Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia.
Health Psychol Rev. 2021 Dec;15(4):508-539. doi: 10.1080/17437199.2020.1721310. Epub 2020 Feb 17.
Poor quality diet, physical inactivity, and obesity are prevalent, covariant risk factors for chronic disease, suggesting that behaviour change techniques (BCTs) that effectively change one risk factor might also improve the others. To examine that question, registered meta-review CRD42019128444 synthesised evidence from 30 meta-analyses published between 2007 and 2017 aggregating data from 409,185 participants to evaluate whether inclusion of 14 self-regulatory BCTs in health promotion interventions was associated with greater improvements in outcomes. Study populations and review quality varied, with minimal overlap among summarised studies. AMSTAR-2 ratings averaged 37.31% ( = 16.21%; range 8.33-75%). All BCTs were examined in at least one meta-analysis; goal setting and self-monitoring were evaluated in 18 and 20 reviews, respectively. No BCT was consistently related to improved outcomes. Although results might indicate that BCTs fail to benefit diet and activity self-regulation, we suggest that a Type 3 error occurred, whereby the meta-analytic research design implemented to analyse effects of multi-component intervention trials designed for a different purpose was mismatched to the question of how BCTs affect health outcomes. An understanding of independent and interactive effects of individual BCTs on different health outcomes and populations is needed urgently to ground a cumulative science of behaviour change.
不良饮食、缺乏身体活动和肥胖是常见的慢性病共同危险因素,这表明有效改变一种风险因素的行为改变技术(BCT)也可能改善其他因素。为了检验这一问题,注册循证综述 CRD42019128444 综合了 2007 年至 2017 年间发表的 30 项荟萃分析的证据,汇总了来自 409185 名参与者的数据,以评估在健康促进干预措施中纳入 14 种自我监管行为改变技术是否与改善结果相关。研究人群和综述质量各不相同,总结研究之间几乎没有重叠。AMSTAR-2 评分平均为 37.31%(=16.21%;范围 8.33-75%)。所有 BCT 都至少在一项荟萃分析中进行了研究;目标设定和自我监测分别在 18 项和 20 项综述中进行了评估。没有 BCT 始终与改善结果相关。尽管结果可能表明 BCT 未能有益于饮食和活动的自我调节,但我们认为发生了 3 型错误,即用于分析针对不同目的设计的多组分干预试验效果的荟萃分析研究设计与 BCT 如何影响健康结果的问题不匹配。需要紧急了解个体 BCT 对不同健康结果和人群的独立和交互作用,以便为行为改变的累积科学奠定基础。