidating the potential role of these technologies when used as an extra aid to quit smoking. Trial Registration ClinicalTrials.gov NCT03553173; https://clinicaltrials.gov/ct2/show/record/NCT03553173 (Archived by WebCite at http://www.webcitation.org/74DuHypOW). International Registered Report Identifier (IRRID) PRR1-10.2196/12464
Collapse
Affiliation(s)
- Francisco Jódar-Sánchez
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital / Spanish National Research Council / University of Seville, Seville, Spain
| | - Laura Carrasco Hernández
- Smoking Cessation Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Sevilla, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Carlos III Institute of Health, Madrid, Spain
| | - Francisco J Núñez-Benjumea
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital / Spanish National Research Council / University of Seville, Seville, Spain
| | - Marco Antonio Mesa González
- Smoking Cessation Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Sevilla, Spain
| | - Jesús Moreno Conde
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital / Spanish National Research Council / University of Seville, Seville, Spain
| | - Carlos Luis Parra Calderón
- Research and Innovation Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, Virgen del Rocío University Hospital / Spanish National Research Council / University of Seville, Seville, Spain
| | | | - Santiago Hors-Fraile
- Department of Architecture and Computer Technology, School of Computer Engineering, University of Seville, Sevilla, Spain.,Department of Health Promotion, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Anton Civit
- Department of Architecture and Computer Technology, School of Computer Engineering, University of Seville, Sevilla, Spain
| | - Panagiotis Bamidis
- Medical Physics Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Francisco Ortega-Ruiz
- Smoking Cessation Unit, Medical-Surgical Unit of Respiratory Diseases, Virgen del Rocío University Hospital, Sevilla, Spain
| |
Collapse
|
27
|
Bull ER, McCleary N, Li X, Dombrowski SU, Dusseldorp E, Johnston M. Interventions to Promote Healthy Eating, Physical Activity and Smoking in Low-Income Groups: a Systematic Review with Meta-Analysis of Behavior Change Techniques and Delivery/Context. Int J Behav Med 2018; 25:605-616. [PMID: 30003476 PMCID: PMC6244564 DOI: 10.1007/s12529-018-9734-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Healthy eating, physical activity and smoking interventions for low-income groups may have small, positive effects. Identifying effective intervention components could guide intervention development. This study investigated which content and delivery components of interventions were associated with increased healthy behavior in randomised controlled trials (RCTs) for low-income adults. METHOD Data from a review showing intervention effects in 35 RCTs containing 45 interventions with 17,000 participants were analysed to assess associations with behavior change techniques (BCTs) and delivery/context components from the template for intervention description and replication (TIDieR) checklist. The associations of 46 BCTs and 14 delivery/context components with behavior change (measures of healthy eating, physical activity and smoking cessation) were examined using random effects subgroup meta-analyses. Synergistic effects of components were examined using classification and regression trees (meta-CART) analyses based on both fixed and random effects assumptions. RESULTS For healthy eating, self-monitoring, delivery through personal contact, and targeting multiple behaviors were associated with increased effectiveness. Providing feedback, information about emotional consequences, or using prompts and cues were associated with reduced effectiveness. In synergistic analyses, interventions were most effective without feedback, or with self-monitoring excluding feedback. More effective physical activity interventions included behavioral practice/rehearsal or instruction, focussed solely on physical activity or took place in home/community settings. Information about antecedents was associated with reduced effectiveness. In synergistic analyses, interventions were most effective in home/community settings with instruction. No associations were identified for smoking. CONCLUSION This study identified BCTs and delivery/context components, individually and synergistically, linked to increased and reduced effectiveness of healthy eating and physical activity interventions. The identified components should be subject to further experimental study to help inform the development effective behavior change interventions for low-income groups to reduce health inequalities.
Collapse
Affiliation(s)
- Eleanor R Bull
- Manchester Metropolitan University, Manchester, UK.
- University of Manchester, Manchester, UK.
