一次改变一种以上行为以管理慢性疾病的干预措施的有效性:系统回顾与元分析》。

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Carolina C Silva, Justin Presseau, Zack van Allen, Paulina M Schenk, Maiara Moreto, John Dinsmore, Marta M Marques
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引用次数: 0

摘要

背景:健康行为在慢性病管理中发挥着重要作用。目的:我们旨在对针对一种以上行为的干预措施的随机试验进行系统回顾和荟萃分析,以研究多种健康行为改变干预措施对慢性病患者的有效性:2023年11月,我们对五个电子数据库(Web of Science、PubMed、CINAHL、EMBASE和Cochrane)进行了系统性检索,并参考了以往综述中包含的研究。我们纳入了旨在改变慢性病患者一种以上健康行为的干预措施的随机试验。两名独立评审员筛选并提取了数据,并使用了 Cochrane 的 "偏倚风险 2 "工具。通过元分析来估算干预措施对健康行为改变的影响。连续数据以 Cohen's d 表示,二分数据以风险比表示:共纳入 61 项研究,涉及多种慢性疾病:心血管疾病(k = 25)、2 型糖尿病(k = 15)、高血压(k = 10)、癌症(k = 7)、一种或多种慢性疾病(k = 3)以及多种疾病(k = 1)。大多数干预措施旨在同时(而不是依次)改变一种以上的行为,大多数干预措施同时针对三种特定行为:"体育锻炼、饮食和吸烟"(k = 20)。对 43 项符合条件的研究进行的 Meta 分析表明,对于连续数据(k = 29),除吸烟(d = -0.019)外,所有健康行为(d = 0.081-2.003)的行为改变都有小到实质性的积极影响。对于二分法数据(k = 23),所有分析均显示针对一种以上行为对所有行为都有积极影响(RR = 1.026-2.247):在慢性病管理中,同时针对一种以上的行为是有效的,应针对多种行为改变的科学发展开展更多研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of Interventions for Changing More Than One Behavior at a Time to Manage Chronic Conditions: A Systematic Review and Meta-analysis.

Background: Health behaviors play a significant role in chronic disease management. Rather than being independent of one another, health behaviors often co-occur, suggesting that targeting more than one health behavior in an intervention has the potential to be more effective in promoting better health outcomes.

Purpose: We aimed to conduct a systematic review and meta-analysis of randomized trials of interventions that target more than one behavior to examine the effectiveness of multiple health behavior change interventions in patients with chronic conditions.

Methods: Five electronic databases (Web of Science, PubMed, CINAHL, EMBASE, and Cochrane) were systematically searched in November 2023, and studies included in previous reviews were also consulted. We included randomized trials of interventions aiming to change more than one health behavior in individuals with chronic conditions. Two independent reviewers screened and extracted data, and used Cochrane's Risk of Bias 2 tool. Meta-analyses were conducted to estimate the effects of interventions on change in health behaviors. Results were presented as Cohen's d for continuous data, and risk ratio for dichotomous data.

Results: Sixty-one studies were included spanning a range of chronic diseases: cardiovascular (k = 25), type 2 diabetes (k = 15), hypertension (k = 10), cancer (k = 7), one or more chronic conditions (k = 3), and multiple conditions (k = 1). Most interventions aimed to change more than one behavior simultaneously (rather than in sequence) and most targeted three particular behaviors at once: "physical activity, diet and smoking" (k = 20). Meta-analysis of 43 eligible studies showed for continuous data (k = 29) a small to substantial positive effect on behavior change for all health behaviors (d = 0.081-2.003) except for smoking (d = -0.019). For dichotomous data (k = 23) all analyses showed positive effects of targeting more than one behavior on all behaviors (RR = 1.026-2.247).

Conclusions: Targeting more than one behavior at a time is effective in chronic disease management and more research should be directed into developing the science of multiple behavior change.

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来源期刊
Annals of Behavioral Medicine
Annals of Behavioral Medicine PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.00
自引率
5.30%
发文量
65
期刊介绍: Annals of Behavioral Medicine aims to foster the exchange of knowledge derived from the disciplines involved in the field of behavioral medicine, and the integration of biological, psychosocial, and behavioral factors and principles as they relate to such areas as health promotion, disease prevention, risk factor modification, disease progression, adjustment and adaptation to physical disorders, and rehabilitation. To achieve these goals, much of the journal is devoted to the publication of original empirical articles including reports of randomized controlled trials, observational studies, or other basic and clinical investigations. Integrative reviews of the evidence for the application of behavioral interventions in health care will also be provided. .
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