A systematic review on the clustering and co-occurrence of multiple risk behaviours.
A systematic review on the clustering and co-occurrence of multiple risk behaviours.
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DOI：
10.1186/s12889-016-3373-6
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发表时间：
2016-07-29
影响因子：
4.5
通讯作者：
Sowden AJ
中科院分区：
文献类型：
--
作者：
Meader N;King K;Moe-Byrne T;Wright K;Graham H;Petticrew M;Power C;White M;Sowden AJ
吸烟和缺乏身体活动等危险行为占所有心血管死亡的三分之二，并与许多疾病（包括癌症和糖尿病）的死亡率大幅增加有关。由于风险行为被认为是共同发生在个人，我们进行了一个系统的审查研究解决集群或共同发生的风险行为及其预测。由于审查的主要目的是为英格兰的公共卫生政策提供信息，我们将纳入范围限制在英国进行的研究。检索了1990年至2016年的关键数据库。我们纳入了英国的横断面和纵向研究，这些研究调查了吸烟、缺乏运动和不健康饮食等风险行为。高异质性排除了荟萃分析。该综述纳入了37项研究（32项横截面研究和5项纵向研究）。大多数研究调查了不健康的饮食、缺乏运动、酗酒和吸烟。在一般成年人口中，有相对强有力的证据表明，酗酒和吸烟以及不健康饮食和吸烟之间存在聚类关系。对于年轻人来说，有证据表明，危险性行为与吸烟、危险性行为与非法药物使用以及危险性行为与酗酒之间存在集群关系。与多种风险行为共同发生和聚集的最强关联是职业（在较低的SES组中，几率增加了4倍）和教育（在没有资格的人群中，几率增加了5倍）。在一般成年人中，酗酒和吸烟是最常见的风险行为集群。在年轻人中，有一致的证据表明，在性风险行为和药物滥用之间发现了集群。社会经济地位是参与多种风险行为的最强预测因素。这表明，有可能采取针对多种风险行为的干预措施，无论是按顺序还是同时进行，特别是在有证据表明存在聚集现象的情况下。此外，由于与社会经济地位密切相关，因此有可能在社会或环境层面进行干预。本文的在线版本（doi：10.1186/s12889-016-3373-6）包含补充材料，可供授权用户使用。
Risk behaviours, such as smoking and physical inactivity account for up to two-thirds of all cardiovascular deaths, and are associated with substantial increased mortality in many conditions including cancer and diabetes. As risk behaviours are thought to co-occur in individuals we conducted a systematic review of studies addressing clustering or co-occurrence of risk behaviours and their predictors. As the main aim of the review was to inform public health policy in England we limited inclusion to studies conducted in the UK. Key databases were searched from 1990 to 2016. We included UK based cross-sectional and longitudinal studies that investigated risk behaviours such as smoking, physical inactivity, unhealthy diet. High heterogeneity precluded meta-analyses. Thirty-seven studies were included in the review (32 cross-sectional and five longitudinal). Most studies investigated unhealthy diet, physical inactivity, alcohol misuse, and smoking. In general adult populations, there was relatively strong evidence of clustering between alcohol misuse and smoking; and unhealthy diet and smoking. For young adults, there was evidence of clustering between sexual risk behaviour and smoking, sexual risk behaviour and illicit drug use, and sexual risk behaviour and alcohol misuse. The strongest associations with co-occurrence and clustering of multiple risk behaviours were occupation (up to 4-fold increased odds in lower SES groups) and education (up to 5-fold increased odds in those with no qualifications). Among general adult populations, alcohol misuse and smoking was the most commonly identified risk behaviour cluster. Among young adults, there was consistent evidence of clustering found between sexual risk behaviour and substance misuse. Socio-economic status was the strongest predictor of engaging in multiple risk behaviours. This suggests the potential for interventions targeting multiple risk behaviours either sequentially or concurrently particularly where there is evidence of clustering. In addition, there is potential for intervening at the social or environmental level due to the strong association with socio-economic status. The online version of this article (doi:10.1186/s12889-016-3373-6) contains supplementary material, which is available to authorized users.