Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Priory Street, Coventry, CV1 5FB, UK.
Int J Behav Nutr Phys Act. 2013 Mar 3;10:29. doi: 10.1186/1479-5868-10-29.
Increasing self-efficacy is generally considered to be an important mediator of the effects of physical activity interventions. A previous review identified which behaviour change techniques (BCTs) were associated with increases in self-efficacy and physical activity for healthy non-obese adults. The aim of the current review was to identify which BCTs increase the self-efficacy and physical activity behaviour of obese adults. A systematic search identified 61 comparisons with obese adults reporting changes in self-efficacy towards engaging in physical activity following interventions. Of those comparisons, 42 also reported changes in physical activity behaviour. All intervention descriptions were coded using Michie et al's (2011) 40 item CALO-RE taxonomy of BCTs. Meta-analysis was conducted with moderator analyses to examine the association between whether or not each BCT was included in interventions, and size of changes in both self-efficacy and physical activity behaviour. Overall, a small effect of the interventions was found on self-efficacy (d = 0.23, 95% confidence interval (CI): 0.16-0.29, p < 0.001) and a medium sized effect on physical activity behaviour (d = 0.50, 95% CI 0.38-0.63, p < 0.001). Four BCTs were significantly associated with positive changes in self-efficacy; 'action planning', 'time management', 'prompt self-monitoring of behavioural outcome' and 'plan social support/social change'. These latter two BCTs were also associated with positive changes in physical activity. An additional 19 BCTs were associated with positive changes in physical activity. The largest effects for physical activity were found where interventions contained 'teach to use prompts/cues', 'prompt practice' or 'prompt rewards contingent on effort or progress towards behaviour'. Overall, a non-significant relationship was found between change in self-efficacy and change in physical activity (Spearman's Rho = -0.18 p = 0.72). In summary, the majority of techniques increased physical activity behaviour, without having discernible effects on self-efficacy. Only two BCTs were associated with positive changes in both physical activity self-efficacy and behaviour. This is in contrast to the earlier review which found a strong relationship between changes in physical activity self-efficacy and behaviour. Mechanisms other than self-efficacy may be more important for increasing the physical activity of obese individuals compared with non-obese individuals.
提高自我效能感通常被认为是体育活动干预效果的重要中介因素。先前的综述确定了哪些行为改变技术（BCTs）与健康非肥胖成年人的自我效能感和体育活动的增加有关。本综述的目的是确定哪些 BCT 可以提高肥胖成年人的自我效能感和体育活动行为。系统搜索确定了 61 项比较，其中肥胖成年人在干预后报告了参与体育活动的自我效能感的变化。在这些比较中，有 42 项还报告了体育活动行为的变化。所有干预描述均使用 Michie 等人（2011 年）的 40 项 BCTs 的 CALO-RE 分类法进行编码。进行荟萃分析和调节分析，以检查干预中是否包含每个 BCT 与自我效能感和体育活动行为变化大小之间的关联。总体而言，干预对自我效能感的影响较小（d=0.23，95%置信区间（CI）：0.16-0.29，p<0.001），对体育活动行为的影响中等（d=0.50，95%CI 0.38-0.63，p<0.001）。有 4 个 BCT 与自我效能感的积极变化显著相关；“行动计划”、“时间管理”、“提示自我监测行为结果”和“计划社会支持/社会变革”。后两个 BCT 也与体育活动的积极变化有关。另外 19 个 BCT 与体育活动的积极变化有关。在干预包含“教授使用提示/线索”、“提示练习”或“提示奖励取决于努力或朝着行为进步”的情况下，体育活动的效果最大。总体而言，自我效能感的变化与体育活动的变化之间未发现显著关系（Spearman's Rho=-0.18，p=0.72）。总之，大多数技术都增加了体育活动行为，而对自我效能感没有明显影响。只有两个 BCT 与自我效能感和行为的积极变化有关。这与早期的综述形成对比，早期综述发现体育活动自我效能感和行为的变化之间存在很强的关系。与非肥胖个体相比，对于增加肥胖个体的体育活动，机制可能比自我效能感更为重要。