| | | | - Xinru Li
- Mathematical Institute, Leiden University, Leiden, the Netherlands
| | | | - Elise Dusseldorp
- Institute of Psychology, Leiden University, Leiden, the Netherlands
| | | |
Collapse
|
28
|
Peters GJY, Ruiter RAC, Ten Hoor GA, Kessels LTE, Kok G. Towards consensus on fear appeals: a rejoinder to the commentaries on Kok, Peters, Kessels, ten Hoor, and Ruiter (2018). Health Psychol Rev 2018; 12:151-156. [PMID: 29558243 DOI: 10.1080/17437199.2018.1454846] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Gjalt-Jorn Ygram Peters
- a Department of Methodology & Statistics , Open University of the Netherlands , Heerlen , Netherlands.,b Department of Work and Social Psychology , Maastricht University , Maastricht , Netherlands
| | - Robert A C Ruiter
- b Department of Work and Social Psychology , Maastricht University , Maastricht , Netherlands
| | - Gill A Ten Hoor
- b Department of Work and Social Psychology , Maastricht University , Maastricht , Netherlands
| | - Loes T E Kessels
- b Department of Work and Social Psychology , Maastricht University , Maastricht , Netherlands
| | - Gerjo Kok
- b Department of Work and Social Psychology , Maastricht University , Maastricht , Netherlands
| |
Collapse
|
29
|
Michie S, West R, Sheals K, Godinho CA. Evaluating the effectiveness of behavior change techniques in health-related behavior: a scoping review of methods used. Transl Behav Med 2018; 8:212-224. [PMID: 29381786 PMCID: PMC6062857 DOI: 10.1093/tbm/ibx019] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Behavior change interventions typically contain multiple potentially active components: behavior change techniques (BCTs). Identifying which specific BCTs or BCT combinations have the potential to be effective for a given behavior in a given context presents a major challenge. The aim of this study was to review the methods that have been used to identify effective BCTs for given behaviors in given contexts and evaluate their strengths and limitations. A scoping review was conducted of studies that had sought to identify effective BCTs. Articles referring to "behavio(u)r change technique(s)" in the abstract/text were located, and ones that involved identification of effective BCTs were selected. The methods reported were coded. The methods were analyzed in general terms using "PASS" criteria: Practicability (facility to apply the method appropriately), Applicability (facility to generalize from findings to contexts and populations of interest), Sensitivity (facility to identify effective BCTs), and Specificity (facility to rule out ineffective BCTs). A sample of 10% of the studies reviewed was then evaluated using these criteria to assess how far the strengths and limitations identified in principle were borne out in practice. One hundred and thirty-five studies were identified. The methods used in those studies were experimental manipulation of BCTs, observational studies comparing outcomes in the presence or absence of BCTs, meta-analyses of BCT comparisons, meta-regressions evaluating effect sizes with and without specific BCTs, reviews of BCTs found in effective interventions, and meta-classification and regression trees. The limitations of each method meant that only weak conclusions could be drawn regarding the effectiveness of specific BCTs or BCT combinations. Methods for identifying effective BCTs linked to target behavior and context all have important inherent limitations. A strategy needs to be developed that can systematically combine the strengths of the different methods and that can link these constructs in an ontology of behavior change interventions.
Collapse
Affiliation(s)
- Susan Michie
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, UK
| | - Robert West
- Department of Behavioural Science and Health, Cancer Research UK Health Behaviour Research Centre, University College London, UK
| | - Kate Sheals
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, UK
| | - Cristina A Godinho
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, UK
| |
Collapse
|
30
|
Herbeć A, Perski O, Shahab L, West R. Smokers' Views on Personal Carbon Monoxide Monitors, Associated Apps, and Their Use: An Interview and Think-Aloud Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E288. [PMID: 29414907 PMCID: PMC5858357 DOI: 10.3390/ijerph15020288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/31/2018] [Accepted: 02/02/2018] [Indexed: 12/29/2022]
Abstract
Smartphone-based personal carbon monoxide (CO) monitors and associated apps, or "CO Smartphone Systems" (CSSs) for short, could enable smokers to independently monitor their smoking and quitting. This study explored views and preferences regarding CSSs and their use among 16 adult, UK-based smokers. First, semi-structured interviews explored participants' expectations of CSSs. Secondly, a think-aloud study identified participants' reactions to a personal CO monitor and to existing or prototype apps. Framework Analysis identified five themes: (1) General views, needs, and motivation to use CSSs; (2) Views on the personal CO monitor; (3) Practicalities of CSS use; (4) Desired features in associated apps; and (5) Factors affecting preferences for CSSs and their use. Participants had high expectations of CSSs and their potential to increase motivation. Priority app features included: easy CO testing journeys, relevant and motivating feedback, and recording of contextual data. Appearance and usability of the personal CO monitor, and accuracy and relevance of CO testing were considered important for engagement. Participants differed in their motivation to use and preferences for CSSs features and use, which might have non-trivial impact on evaluation efforts. Personal CO monitors and associated apps may be attractive tools for smokers, but making CSSs easy to use and evaluating these among different groups of smokers may be challenging.
Collapse
Affiliation(s)
- Aleksandra Herbeć
- Research Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK.
| | - Olga Perski
- Research Department of Clinical, Educational & Health Psychology, University College London, London WC1E 7HB, UK.
| | - Lion Shahab
- Research Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK.
| | - Robert West
- Research Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK.
