Prochaska Judith J, Prochaska James O
Department of Psychiatry, University of California, San Francisco, California (JJP), and Cancer Prevention Research Center, University of Rhode Island, Kingston, Rhode Island.
Am J Lifestyle Med. 2011 May;5(3). doi: 10.1177/1559827610391883.
Most individuals engage in multiple unhealthy lifestyle behaviors with the potential for negative health consequences. Yet most health promotion research has addressed risk factors as categorically separate entities, and little is known about how to effectively promote multiple health behavior change (MHBC). This review summarizes the recent literature (January 2004 to December 2009) on randomized clinical trials evaluating MHBC interventions for primary prevention. Combining all the studies across all the reviews, fewer than 150 studies were identified. This is a fraction of the number of trials conducted on changing individual behavioral risks. Three primary behavioral clusters dominated: (1) the energy balance behaviors of physical activity and diet; (2) addictive behaviors like smoking and other drugs; and (3) disease-related behaviors, specifically cardiovascular disease (CVD) and cancer related. Findings were largely disappointing for studies of diet and physical activity, particularly with youth. Treating 2 addictions, including smoking, resulted in greater long-term sobriety from alcohol and illicit drugs. MHBC intervention effects were stronger and more consistent for cancer prevention than CVD prevention. MHBC interventions offer a new paradigm for broader, more comprehensive health promotion; however, the potential value in maximizing intervention impact is largely unmet.
大多数人都有多种不健康的生活方式行为，这可能会对健康产生负面影响。然而，大多数健康促进研究都将风险因素作为完全独立的实体来处理，对于如何有效促进多种健康行为改变（MHBC）知之甚少。本综述总结了近期（2004年1月至2009年12月）关于评估MHBC一级预防干预措施的随机临床试验的文献。综合所有综述中的所有研究，确定的研究少于150项。这只是针对改变个体行为风险所进行试验数量的一小部分。三个主要行为集群占主导地位：（1）身体活动和饮食的能量平衡行为；（2）吸烟和其他药物等成瘾行为；（3）与疾病相关的行为，特别是心血管疾病（CVD）和癌症相关行为。对于饮食和身体活动的研究结果大多令人失望，尤其是针对青少年的研究。治疗包括吸烟在内的两种成瘾行为，能使饮酒和使用非法药物的长期戒断率更高。与预防心血管疾病相比，MHBC干预措施在预防癌症方面的效果更强且更一致。MHBC干预措施为更广泛、更全面的健康促进提供了一种新范式；然而，在最大化干预影响方面的潜在价值在很大程度上尚未实现。
