Department of Preventive Medicine, Northwestern University, 680 North Lakeshore Drive, Suite 1220, Chicago, IL 60611, USA.
J Public Health (Oxf). 2012 Mar;34 Suppl 1(Suppl 1):i3-10. doi: 10.1093/pubmed/fdr111.
More remains unknown than known about how to optimize multiple health behaviour change.
After reviewing the prevalence and comorbidities among major chronic disease risk behaviours for adults and youth, we consider the origins and applicability of high-risk and population strategies to foster multiple health behaviour change.
Findings indicate that health risk behaviours are prevalent, increase with age and co-occur as risk behaviour clusters or bundles.
We conclude that both population and high-risk strategies for health behaviour intervention are warranted, potentially synergistic and need intervention design that accounts for substitute and complementary relationships among bundled health behaviours. To maximize positive public health impact, a pressing need exists for bodies of basic and translational science that explain health behaviour bundling. Also needed is applied science that elucidates the following: (1) the optimal number of behaviours to intervene upon; (2) how target behaviours are best selected (e.g. greatest health impact; patient preference or positive effect on bundled behaviours); (3) whether to increase healthy or decrease unhealthy behaviours; (4) whether to intervene on health behaviours simultaneously or sequentially and (5) how to achieve positive synergies across individual-, group- and population-level intervention approaches.
对于如何优化多种健康行为改变，我们知之甚少。
在回顾了成年人和青少年主要慢性病风险行为的流行程度和共病情况后，我们考虑了高风险和人群策略的起源和适用性，以促进多种健康行为改变。
研究结果表明，健康风险行为普遍存在，随着年龄的增长而增加，并且以风险行为群集或束的形式出现。
我们得出结论，针对健康行为干预的人群和高风险策略都是合理的，可能具有协同作用，需要设计干预措施，以考虑捆绑健康行为之间的替代和互补关系。为了最大限度地发挥积极的公共卫生影响，迫切需要基础和转化科学来解释健康行为捆绑。还需要应用科学来阐明以下问题：（1）干预的最佳行为数量；（2）如何最好地选择目标行为（例如，对健康的最大影响；患者偏好或对捆绑行为的积极影响）；（3）是否增加健康行为或减少不健康行为；（4）是否同时或顺序干预健康行为，以及（5）如何在个体、群体和人群层面的干预方法中实现积极协同作用。