| |
Collapse
|
31
|
Hartman SJ, Nelson SH, Weiner LS. Patterns of Fitbit Use and Activity Levels Throughout a Physical Activity Intervention: Exploratory Analysis from a Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e29. [PMID: 29402761 PMCID: PMC5818675 DOI: 10.2196/mhealth.8503] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/24/2017] [Accepted: 11/16/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND There has been a rapid increase in the use of technology-based activity trackers to promote behavior change. However, little is known about how individuals use these trackers on a day-to-day basis or how tracker use relates to increasing physical activity. OBJECTIVE The aims were to use minute level data collected from a Fitbit tracker throughout a physical activity intervention to examine patterns of Fitbit use and activity and their relationships with success in the intervention based on ActiGraph-measured moderate to vigorous physical activity (MVPA). METHODS Participants included 42 female breast cancer survivors randomized to the physical activity intervention arm of a 12-week randomized controlled trial. The Fitbit One was worn daily throughout the 12-week intervention. ActiGraph GT3X+ accelerometer was worn for 7 days at baseline (prerandomization) and end of intervention (week 12). Self-reported frequency of looking at activity data on the Fitbit tracker and app or website was collected at week 12. RESULTS Adherence to wearing the Fitbit was high and stable, with a mean of 88.13% of valid days over 12 weeks (SD 14.49%). Greater adherence to wearing the Fitbit was associated with greater increases in ActiGraph-measured MVPA (binteraction=0.35, P<.001). Participants averaged 182.6 minutes/week (SD 143.9) of MVPA on the Fitbit, with significant variation in MVPA over the 12 weeks (F=1.91, P=.04). The majority (68%, 27/40) of participants reported looking at their tracker or looking at the Fitbit app or website once a day or more. Changes in Actigraph-measured MVPA were associated with frequency of looking at one's data on the tracker (b=-1.36, P=.07) but not significantly associated with frequency of looking at one's data on the app or website (P=.36). CONCLUSIONS This is one of the first studies to explore the relationship between use of a commercially available activity tracker and success in a physical activity intervention. A deeper understanding of how individuals engage with technology-based trackers may enable us to more effectively use these types of trackers to promote behavior change. TRIAL REGISTRATION ClinicalTrials.gov NCT02332876; https://clinicaltrials.gov/ct2/show/NCT02332876?term=NCT02332876 &rank=1 (Archived by WebCite at http://www.webcitation.org/6wplEeg8i).
Collapse
Affiliation(s)
- Sheri J Hartman
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States.,University of California San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| | - Sandahl H Nelson
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States.,University of California San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| | - Lauren S Weiner
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, United States.,University of California San Diego Moores Cancer Center, University of California San Diego, La Jolla, CA, United States
| |
Collapse
|
32
|
Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC. Aplicación de metodología con formato PICO. Arch Bronconeumol 2017; 53:622-628. [DOI: 10.1016/j.arbres.2017.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 04/05/2017] [Accepted: 04/09/2017] [Indexed: 01/06/2023]
|
33
|
Kingkaew P, Glidewell L, Walwyn R, Fraser H, Wyatt JC. Identifying effective components for mobile health behaviour change interventions for smoking cessation and service uptake: protocol of a systematic review and planned meta-analysis. Syst Rev 2017; 6:193. [PMID: 28985765 PMCID: PMC6389191 DOI: 10.1186/s13643-017-0591-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 10/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) interventions for smoking cessation have been shown to be associated with an increase in effectiveness. However, interventions using mobile phones to change people's behaviour are often perceived as complex interventions, and the interactions between several components within them may affect the outcome. Therefore, it is important to understand how we can improve the design of mHealth interventions using mobile phones as a medium to deliver services. METHODS Randomised controlled trials (RCTs) of mHealth interventions to support smoking cessation or uptake of smoking cessation services for smokers will be included in this systematic review. A search will be performed by searching MEDLINE, MEDLINE(R) In-Process & Other Non-Indexed Citations, EMBASE, PsycINFO, Web of Science, and CINAHL. A search for new publications will be conducted 3 months prior to submission for publication as mHealth is an emerging area of research. A random-effects meta-analysis model will be used to summarise the effectiveness of mHealth interventions. The risk ratio will be used for the primary outcome, self-reported or verified smoking abstinence, and any binary outcomes for uptake of smoking cessation services. The standardised mean difference using Hedges' g will be reported for continuous data. Heterogeneity will be assessed using I 2 statistics. Where feasible, meta-regression analysis using random-effects multilevel modelling will be conducted to examine the association of pre-specified characteristics (covariates) at the study level with the effectiveness of interventions. Publication bias will be explored using Egger's test for continuous outcomes and Harbord and Peters tests for dichotomous outcomes. The funnel plot will be used to evaluate the presence of publication bias. The Cochrane Risk of Bias Tool will be used to assess differences in risks of bias. DISCUSSION The results of this systematic review will provide future research with a foundation for designing and evaluating complex interventions that use mobile phones as a platform to deliver behaviour change techniques. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016026918 .
Collapse
Affiliation(s)
- Pritaporn Kingkaew
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, UK. .,Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.
