Prochaska Judith J, Velicer Wayne F, Nigg Claudio R, Prochaska James O
Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave - TRC 0984, San Francisco, CA 94143-0984, USA.
Prev Med. 2008 Mar;46(3):260-5. doi: 10.1016/j.ypmed.2007.07.035. Epub 2007 Aug 15.
Risky behaviors such as smoking, alcohol abuse, physical inactivity, and poor diet are detrimental to health, costly, and often co-occur. Greater efforts are being targeted at changing multiple risk behaviors to more comprehensively address the health needs of individuals and populations. With increased interest in multiple risk factor interventions, the field will need ways to conceptualize the issue of overall behavior change.
Analyzing data from over 8000 participants in four multibehavioral interventions, we present five different methods for quantifying and reporting changes in multiple risk behaviors.
The methods are: (a) the traditional approach of reporting changes in individual risk behaviors; (b) creating a combined statistical index of overall behavior change, standardizing scores across behaviors on different metrics; (c) using a behavioral index; (d) calculating an overall impact factor; and (e) using overarching outcome measures such as quality of life, related biometrics, or cost outcomes. We discuss the methods' interpretations, strengths, and limitations.
Given the lack of consensus in the field on how to examine change in multiple risk behaviors, we recommend researchers employ and compare multiple methods in their publications. A dialogue is needed to work toward developing a consensus for optimal ways of conceptualizing and reporting changes in multibehavioral interventions.
吸烟、酗酒、缺乏身体活动和不良饮食等危险行为对健康有害、成本高昂且常常同时出现。人们正在做出更大努力来改变多种危险行为，以便更全面地满足个人和人群的健康需求。随着对多种危险因素干预措施的兴趣增加，该领域将需要一些方法来概念化整体行为改变问题。
通过分析四项多行为干预措施中8000多名参与者的数据，我们提出了五种不同的方法来量化和报告多种危险行为的变化。
这些方法包括：（a）报告个体危险行为变化的传统方法；（b）创建一个整体行为变化的综合统计指标，对不同指标上的行为得分进行标准化；（c）使用行为指数；（d）计算总体影响因子；（e）使用诸如生活质量、相关生物特征指标或成本结果等总体结果指标。我们讨论了这些方法的解释、优点和局限性。
鉴于该领域在如何研究多种危险行为变化方面缺乏共识，我们建议研究人员在其出版物中采用并比较多种方法。需要开展对话，以努力就概念化和报告多行为干预措施变化的最佳方式达成共识。
