Key result
Interventions targeting multiple health behaviors showed positive effects on behavior change for continuous (d=0.081 to 2.003, except smoking) and dichotomous (RR=1.026 to 2.247) outcomes.
Why the study?
Do interventions targeting more than one health behavior improve behavior change in individuals with chronic conditions?
Meta-Analysis
Do interventions targeting more than one health behavior improve behavior change in individuals with chronic conditions?
Interventions targeting multiple health behaviors simultaneously are effective in promoting positive behavior changes in patients with chronic conditions.
Answers are grounded in this paper and cite their sources.
Supports integrating multiple-behavior interventions into chronic disease care; confirms effectiveness across behaviors except smoking and extends single-behavior evidence.
Background: Health behaviors play a significant role in chronic disease management. Rather than being independent of one another, health behaviors often co-occur, suggesting that targeting more than one health behavior in an intervention has the potential to be more effective in promoting better health outcomes. Purpose: We aimed to conduct a systematic review and meta-analysis of randomized trials of interventions that target more than one behavior to examine the effectiveness of multiple health behavior change interventions in patients with chronic conditions.Methods: Five electronic databases (Web of Science, PubMed, CINAHL, EMBASE and Cochrane) were systematically searched in November 2023, and studies included in previous reviews were also consulted. We included randomized trials of interventions aiming to change more than one health behavior in individuals with chronic conditions. Two independent reviewers screened and extracted data, and used Cochrane’s Risk of Bias 2 tool. Meta-analyses were conducted to estimate the effects of interventions on change of health behaviors. Results were presented as Cohen’s d for continuous data, and risk ratio for dichotomous data. Results: Sixty-one studies were included spanning a range of chronic diseases: cardiovascular (k = 25), type 2 diabetes (k = 15), hypertension (k = 10), cancer (k = 7), multiple conditions (k = 3). Most interventions aimed to change more than one behavior simultaneously (rather than in sequence) and most targeted three particular behaviors at once: ‘physical activity, diet and smoking’ (k = 20). Meta-analysis of 43 eligible studies showed for continuous data (k = 29) a small to substantial positive effect on behavior change for all health behaviors (d = .081 to 2.003) except for smoking (d = -.019). For dichotomous data (k = 23) all analyses showed positive effects of targeting more than one behavior on all behaviors (RR = 1.026 to 2.247). Conclusions: Targeting more than one behavior at a time is effective in chronic disease management and more research should be directed into developing the science of multiple behavior change.
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Silva et al. (2023) conducted a meta-analysis in chronic conditions. Interventions targeting more than one health behavior was evaluated on Change of health behaviors (d = 0.081 to 2.003; RR = 1.026 to 2.247). Interventions targeting multiple health behaviors showed positive effects on behavior change for continuous (d=0.081 to 2.003, except smoking) and dichotomous (RR=1.026 to 2.247) outcomes.
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