| | - Liz Glidewell
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, UK
| | - Rebecca Walwyn
- Leeds Institute of Clinical Trials Research, University of Leeds, Worsley Building, Clarendon Way, Leeds, UK
| | - Hamish Fraser
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, UK
| | - Jeremy C Wyatt
- Wessex Institute of Health and Research, Faculty of Medicine, University of Southampton, Southampton, UK
| |
Collapse
|
34
|
Voncken-Brewster V, Amoureus M, de Vries H, Nagykaldi Z, Winkens B, van der Weijden T, Tange H. The Impact of Participant Characteristics on Use and Satisfaction of a Web-Based Computer-Tailored Chronic Obstructive Pulmonary Disease Self-Management Intervention: A Process Evaluation. JMIR Form Res 2017; 1:e1. [PMID: 30684399 PMCID: PMC6334693 DOI: 10.2196/formative.6585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 07/18/2017] [Accepted: 07/21/2017] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND A randomized controlled trial (RCT) showed that a Web-based computer-tailored self-management intervention for people with or at risk for chronic obstructive pulmonary disease (COPD) did not have a significant treatment effect. Process evaluation measures such as application use and satisfaction with the intervention can help understand these results. OBJECTIVES The aim of this paper is to uncover reasons for suboptimal application use, evaluate satisfaction with the intervention, and investigate which participant characteristics predict application use and user satisfaction. METHODS Participants were recruited through 2 different channels: an online panel and general practice. The intervention group received the intervention, which consisted of 2 modules (smoking cessation and physical activity). The control group received no intervention. The study employed a mixed methods design. Quantitative and qualitative data were gathered assessing participant characteristics, application use, reasons for not using the application, and satisfaction with the intervention. RESULTS The RCT included 1325 participants. The proportion of individuals who participated was significantly higher in the online group (4072/6844, 59.5%) compared to the general practice group (43/335, 12.8%) (P<.001). Application use was low. Of all participants in the intervention group, 52.9% (348/658) initiated use of one or both modules, 36.0% (237/658) completed an intervention component (prolonged use), and 16.6% (109/658) revisited one of the modules after completing an intervention component (sustained use). Older age, established diagnosis of COPD, or experiencing breathlessness predicted sustained use. Participant satisfaction with the 2 modules was 6.7 (SD 1.6) on a scale from 0 to 10. The interviews revealed that a computer application was believed not to be sufficient and the help of a health care professional was necessary. Participants with a greater intention to change were more satisfied with the application. CONCLUSIONS The application was not used sufficiently. Study materials should be further tailored to younger individuals, those at risk for COPD, and those who do not experience breathlessness in order to increase sustained use among them. Involvement of a health care professional could improve satisfaction with the intervention and potentially increase engagement with the intervention materials. However, to make this possible, recruitment in general practice needs to be improved. Recommendations are made for improving the study design, strengthening the intervention (eg, practice facilitation), and linking the computer application to interaction with a health care provider.
Collapse
Affiliation(s)
- Viola Voncken-Brewster
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Mylène Amoureus
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Zsolt Nagykaldi
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma, OK, United States
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Trudy van der Weijden
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Huibert Tange
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| |
Collapse
|
35
|
Voncken-Brewster V, Amoureus M, de Vries H, Nagykaldi Z, Winkens B, van der Weijden T, Tange H. The Impact of Participant Characteristics on Use and Satisfaction of a Web-Based Computer-Tailored Chronic Obstructive Pulmonary Disease Self-Management Intervention: A Process Evaluation. JMIR Form Res 2017. [PMID: 30684399 PMCID: PMC6334693 DOI: 10.2196//formative.6585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A randomized controlled trial (RCT) showed that a Web-based computer-tailored self-management intervention for people with or at risk for chronic obstructive pulmonary disease (COPD) did not have a significant treatment effect. Process evaluation measures such as application use and satisfaction with the intervention can help understand these results. OBJECTIVES The aim of this paper is to uncover reasons for suboptimal application use, evaluate satisfaction with the intervention, and investigate which participant characteristics predict application use and user satisfaction. METHODS Participants were recruited through 2 different channels: an online panel and general practice. The intervention group received the intervention, which consisted of 2 modules (smoking cessation and physical activity). The control group received no intervention. The study employed a mixed methods design. Quantitative and qualitative data were gathered assessing participant characteristics, application use, reasons for not using the application, and satisfaction with the intervention. RESULTS The RCT included 1325 participants. The proportion of individuals who participated was significantly higher in the online group (4072/6844, 59.5%) compared to the general practice group (43/335, 12.8%) (P<.001). Application use was low. Of all participants in the intervention group, 52.9% (348/658) initiated use of one or both modules, 36.0% (237/658) completed an intervention component (prolonged use), and 16.6% (109/658) revisited one of the modules after completing an intervention component (sustained use). Older age, established diagnosis of COPD, or experiencing breathlessness predicted sustained use. Participant satisfaction with the 2 modules was 6.7 (SD 1.6) on a scale from 0 to 10. The interviews revealed that a computer application was believed not to be sufficient and the help of a health care professional was necessary. Participants with a greater intention to change were more satisfied with the application. CONCLUSIONS The application was not used sufficiently. Study materials should be further tailored to younger individuals, those at risk for COPD, and those who do not experience breathlessness in order to increase sustained use among them. Involvement of a health care professional could improve satisfaction with the intervention and potentially increase engagement with the intervention materials. However, to make this possible, recruitment in general practice needs to be improved. Recommendations are made for improving the study design, strengthening the intervention (eg, practice facilitation), and linking the computer application to interaction with a health care provider.
Collapse
Affiliation(s)
- Viola Voncken-Brewster
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Mylène Amoureus
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Hein de Vries
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Zsolt Nagykaldi
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma, OK, United States
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Trudy van der Weijden
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| | - Huibert Tange
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Netherlands
| |
Collapse
|
36
|
Williams MT, Effing TW, Paquet C, Gibbs CA, Lewthwaite H, Li LSK, Phillips AC, Johnston KN. Counseling for health behavior change in people with COPD: systematic review. Int J Chron Obstruct Pulmon Dis 2017; 12:2165-2178. [PMID: 28794621 PMCID: PMC5536233 DOI: 10.2147/copd.s111135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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.
