Roche Anne I, Kroska Emily B, Denburg Natalie L
Department of Psychological and Brain Sciences, University of Iowa.
Department of Neurology, University of Iowa.
J Contextual Behav Sci. 2019 Jul;13:74-93. doi: 10.1016/j.jcbs.2019.06.002. Epub 2019 Jun 19.
Behavioral health issues such as smoking and overweight are risk factors for a variety of adverse health outcomes, including mortality. Over the past decade, a growing number of randomized controlled trials have examined the efficacy of acceptance- and mindfulness-based interventions for smoking cessation and weight loss. The purpose of the current meta-analytic reviews was to quantitatively synthesize the existing literature comparing these interventions to controls for a) smoking cessation and b) weight loss outcomes. Searches identified 17 smoking cessation studies and 31 weight loss studies eligible for inclusion. Meta-analytic results indicated a non-significant effect favoring acceptance- and mindfulness-based interventions over controls for smoking cessation (OR = 1.13) and a small, significant effect favoring these interventions over controls for weight loss outcomes (Hedge's = 0.30). Statistical heterogeneity and risk of bias were assessed. Subgroup and meta-regression analyses were conducted to examine moderating variables (e.g., sample and intervention characteristics). The findings indicated that acceptance- and mindfulness-based interventions were at least as efficacious as active control conditions. Given the significant health risks associated with smoking and overweight, these findings have important clinical and public health implications. Limitations (e.g., relative infancy of the literature; lack of diversity in sample demographics) and future directions (e.g., further exploration of mediators and moderators of change) are discussed.
吸烟和超重等行为健康问题是包括死亡率在内的多种不良健康结果的风险因素。在过去十年中，越来越多的随机对照试验研究了基于接纳和正念的干预措施在戒烟和减肥方面的效果。当前荟萃分析综述的目的是对现有文献进行定量综合，比较这些干预措施与对照组在以下方面的效果：a）戒烟；b）减肥结果。检索发现有17项戒烟研究和31项减肥研究符合纳入标准。荟萃分析结果表明，在戒烟方面，与对照组相比，基于接纳和正念的干预措施效果不显著（优势比=1.13）；在减肥结果方面，与对照组相比，这些干预措施有小的显著效果（赫奇斯效应量=0.30）。评估了统计异质性和偏倚风险。进行了亚组分析和元回归分析以检验调节变量（如样本和干预特征）。研究结果表明，基于接纳和正念的干预措施至少与积极对照条件一样有效。鉴于吸烟和超重带来的重大健康风险，这些发现具有重要的临床和公共卫生意义。讨论了研究的局限性（如该领域文献相对较少；样本人口统计学缺乏多样性）和未来方向（如进一步探索变化的中介因素和调节因素）。
