促进癌症幸存者的身体活动:随机对照试验的荟萃分析和元 CART 分析。
Promoting physical activity among cancer survivors: Meta-analysis and meta-CART analysis of randomized controlled trials.
机构信息
Department of Psychology and Neuroscience.
School of Psychological Sciences.
出版信息
Health Psychol. 2019 Jun;38(6):467-482. doi: 10.1037/hea0000712. Epub 2019 Apr 11.
OBJECTIVE
We conducted a meta-analysis of physical activity interventions among cancer survivors to (a) quantify the magnitude of intervention effects on physical activity and (b) determine what combination of intervention strategies maximizes behavior change.
METHOD
Out of 32,626 records that were located using computerized searches, 138 independent tests ( = 13,050) met the inclusion criteria for the review. We developed a bespoke taxonomy of 34 categories of techniques designed to promote psychological change, and categorized sample, intervention, and methodological characteristics. Random effects meta-analysis and metaregressions were conducted; effect size data were also submitted to meta-analysis with classification and regression trees (i.e., meta-CART).
RESULTS
The sample-weighted average effect size for physical activity interventions was = .35, equivalent to an increase of 1,149 steps per day. Effect sizes exhibited both publication bias and small sample bias but remained significantly different from zero, albeit of smaller magnitude ( ≥ .20), after correction for bias. Meta-CART indicated that the major difference in effectiveness was attributable to supervised versus unsupervised programs ( = .49 vs. .26). Greater contact time was associated with larger effects in supervised programs. For unsupervised programs, establishing outcome expectations, greater contact time, and targeting overweight or sedentary participants each predicted greater program effectiveness, whereas prompting barrier identification and providing workbooks were associated with smaller effect sizes.
CONCLUSION
The present review indicates that interventions have a small but significant effect on physical activity among cancer survivors and offers insights into how the effectiveness of future interventions might be improved. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
目的
我们对癌症幸存者的身体活动干预措施进行了荟萃分析,以(a)量化干预对身体活动的影响程度,(b)确定哪种干预策略组合能最大程度地改变行为。
方法
通过计算机检索,共找到 32626 条记录,其中 138 项独立测试(n=13050)符合综述纳入标准。我们开发了一个定制的 34 类技术分类法,旨在促进心理变化,并对样本、干预和方法特征进行分类。我们进行了随机效应荟萃分析和元回归;还将效应大小数据提交给分类回归树(即元 CART)进行荟萃分析。
结果
身体活动干预的样本加权平均效应大小为 =.35,相当于每天增加 1149 步。尽管经过偏倚校正后,效应大小仍显著不为零(≥.20),但存在发表偏倚和小样本偏倚。元 CART 表明,有效性的主要差异归因于监督与非监督方案(=.49 比.26)。监督方案中,接触时间更长与更大的效果相关。对于非监督方案,建立预期结果、增加接触时间以及针对超重或久坐的参与者,均能预测方案更有效,而提示识别障碍和提供工作簿与较小的效果相关。
结论
本综述表明,干预措施对癌症幸存者的身体活动有一定的、但有显著意义的影响,并提供了如何提高未来干预措施有效性的见解。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。