Collapse
Affiliation(s)
- Marie T Williams
- Health and Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, Sansom Institute for Health Research, University of South Australia
| | - Tanja W Effing
- Department of Respiratory Medicine, Repatriation General Hospital
- School of Medicine, Flinders University
| | - Catherine Paquet
- Division of Health Sciences, Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research
| | | | - Hayley Lewthwaite
- Health and Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, Sansom Institute for Health Research, University of South Australia
| | - Lok Sze Katrina Li
- Division of Health Sciences, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Anna C Phillips
- Division of Health Sciences, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Kylie N Johnston
- Division of Health Sciences, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| |
Collapse
|
37
|
Prestwich A, Moore S, Kotze A, Budworth L, Lawton R, Kellar I. How Can Smoking Cessation Be Induced Before Surgery? A Systematic Review and Meta-Analysis of Behavior Change Techniques and Other Intervention Characteristics. Front Psychol 2017. [PMID: 28638356 PMCID: PMC5461364 DOI: 10.3389/fpsyg.2017.00915] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Smokers who continue to smoke up to the point of surgery are at increased risk of a range of complications during and following surgery. Objective: To identify whether behavioral and/or pharmacological interventions increase the likelihood that smokers quit prior to elective surgery and which intervention components are associated with larger effects. Design: Systematic review with meta-analysis. Data sources: MEDLINE, Embase, and Embase Classic, CINAHL, CENTRAL. Study selection: Studies testing the effect of smoking reduction interventions delivered at least 24 h before elective surgery were included. Study appraisal and synthesis: Potential studies were independently screened by two people. Data relating to study characteristics and risk of bias were extracted. The effects of the interventions on pre-operative smoking abstinence were estimated using random effects meta-analyses. The association between specific intervention components (behavior change techniques; mode; duration; number of sessions; interventionist) and smoking cessation effect sizes were estimated using meta-regressions. Results: Twenty-two studies comprising 2,992 smokers were included and 19 studies were meta-analyzed. Interventions increased the proportion of smokers who were abstinent or reduced smoking by surgery relative to control: g = 0.56, 95% CI 0.32–0.80, with rates nearly double in the intervention (46.2%) relative to the control (24.5%). Interventions that comprised more sessions, delivered face-to-face and by nurses, as well as specific behavior change techniques (providing information on consequence of smoking/cessation; providing information on withdrawal symptoms; goal setting; review of goals; regular monitoring by others; and giving options for additional or later support) were associated with larger effects. Conclusion: Rates of smoking can be halved prior to surgery and a number of intervention characteristics can increase these effects. There was, however, some indication of publication bias meaning the benefits of such interventions may be smaller than estimated. Registration: Prospero 2015: CRD42015024733
Collapse
Affiliation(s)
| | - Sally Moore
- Bradford Institute for Health ResearchBradford, United Kingdom
| | - Alwyn Kotze
- Department of Anaesthesia, Leeds Teaching Hospitals NHS TrustLeeds, United Kingdom
| | - Luke Budworth
- School of Psychology, University of LeedsLeeds, United Kingdom
| | - Rebecca Lawton
- School of Psychology, University of LeedsLeeds, United Kingdom.,Bradford Institute for Health ResearchBradford, United Kingdom
| | - Ian Kellar
- School of Psychology, University of LeedsLeeds, United Kingdom
| |
Collapse
|
38
|
Klemperer EM, Hughes JR, Callas PW, Solomon LJ. Working alliance and empathy as mediators of brief telephone counseling for cigarette smokers who are not ready to quit. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:130-135. [PMID: 28165273 DOI: 10.1037/adb0000243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Working alliance and empathy are believed to be important components of counseling, although few studies have empirically tested this. We recently conducted a randomized controlled trial in which brief motivational and reduction counseling failed to increase the number of participants who made a quit attempt (QA) in comparison to usual care (i.e., brief advice to quit). Our negative findings could have been due to nonspecific factors. This secondary analysis used a subset of participants (n = 347) to test (a) whether, in comparison to usual care, brief telephone-based motivational or reduction counseling predicted greater working alliance or empathy; (b) whether changes in these nonspecific factors predicted an increased probability of a QA at a 6-month follow-up; and (c) whether counseling affected the probability of a QA via working alliance or empathy (i.e., mediation). Findings were similar for both active counseling conditions (motivational and reduction) versus usual care. In comparison to usual care, active counseling predicted greater working alliance (p < .001) and empathy (p < .05). Greater working alliance predicted a greater probability of a QA (p < .001) but, surprisingly, greater empathy predicted a decreased probability of a QA (p < .05) at the 6-month follow-up. Working alliance (p < .001) and empathy (p < .05) mediated the active counseling's effects on the probability of a QA. One explanation for our motivational and reduction interventions' failure to influence QAs in comparison to usual care is that working alliance and empathy had opposing effects on quitting. Our analyses illustrate how testing nonspecific factors as mediators can help explain why a treatment failed. (PsycINFO Database Record
Collapse
Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, Department of Psychological Science, University of Vermont
| | - John R Hughes
- Vermont Center on Behavior and Health, Department of Psychological Science, University of Vermont
| | | | | |
Collapse
|
39
|
Behaviour change technique taxonomy: a method of describing head and neck cancer dysphagia intervention delivery. Curr Opin Otolaryngol Head Neck Surg 2017; 25:182-187. [PMID: 28306585 DOI: 10.1097/moo.0000000000000360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of the review is to examine the current state of the art of dysphagia intervention delivery description and to propose use of a new tool to facilitate this: the behaviour change technique taxonomy version 1 (BCTTv1). RECENT FINDINGS Describing intervention delivery is difficult, and published research in the field of speech and language therapy (SLT) does not include detail on this key aspect of research protocols. Interventions themselves are often poorly delineated, and a way is needed of classifying how these interventions are delivered in practice. SUMMARY Use of the BCTTv1 would facilitate clarity and transparency in intervention delivery description and have positive implications for research, clinical practice and undergraduate teaching if employed by the SLT profession.
