The effectiveness of interventions to change six health behaviours: a review of reviews.
The effectiveness of interventions to change six health behaviours: a review of reviews.
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DOI：
10.1186/1471-2458-10-538
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发表时间：
2010-09-08
影响因子：
4.5
通讯作者：
Tannahill C
中科院分区：
文献类型：
--
作者：
Jepson RG;Harris FM;Platt S;Tannahill C
近年来，世界卫生组织的几份报告都强调了糖尿病、冠心病和癌症等慢性病的高发病率。致病因素包括不健康的饮食、烟酒使用和久坐不动的生活方式。这篇论文报告了对行为改变干预减少不健康行为或促进健康行为的综述的研究结果。我们在回顾中纳入了六种不同的健康相关行为：健康饮食、体育锻炼、吸烟、滥用酒精、（年轻人）性冒险和非法药物使用。我们排除了侧重于药物治疗或需要强化治疗（如药物或酒精依赖）的综述。检索了Cochrane图书馆、有效性评价摘要数据库（DARE）和几个Ovid数据库，对六种行为的干预措施进行了系统评价（2008年更新检索）。两名审稿人应用纳入标准，提取数据并评估评价的质量。结果在叙述综合中进行了讨论。我们纳入了1995年至2008年间发表的103篇综述。干预措施的重点各不相同，但针对特定个人的干预措施一般旨在改变现有行为（如吸烟、酗酒），而针对一般人群或群体（如在校儿童）的干预措施旨在促进积极行为（如健康饮食）。近50% （n = 48）的综述关注吸烟（预防或戒烟）。在一系列健康行为中最有效的干预措施包括医生建议或个人咨询，以及在工作场所和学校开展活动。大众媒体宣传和立法干预在改变健康行为方面也显示出小到中等的效果。一般来说，证据与短期影响有关，而不是持续/长期影响，关于如何最好地解决不平等问题的证据相对缺乏。尽管审查审查方法存在局限性，但令人鼓舞的是，在实现行为改变方面有有效的干预措施。初级研究和次级分析（例如系统审查）都应进一步强调评估不同人群亚组干预措施的不同效果，以确保解决卫生不平等问题。
Several World Health Organisation reports over recent years have highlighted the high incidence of chronic diseases such as diabetes, coronary heart disease and cancer. Contributory factors include unhealthy diets, alcohol and tobacco use and sedentary lifestyles. This paper reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours. We included six different health-related behaviours in the review: healthy eating, physical exercise, smoking, alcohol misuse, sexual risk taking (in young people) and illicit drug use. We excluded reviews which focussed on pharmacological treatments or those which required intensive treatments (e.g. for drug or alcohol dependency). The Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE) and several Ovid databases were searched for systematic reviews of interventions for the six behaviours (updated search 2008). Two reviewers applied the inclusion criteria, extracted data and assessed the quality of the reviews. The results were discussed in a narrative synthesis. We included 103 reviews published between 1995 and 2008. The focus of interventions varied, but those targeting specific individuals were generally designed to change an existing behaviour (e.g. cigarette smoking, alcohol misuse), whilst those aimed at the general population or groups such as school children were designed to promote positive behaviours (e.g. healthy eating). Almost 50% (n = 48) of the reviews focussed on smoking (either prevention or cessation). Interventions that were most effective across a range of health behaviours included physician advice or individual counselling, and workplace- and school-based activities. Mass media campaigns and legislative interventions also showed small to moderate effects in changing health behaviours. Generally, the evidence related to short-term effects rather than sustained/longer-term impact and there was a relative lack of evidence on how best to address inequalities. Despite limitations of the review of reviews approach, it is encouraging that there are interventions that are effective in achieving behavioural change. Further emphasis in both primary studies and secondary analysis (e.g. systematic reviews) should be placed on assessing the differential effectiveness of interventions across different population subgroups to ensure that health inequalities are addressed.
影响因子：
4.2
作者：
Bandura, A
通讯作者：
Bandura, A