Use of Theory in Behavior Change Interventions.

Use of Theory in Behavior Change Interventions.
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DOI:
10.1177/1090198116647712
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发表时间:
2017-04
期刊:
Health education & behavior : the official publication of the Society for Public Health Education
影响因子:
--
通讯作者:
Vernon SW
Vernon SW
中科院分区:
其他
文献类型:
--
作者:
Bluethmann SM;Bartholomew LK;Murphy CC;Vernon SW

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理论的使用可能会提高行为干预的有效性,但批评者质疑是否理论为基础的干预措施已得到充分的审查。本研究应用一个框架来评估理论在乳腺癌幸存者体力活动干预中的应用。目的是(1)评估理论应用强度和(2)评估理论使用的广泛性和干预效果之间的关联。先前通过系统检索确定了研究,仅包括2005年至2013年发表的随机对照试验,这些试验涉及体力活动行为变化并研究治疗后<5年的幸存者。从米吉和Prestwich的编码框架中选择八个理论项目来计算理论强度得分。根据理论使用的广泛性将研究分为三个亚组(1级=稀疏; 2级=中度; 3级=广泛)。14项随机对照试验符合检索标准。大多数试验使用跨理论模型(n = 5)或社会认知理论(n = 3)。对于理论使用的广泛性,5项研究被归类为1级,4项为2级,5项为3级。广泛组(3级)的研究具有最大的总体效应量(g = 0.76)。水平1组和水平2组的效应更为适度,总体效应量分别为g = 0.28和g = 0.36。理论的应用通常被认为是行为改变的关键,但理论的应用却有很大的不同。在本研究中,有一些证据表明,理论使用的广泛性提高了干预的有效性。然而,关于理论如何改善乳腺癌幸存者的干预措施,还有更多的东西要学。
Theory use may enhance effectiveness of behavioral interventions, yet critics question whether theory-based interventions have been sufficiently scrutinized. This study applied a framework to evaluate theory use in physical activity interventions for breast cancer survivors. The aims were to (1) evaluate theory application intensity and (2) assess the association between extensiveness of theory use and intervention effectiveness. Studies were previously identified through a systematic search, including only randomized controlled trials published from 2005 to 2013, that addressed physical activity behavior change and studied survivors who were <5 years posttreatment. Eight theory items from Michie and Prestwich’s coding framework were selected to calculate theory intensity scores. Studies were classified into three subgroups based on extensiveness of theory use (Level 1 = sparse; Level 2 = moderate; and Level 3 = extensive). Fourteen randomized controlled trials met search criteria. Most trials used the transtheoretical model (n = 5) or social cognitive theory (n = 3). For extensiveness of theory use, 5 studies were classified as Level 1, 4 as Level 2, and 5 as Level 3. Studies in the extensive group (Level 3) had the largest overall effect size (g = 0.76). Effects were more modest in Level 1 and 2 groups with overall effect sizes of g = 0.28 and g = 0.36, respectively. Theory use is often viewed as essential to behavior change, but theory application varies widely. In this study, there was some evidence to suggest that extensiveness of theory use enhanced intervention effectiveness. However, there is more to learn about how theory can improve interventions for breast cancer survivors.
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