Collapse
|
40
|
Prestwich A, Conner M, Hurling R, Ayres K, Morris B. An experimental test of control theory-based interventions for physical activity. Br J Health Psychol 2017; 21:812-826. [PMID: 27169809 DOI: 10.1111/bjhp.12198] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/14/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To provide an experimental test of control theory to promote physical activity. DESIGN Parallel groups, simple randomized design with an equal chance of allocation to any group. METHODS Participants not meeting recommended levels of physical activity but physically safe to do so (N = 124) were recruited on a UK university campus and randomized to goal-setting + self-monitoring + feedback (GS + SM + F, n = 40), goal-setting + self-monitoring (GS + SM, n = 40), or goal-setting only (GS, n = 44) conditions that differentially tapped the key features of control theory. Accelerometers assessed physical activity (primary outcome) as well as self-report over a 7-day period directly before/after the start of the intervention. RESULTS The participants in the GS + SM + F condition significantly outperformed those in the GS condition, d = 0.62, 95% CI d = 0.15-1.08, and marginally outperformed those in the GS + SM condition in terms of total physical activity at follow-up on the accelerometer measure, d = 0.33, 95% CI d = -0.13 to 0.78. The feedback manipulation (GS + SM + F vs. GS + SM and GS) was most effective when baseline intentions were weak. These patterns did not emerge on the self-report measure but, on the basis of this measure, the feedback manipulation increased the risk that participants coasted in relation to their goal in the first few days of the intervention period. CONCLUSIONS Using behaviour change techniques consistent with control theory can lead to significant short-term improvements on objectively assessed physical activity. Further research is needed to examine the underlying theoretical principles of the model. Statement of contribution What is already known on this subject? Interventions incorporating more techniques that are consistent with control theory are associated with larger positive changes in health behaviours and related outcomes (see reviews by Dombrowski et al., ; Michie et al., ). However, none of the studies included in these reviews were explicitly based on control theory (see Prestwich et al., ). What does this study add? This study is the first experimental test of the cumulative effects of behaviour change techniques as proposed by control theory. Intervening on all aspects of the feedback loop noted by control theory leads to more change; however, the risk that some participants coast in relation to their set goal is significant. This approach increased physical activity more in those with weaker intentions pre-intervention.
Collapse
Affiliation(s)
| | - Mark Conner
- School of Psychology, University of Leeds, UK
| | - Robert Hurling
- Unilever Research & Development, Colworth Laboratory, Sharnbrook, Bedford, UK
| | - Karen Ayres
- School of Psychology, University of Leeds, UK
| | - Ben Morris
- School of Psychology, University of Leeds, UK.,Department of Psychology, Leeds Trinity University, UK
| |
Collapse
|
41
|
Sheeran P, Klein WM, Rothman AJ. Health Behavior Change: Moving from Observation to Intervention. Annu Rev Psychol 2017; 68:573-600. [DOI: 10.1146/annurev-psych-010416-044007] [Citation(s) in RCA: 242] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina 27599;
| | - William M.P. Klein
- Behavioral Research Program, National Cancer Institute, Bethesda, Maryland 20892
| | | |
Collapse
|
42
|
Nakken N, Janssen DJ, van den Bogaart EH, van Vliet M, de Vries GJ, Bootsma GP, Gronenschild MH, Delbressine JM, Muris JW, Wouters EF, Spruit MA. Patient versus proxy-reported problematic activities of daily life in patients with COPD. Respirology 2016; 22:307-314. [DOI: 10.1111/resp.12915] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/23/2016] [Accepted: 07/26/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Nienke Nakken
- Department of Research and Education; CIRO; Horn The Netherlands
| | - Daisy J.A. Janssen
- Department of Research and Education; CIRO; Horn The Netherlands
- Centre of Expertise for Palliative Care; Maastricht University Medical Centre+ (MUMC+); Maastricht The Netherlands
| | | | - Monique van Vliet
- Department of Respiratory Medicine; Zuyderland; Heerlen The Netherlands
| | - Geeuwke J. de Vries
- Department of Respiratory Medicine; Zuyderland; Sittard-Geleen The Netherlands
| | - Gerben P. Bootsma
- Department of Respiratory Medicine; Zuyderland; Heerlen The Netherlands
| | | | | | - Jean W.M. Muris
- Department of Family Medicine, CAPHRI School of Public Health and Primary Care; Maastricht University; Maastricht The Netherlands
| | - Emiel F.M. Wouters
- Department of Research and Education; CIRO; Horn The Netherlands
- Department of Respiratory Medicine; Maastricht University Medical Centre+ (MUMC+); Maastricht The Netherlands
| | | |
Collapse
|
43
|
Affiliation(s)
- Dolores Albarracin
- a Department of Psychology , University of Illinois at Urbana-Champaign , Champaign , IL , USA.,b Department of Business Administration , University of Illinois at Urbana-Champaign , Champaign , IL , USA
| | | |
Collapse
|
44
|
