Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
Medical Library, VU University Amsterdam, Amsterdam, The Netherlands.
Int J Behav Nutr Phys Act. 2020 Apr 7;17(1):47. doi: 10.1186/s12966-020-00942-7.
Choice architecture interventions, which subtly change the environment in which individuals make decisions, can be used to promote behavior change. This systematic review aimed to summarize studies on micro-environmental choice architecture interventions that encouraged physical activity or discouraged sedentary behavior in adults, and to describe the effectiveness of those interventions on these behaviors - and on related intentions or health outcomes - in presence of the intervention and after removal of the intervention (i.e. post-intervention, regardless of the time elapsed).
We systematically searched PubMed, Embase, PsycINFO and the Cochrane Library for (quasi) experimental studies published up to December 2019 that evaluated the effect of choice architecture interventions on physical activity and sedentary behavior, as well as on intentions and health outcomes related to physical activity/sedentary behavior. Studies that combined choice architecture techniques with other behavior change techniques were excluded. All studies were screened for eligibility, relevant data was extracted and two independent reviewers assessed the methodological quality using the QualSyst tool.
Of the 9609 records initially identified, 88 studies met our eligibility criteria. Most studies (n = 70) were of high methodologic quality. Eighty-six studies targeted physical activity, predominantly stair use, whereas two studies targeted sedentary behavior, and one targeted both behaviors. Intervention techniques identified were prompting (n = 53), message framing (n = 24), social comparison (n = 12), feedback (n = 8), default change (n = 1) and anchoring (n = 1). In presence of the intervention, 68% of the studies reported an effect of choice architecture on behavior, whereas after removal of the intervention only 47% of the studies reported a significant effect. For all choice architecture techniques identified, except for message framing, the majority of studies reported a significant effect on behavioral intentions or behavior in presence of the intervention.
The results suggest that prompting can effectively encourage stair use in adults, especially in presence of a prompt. The effectiveness of the choice architecture techniques social influence, feedback, default change and anchoring cannot be assessed based on this review. More (controlled) studies are needed to assess the (sustained) effectiveness of choice architecture interventions on sedentary behavior and other types of physical activity than stair use.
选择架构干预措施可以微妙地改变个体做出决策的环境，从而促进行为改变。本系统评价旨在总结关于微环境选择架构干预措施的研究，这些干预措施鼓励成年人进行身体活动或减少久坐行为，并描述这些干预措施对这些行为的有效性——以及对相关意图或健康结果的有效性——在干预存在时和干预去除后（即干预后，无论经过多长时间）。
我们系统地检索了 PubMed、Embase、PsycINFO 和 Cochrane Library 中截至 2019 年 12 月发表的评估选择架构干预措施对身体活动和久坐行为以及与身体活动/久坐行为相关的意图和健康结果的影响的（准）实验研究。排除了将选择架构技术与其他行为改变技术结合使用的研究。所有研究都经过了资格筛选，提取了相关数据，两名独立评审员使用 QualSyst 工具评估了方法学质量。
最初确定的 9609 条记录中，有 88 项研究符合入选标准。大多数研究（n=70）具有较高的方法学质量。86 项研究针对身体活动，主要是楼梯使用，而两项研究针对久坐行为，一项研究针对两种行为。确定的干预技术包括提示（n=53）、信息框定（n=24）、社会比较（n=12）、反馈（n=8）、默认更改（n=1）和锚定（n=1）。在干预存在时，68%的研究报告了选择架构对行为的影响，而在干预去除后，只有 47%的研究报告了显著影响。对于确定的所有选择架构技术，除了信息框定外，大多数研究报告在干预存在时对行为意图或行为有显著影响。
结果表明，提示可以有效地鼓励成年人使用楼梯，尤其是在有提示的情况下。不能根据本综述评估社会影响、反馈、默认更改和锚定等选择架构技术的有效性。需要更多（对照）研究来评估选择架构干预措施对久坐行为和其他类型的身体活动（而非楼梯使用）的（持续）有效性。
