Department of Public Health and Management, Mohammed VI International School of Public Health, Mohammed VI University of Sciences and Health (UM6SS), Casablanca, Morocco.
Mohammed VI Centre for Research and Innovation, Rabat, CM6RI, Morocco.
BMC Public Health. 2024 Aug 3;24(1):2099. doi: 10.1186/s12889-024-19600-9.
Worldwide, physical inactivity (PIA) and sedentary behavior (SB) are recognized as significant challenges hindering the achievement of the United Nations (UN) sustainable development goals (SDGs). PIA and SB are responsible for 1.6 million deaths attributed to non-communicable diseases (NCDs). The World Health Organization (WHO) has urged governments to implement interventions informed by behavioral theories aimed at reducing PIA and SB. However, limited attention has been given to the range of theories, techniques, and contextual conditions underlying the design of behavioral theories. To this end, we set out to map these interventions, their levels of action, their mode of delivery, and how extensively they apply behavioral theories, constructs, and techniques.
Following the scoping review methodology of Arksey and O'Malley (2005), we included peer-reviewed articles on behavioral theories interventions centered on PIA and SB, published between 2010 and 2023 in Arabic, French, and English in four databases (Scopus, Web of Science [WoS], PubMed, and Google Scholar). We adopted a framework thematic analysis based on the upper-level ontology of behavior theories interventions, Behavioral theories taxonomies, and the first version (V1) taxonomy of behavior change techniques(BCTs).
We included 29 studies out of 1,173 that were initially screened/searched. The majority of interventions were individually focused (n = 15). Few studies have addressed interpersonal levels (n = 6) or organizational levels (n = 6). Only two interventions can be described as systemic (i.e., addressing the individual, interpersonal, organizational, and institutional factors)(n = 2). Most behavior change interventions use four theories: The Social cognitive theory (SCT), the socioecological model (SEM), SDT, and the transtheoretical model (TTM). Most behavior change interventions (BCIS) involve goal setting, social support, and action planning with various degrees of theoretical use (intensive [n = 15], moderate [n = 11], or low [n = 3]).
Our review suggests the need to develop systemic and complementary interventions that entail the micro-, meso- and macro-level barriers to behavioral changes. Theory informed BCI need to integrate synergistic BCTs into models that use micro-, meso- and macro-level theories to determine behavioral change. Future interventions need to appropriately use a mix of behavioral theories and BCTs to address the systemic nature of behavioral change as well as the heterogeneity of contexts and targeted populations.
在全球范围内，身体活动不足（PIA）和久坐行为（SB）被认为是阻碍联合国（UN）可持续发展目标（SDGs）实现的重大挑战。PIA 和 SB 导致 160 万人死于非传染性疾病（NCD）。世界卫生组织（WHO）敦促各国政府实施基于行为理论的干预措施，以减少 PIA 和 SB。然而，对于设计行为理论所依据的理论、技术和背景条件的范围，关注有限。为此，我们着手绘制这些干预措施、它们的行动水平、传递方式，以及它们在多大程度上应用行为理论、结构和技术。
根据 Arksey 和 O'Malley（2005 年）的范围审查方法，我们纳入了 2010 年至 2023 年期间在 Scopus、Web of Science[WoS]、PubMed 和 Google Scholar 四个数据库中以阿拉伯语、法语和英语发表的关于 PIA 和 SB 为中心的行为理论干预的同行评审文章。我们采用了一种基于行为理论干预的上一级本体、行为理论分类法和行为改变技术（BCT）第一版（V1）分类法的框架主题分析。
我们从最初筛选/搜索的 1173 篇中纳入了 29 项研究。大多数干预措施都是针对个人的（n=15）。很少有研究涉及人际层面（n=6）或组织层面（n=6）。只有两项干预措施可以被描述为系统的（即，针对个人、人际、组织和制度因素）（n=2）。大多数行为改变干预措施使用四种理论：社会认知理论（SCT）、社会生态学模型（SEM）、自我决定理论（SDT）和跨理论模型（TTM）。大多数行为改变干预措施（BCIS）涉及目标设定、社会支持和行动计划，以及不同程度的理论使用（强化[n=15]、中等[n=11]或低[n=3]）。
我们的综述表明，需要制定系统和互补的干预措施，以解决行为改变的微观、中观和宏观障碍。以理论为依据的 BCI 需要将协同的 BCT 纳入使用微观、中观和宏观理论来确定行为改变的模型中。未来的干预措施需要适当使用混合行为理论和 BCT，以解决行为变化的系统性以及目标人群和背景的异质性。