Inflammatory Markers and the Risk of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0150586. [PMID: 27104349 PMCID: PMC4841528 DOI: 10.1371/journal.pone.0150586] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 02/16/2016] [Indexed: 11/19/2022] Open
Abstract
Systemic inflammatory factors are inconsistently associated with the pathogenesis of chronic obstructive pulmonary disease (COPD). We conducted a systematic review and meta-analysis to summarize the evidence supporting the association between systemic inflammation and the risk of COPD. Pertinent studies were retrieved from PubMed, EmBase, and the Cochrane Library until April 2015. A random-effects model was used to process the data, and the analysis was further stratified by factors affecting these associations. Sensitivity analyses for publication bias were performed. We included 24 observational studies reporting data on 10,677 COPD patients and 28,660 controls. Overall, we noted that COPD was associated with elevated serum CRP (SMD: 1.21; 95%CI: 0.92–1.50; P < 0.001), leukocytes (SMD: 1.07; 95%: 0.25–1.88; P = 0.010), IL-6 (SMD: 0.90; 95%CI: 0.48–1.31; P < 0.001), IL-8 (SMD: 2.34; 95%CI: 0.69–4.00; P = 0.006), and fibrinogen levels (SMD: 0.87; 95%CI: 0.44–1.31; P < 0.001) when compared with control. However, COPD was not significantly associated with TNF-α levels when compared with control (SMD: 0.60; 95%CI: -0.46 to 1.67; P = 0.266). Our findings suggested that COPD was associated with elevated serum CRP, leukocytes, IL-6, IL-8, and fibrinogen, without any significant relationship with TNF-α.
Collapse
|
45
|
Effectiveness of personalised support for self-management in primary care: a cluster randomised controlled trial. Br J Gen Pract 2016; 66:e354-61. [PMID: 27080318 DOI: 10.3399/bjgp16x684985] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 10/25/2015] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Self-management support is an important component of the clinical management of many chronic conditions. The validated Self-Management Screening questionnaire (SeMaS) assesses individual characteristics that influence a patient's ability to self-manage. AIM To assess the effect of providing personalised self-management support in clinical practice on patients' activation and health-related behaviours. DESIGN AND SETTING A cluster randomised controlled trial was conducted in 15 primary care group practices in the south of the Netherlands. METHOD After attending a dedicated self-management support training session, practice nurses in the intervention arm discussed the results of SeMaS with the patient at baseline, and tailored the self-management support. Participants completed a 13-item Patient Activation Measure (PAM-13) and validated lifestyle questionnaires at baseline and after 6 months. Data, including individual care plans, referrals to self-management interventions, self-monitoring, and healthcare use, were extracted from patients' medical records. Multilevel multiple regression was used to assess the effect on outcomes. RESULTS The PAM-13 score did not differ significantly between the control (n = 348) and intervention (n = 296) arms at 6 months. In the intervention arm, 29.4% of the patients performed self-monitoring, versus 15.2% in the control arm (effect size r = 0.9, P = 0.01). In the per protocol analysis (control n = 348; intervention n = 136), the effect of the intervention was significant on the number of individual care plans (effect size r = 1.3, P = 0.04) and on self-monitoring (effect size r = 1.0, P = 0.01). CONCLUSION This study showed that discussing SeMaS and offering tailored support did not affect patient activation or lifestyle, but did stimulate patients to self-monitor and use individual care plans.
Collapse
|
46
|
Lippke S, Fleig L, Wiedemann AU, Schwarzer R. A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects. J Med Internet Res 2015; 17:e225. [PMID: 26429115 PMCID: PMC4642394 DOI: 10.2196/jmir.4486] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/07/2015] [Accepted: 07/24/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Preventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective. OBJECTIVE It was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention). METHODS In a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2). RESULTS The stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and nutrition (χ(2) 1=3.5; P=.04, for N=384) as well as psychological variables (physical activity intention, P=.04; nutrition intention, P=.03; nutrition planning, P=.02; and general social support to live healthily, P=.01). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR, 2.25, 95% CI 1.73-2.92; P<.01) and the intervention (OR 1.96, 95% CI 1.00-3.82; P=.05) were found to be significant predictors. Physical activity planning mediated the effect of the intervention on the adoption of an overall healthy lifestyle (consisting of activity and nutrition, R(2) adj=.08; P<.01), indicating that if the stage-matched intervention increased planning, the adoption of a healthy lifestyle was more likely. CONCLUSIONS Matching an intervention to the motivational readiness of employees can make a health promotion program effective. Employees' motivation, planning, social support, and lifestyle can be supported by a stage-matched intervention that focuses on both physical activity and healthy nutrition. Occupational settings provide a potential to implement parsimonious computer-based health promotion programs and to facilitate multiple behavior change.
