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积极心理干预能否改善健康行为?文献系统综述。

Can positive psychological interventions improve health behaviors? A systematic review of the literature.

机构信息

Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.

Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.

出版信息

Prev Med. 2022 Oct;163:107214. doi: 10.1016/j.ypmed.2022.107214. Epub 2022 Aug 23.

Abstract

Positive psychological interventions (PPIs), which aim to cultivate psychological well-being, have the potential to improve health behavior adherence. This systematic review summarized the existing literature on PPI studies with a health behavior outcome to examine study methodology, quality, and efficacy. Of the 27 identified studies, 20 measured physical activity, eight measured medication adherence, seven measured diet, and three measured smoking (eight targeted multiple behaviors). Twenty studies were randomized controlled trials (RCTs; 13 fully powered), and seven had a single-arm design. Study samples were usually adults (n = 21), majority non-Hispanic white (n = 15) and female (n = 14), and with a specific disease (e.g., diabetes, n = 16). Most interventions combined a PPI with health behavior-focused content (n = 17), used a remote delivery method (n = 17), and received a moderate or low study quality rating. Overall, 19/27 studies found a health behavior improvement of at least medium effect size, while six of the 13 studies powered to detect significant effects were statistically significant. Of the behaviors measured, physical activity was most likely to improve (14/20 studies). In summary, PPIs are being increasingly studied as a strategy to enhance health behavior adherence. The existing literature is limited by small sample size, low study quality and inconsistent intervention content and outcome measurement. Future research should establish the most effective components of PPIs that can be tailored to different populations, use objective health behavior measurement, and robustly examine the effects of PPIs on health behaviors in fully powered RCTs.

摘要

积极心理干预(PPIs)旨在培养心理健康,具有改善健康行为依从性的潜力。本系统综述总结了具有健康行为结果的 PPI 研究的现有文献,以检查研究方法、质量和疗效。在确定的 27 项研究中,20 项测量了体育活动,8 项测量了药物依从性,7 项测量了饮食,3 项测量了吸烟(8 项针对多种行为)。20 项研究为随机对照试验(RCT;13 项完全有效),7 项为单臂设计。研究样本通常为成年人(n=21),大多数为非西班牙裔白人(n=15)和女性(n=14),且患有特定疾病(例如糖尿病,n=16)。大多数干预措施将 PPI 与以健康行为为重点的内容相结合(n=17),使用远程交付方法(n=17),并获得中等或低研究质量评分。总体而言,27 项研究中有 19/项发现健康行为改善至少具有中等效果量,而 13 项有能力检测到显著效果的研究中有 6 项具有统计学意义。在所测量的行为中,体育活动最有可能改善(20/14 项研究)。总之,PPIs 作为增强健康行为依从性的策略越来越受到关注。现有文献的局限性在于样本量小、研究质量低以及干预内容和结果测量不一致。未来的研究应该确定可以针对不同人群进行定制的 PPI 的最有效成分,使用客观的健康行为测量,并在完全有效的 RCT 中稳健地检验 PPI 对健康行为的影响。

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