Kapukotuwa Sidath, Nerida Tara, Batra Kavita, Sharma Manoj
Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA.
Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, NV 89102, USA.
Health Promot Perspect. 2024 Jul 29;14(2):121-135. doi: 10.34172/hpp.42887. eCollection 2024.
The utilization of a theoretical framework is vital in health promotion research, particularly when endeavoring to modify health behaviors. This systematic review aimed at evaluating and synthesizing evidence through studies conducted using the fourth-generation multi-theory model (MTM) of health behavior change for its effectiveness.
A comprehensive article search was performed across MEDLINE, CINAHL, and Academic Search Premier. The search focused on studies utilizing MTM from 2016 to December 2023, following the PRISMA guidelines for systemic reviews.
An initial pool of 7583 articles was narrowed down through screening of titles, abstracts, and full texts. A total of 69 articles met the inclusion criteria. These studies, encompassing a global range of diverse target groups and health behaviors, were categorized as qualitative, cross-sectional, or experimental. The six qualitative studies revealed MTM themes for diverse health behaviors. The fifty-six cross-sectional studies showed MTM constructs effectively predicting behavior change, albeit with varying statistical significance. The seven experiments demonstrated MTM's role in initiating and sustaining change. For the initiation model, operationalized by 49 studies, the mean adjusted R was 38.4% (SD=16.4%). For the sustenance model, operationalized by 45 studies, the mean adjusted R was 38.9% (SD=15.5%).
This systematic review corroborates the MTM as a potent framework for understanding, predicting, and facilitating health behavior changes. Its universal applicability and effectiveness underscore the model's potential as a foundational tool in designing future health promotion strategies and interventions aimed at positive and enduring behavior modifications.
理论框架的运用在健康促进研究中至关重要，尤其是在试图改变健康行为时。本系统综述旨在通过使用健康行为改变的第四代多理论模型（MTM）进行的研究来评估和综合证据，以验证其有效性。
在MEDLINE、CINAHL和学术搜索高级版数据库中进行了全面的文献检索。检索重点是2016年至2023年12月期间运用MTM的研究，遵循PRISMA系统评价指南。
通过对标题、摘要和全文的筛选，最初的7583篇文章数量减少。共有69篇文章符合纳入标准。这些研究涵盖全球范围的不同目标群体和健康行为，分为定性研究、横断面研究或实验研究。六项定性研究揭示了不同健康行为的MTM主题。五十六项横断面研究表明MTM结构能够有效预测行为改变，尽管统计显著性各不相同。七项实验证明了MTM在启动和维持改变方面的作用。对于由49项研究实施的启动模型，平均调整R为38.4%（标准差=16.4%）。对于由45项研究实施的维持模型，平均调整R为38.9%（标准差=15.5%）。
本系统综述证实MTM是理解、预测和促进健康行为改变的有力框架。其普遍适用性和有效性凸显了该模型作为设计未来健康促进策略和干预措施的基础工具的潜力，这些策略和干预旨在实现积极且持久的行为改变。