Collapse
Affiliation(s)
- Sonia Lippke
- Jacobs Center for Lifelong Learning and Institutional Development (JCLL), Focus Area Diversity, Health Psychology, Jacobs University Bremen, Bremen, Germany.
| | | | | | | |
Collapse
|
47
|
Sangelaji B, Smith CM, Paul L, Sampath KK, Treharne GJ, Hale LA. The effectiveness of behaviour change interventions to increase physical activity participation in people with multiple sclerosis: a systematic review and meta-analysis. Clin Rehabil 2015. [DOI: 10.1177/0269215515595274] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: A systematic review and meta-analysis was conducted to illustrate whether people with multiple sclerosis engage in more physical activity following behaviour change interventions. Data resources: MEDLINE, CINAHL, PubMed, Web of Sciences, Cochrane Library, SCOPUS, EMBASE and PEDro were searched from their inception till 30 April 2015. Trial selection: Randomized and clinical controlled trials that used behaviour change interventions to increase physical activity in people with multiple sclerosis were selected, regardless of type or duration of multiple sclerosis or disability severity. Data extraction: Data extraction was conducted by two independent reviewers and the Cochrane Collaboration’s recommended method was used to assess the risk of bias of each included study. Results: A total of 19 out of 573 studies were included. Focusing on trials without risk of bias, meta-analysis showed that behaviour change interventions can significantly increase physical activity participation (z = 2.20, p = 0.03, standardised main difference 0.65, 95% confidence interval 0.07 to 1.22, 3 trials, I2 = 68%) (eight to 12 weeks’ duration). Behaviour change interventions did not significantly impact on the physical components of quality of life or fatigue. Conclusion: Behaviour change interventions provided for relatively short duration (eight to 12 weeks) may increase the amount of physical activity people with multiple sclerosis engage in, but appear to have no effect on the physical components of quality of life and fatigue. Further high quality investigations of the efficacy of behaviour change interventions to increase physical activity participation that focus on dose, long-term impact and method of delivery are warranted for people with multiple sclerosis.
Collapse
|
48
|
Yap SY, Lunn S, Pang E, Croft C, Stern M. A psychological intervention for smoking cessation delivered as treatment for smokers with chronic obstructive pulmonary disease: Multiple needs of a complex group and recommendations for novel service development. Chron Respir Dis 2015; 12:230-7. [PMID: 25990130 DOI: 10.1177/1479972315586198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This pilot study investigated the benefits of adjunctive psychological intervention for smokers accessing standard smoking cessation interventions. Chronic obstructive pulmonary disease (COPD) smokers attending a smoking cessation service were offered up to 12 adjunctive clinical psychology sessions. Baseline data included demographics, smoking history, and disease severity. Outcomes included attendance and quit rate. In all, 59 patients with moderate COPD were referred. Of the 20 patients who attended training sessions, 7 (35%) were relapse prevention referrals and 13 (65%) were current smokers. Of the seven relapse prevention referrals, six (86%) maintained their quit, 2 of 13 (15%) of the current smoker group maintained a 28-day quit and 3 of 13 (23%) of current smokers reduced their tobacco intake. For COPD smokers with a heavy smoking history and multiple past quit attempts, there was insufficient evidence to show that additional psychological intervention leads to higher quit rates. Significant barriers to quitting and complex medical and psychosocial needs were identified in this group, suggesting that the current 'one-size-fits-all' approach to smoking cessation may not be sufficient to meet the needs of such a complex group.
Collapse
Affiliation(s)
- Su Yin Yap
- Department of Respiratory Medicine, Whittington Health, London, UK
| | - Sarah Lunn
- Department of Respiratory Medicine, Whittington Health, London, UK
| | - Elizabeth Pang
- Department of Respiratory Medicine, Whittington Health, London, UK
| | - Carla Croft
- Department of Respiratory Medicine, Whittington Health, London, UK
| | - Myra Stern
- Department of Respiratory Medicine, Whittington Health, London, UK
| |
Collapse
|
49
|
Using Action Research and Peer Perspectives to Develop Technology That Facilitates Behavioral Change and Self-Management in COPD. Int J Telemed Appl 2014; 2014:380919. [PMID: 24959177 PMCID: PMC4052182 DOI: 10.1155/2014/380919] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/17/2014] [Accepted: 04/29/2014] [Indexed: 12/03/2022] Open
Abstract
Background. Behavioural change and self-management in patients with chronic illness may help to control symptoms, avoid rehospitalization, enhance quality of life, and decrease mortality and morbidity. Objective. Guided by action research principles and using mixed methods, the aim of this project was to develop peer based educational, motivational, and health-promoting peer based videos, using behavioural change principles, to support self-management in patients with COPD. Methods. Individuals (n = 32) living with COPD at home and involved in two community based COPD support groups were invited to participate in this project. Focus group/individual interviews and a demographic questionnaire were used to collect data. Results. Analysis revealed 6 categories relevant to behavioural change which included self-management, support, symptoms, knowledge, rehabilitation, and technology. Participants commented that content needed to be specific, and videos needed to be shorter, to be tailored to severity of condition, to demonstrate “normal” activities, to be positive, and to ensure that content is culturally relevant. Conclusions. This study demonstrated that detailed analysis of patient perspectives and needs for self-management is essential and should underpin the development of any framework, materials, and technology. The action research design principles provided an effective framework for eliciting the data and applying it to technology and testing its relevance to the user.
Collapse
|