Low-income groups and behaviour change interventions: a review of intervention content, effectiveness and theoretical frameworks
Low-income groups and behaviour change interventions: a review of intervention content, effectiveness and theoretical frameworks
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DOI：
10.1136/jech.2008.078725
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发表时间：
2009-08-01
影响因子：
6.3
通讯作者：
Bridle, C.
中科院分区：
文献类型：
--
作者：
Michie, S.;Jochelson, K.;Bridle, C.
背景：改变健康相关行为的干预措施有可能加剧健康不平等。方法：本综述调查了针对低收入群体减少吸烟或增加体育活动和/或健康饮食的干预措施的有效性。在检索策略确定的9766篇论文中，有13篇符合纳入标准。将干预内容编码为成分技术和理论基础，并作为影响异质性的潜在来源进行检验。结果：干预措施是异质性的，包括4-19种技术。9项干预有积极影响，7项没有改变，1项有不利影响。有效的干预措施往往比无效的干预措施采用更少的技术，没有证据表明任何技术普遍有效或无效。只有6项研究引用了与干预发展相关的理论，几乎没有关于如何使用理论的信息，也没有与干预内容或效果的明显联系。结论：这篇综述表明，行为改变干预措施，特别是那些技术较少的干预措施，在低收入群体中可能有效，但强调缺乏证据来为弱势群体的干预措施设计提供信息。
Background: Interventions to change health-related behaviours have potential to increase health inequalities.Methods: This review investigated the effectiveness of interventions targeting low-income groups to reduce smoking or increase physical activity and/or healthy eating. Of 9766 papers identified by the search strategy, 13 met the inclusion criteria. Intervention content was coded into component technique and theoretical basis, and examined as a potential source of effect heterogeneity.Results: Interventions were heterogeneous, comprising 4-19 techniques. Nine interventions had positive effects, seven resulted in no change and one had an adverse effect. Effective interventions had a tendency to have fewer techniques than ineffective interventions, with no evidence for any technique being generally effective or ineffective. Only six studies cited theory relative to intervention development, with little information about how theory was used and no obvious association with intervention content or effect.Conclusion: This review shows that behaviour change interventions, particularly those with fewer techniques, can be effective in low-income groups, but highlights the lack of evidence to draw on in informing the design of interventions for disadvantaged groups.