scholarly journals A systematic review of the effectiveness of interventions based on a stages-of-change approach to promote individual behaviour change

2002 ◽  
Vol 6 (24) ◽  
Author(s):  
R. P. Riemsma ◽  
J. Pattenden ◽  
C. Bridle ◽  
A. J. Sowden ◽  
L. Mather ◽  
...  
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Stages Of Change ◽  
Individual Behaviour ◽  
Individual Behaviour Change

scholarly journals A systematic review of the transtheoretical model of behaviour change and alcohol use

Psychologica ◽  
2014 ◽  
Vol 57 (1) ◽  
pp. 7-22
Author(s):  
Flaviane Bevilaqua Felicíssimo ◽  
Víviam Vargas Barros ◽  
Sabrina Maura Pereira ◽  
Natália Quintela Rocha ◽  
Lélio Moura Lourenço
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Rhode Island ◽  
Behaviour Change ◽  
Stages Of Change ◽  
Transtheoretical Model ◽  
Readiness To Change ◽  
Change Processes ◽  
Processes Of Change ◽  
Change Assessment

Introdução: O estudo sobre o álcool tem aumentado em todo o mundo devido ao seu impacto social e econômico, e as doenças relacionadas ao uso de álcool estarem entre os distúrbios mais comuns de abuso de substâncias. Desta forma, faz-se necessário investigar os métodos mais eficazes e adequados de tratamento para diferentes populações. Método: Este trabalho analisou a literatura científica sobre o Modelo Transteórico de Mudança de Comportamento relacionados ao consumo de álcool. Foram consultadas as bases de dados Scopus, PubMed, PsycINFO, PepsiCo e Lilacs, utilizando os descritores transtheoretical model, transtheoretical approach, stages of change, processes of change e cycle of change cruzado com o descritor alcoholism, no período de dez anos (2001 a 2011). Principais resultados: A maioria das pesquisas encontradas utilizavam métodos longitudinais e quantitativos, além de uma prevalência no uso dos questionários Readiness to Change Questionnaire e University of Rhode Island Change Assessment utilizados na mensuração do ModeloTransteórico. Os resultados indicaram que outras variáveis podem influenciar o comportamento do indivíduo em relação à sua fase de mudança de comportamento e identificou problemas relacionados ao uso de álcool em pacientes que procuravam tratamento para outras condições de saúde. Esta constatação reforça a necessidade de práticas de triagens para a prevenção dos agravos relacionados ao uso de álcool.Implicações: O modelo Transteórico é importante no processo de mudança de comportamento, uma vez que permite a identificação dos estágios e a escolha de intervenções mais adequadas ao estágio do paciente, além de evitar que esforços sejam feitos na direção contrária à necessidade do usuário. Conclusão: Ressalta-se a necessidade de mais estudos na área, especialmente em relação às práticas de profissionais de saúde.

scholarly journals The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development

2017 ◽  
Vol 21 (5) ◽  
pp. 1-164 ◽  
Author(s):  
Paul Flowers ◽  
Olivia Wu ◽  
Karen Lorimer ◽  
Bipasha Ahmed ◽  
Hannah Hesselgreaves ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Behaviour Change ◽  
Hiv Transmission ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Individual Behaviour ◽  
Behaviour Change Interventions ◽  
Individual Level ◽  
The Uk ◽  
Individual Behaviour Change

AbstractBackgroundMen who have sex with men (MSM) experience significant inequalities in health and well-being. They are the group in the UK at the highest risk of acquiring a human immunodeficiency virus (HIV) infection. Guidance relating to both HIV infection prevention, in general, and individual-level behaviour change interventions, in particular, is very limited.ObjectivesTo conduct an evidence synthesis of the clinical effectiveness of behaviour change interventions to reduce risky sexual behaviour among MSM after a negative HIV infection test. To identify effective components within interventions in reducing HIV risk-related behaviours and develop a candidate intervention. To host expert events addressing the implementation and optimisation of a candidate intervention.Data sourcesAll major electronic databases (British Education Index, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Educational Resource Index and Abstracts, Health and Medical Complete, MEDLINE, PsycARTICLES, PsycINFO, PubMed and Social Science Citation Index) were searched between January 2000 and December 2014.Review methodsA systematic review of the clinical effectiveness of individual behaviour change interventions was conducted. Interventions were examined using the behaviour change technique (BCT) taxonomy, theory coding assessment, mode of delivery and proximity to HIV infection testing. Data were summarised in narrative review and, when appropriate, meta-analysis was carried out. Supplemental analyses for the development of the candidate intervention focused on post hoc realist review method, the assessment of the sequential delivery and content of intervention components, and the social and historical context of primary studies. Expert panels reviewed the candidate intervention for issues of implementation and optimisation.ResultsOverall, trials included in this review (n = 10) demonstrated that individual-level behaviour change interventions are effective in reducing key HIV infection risk-related behaviours. However, there was considerable clinical and methodological heterogeneity among the trials. Exploratory meta-analysis showed a statistically significant reduction in behaviours associated with high risk of HIV transmission (risk ratio 0.75, 95% confidence interval 0.62 to 0.91). Additional stratified analyses suggested that effectiveness may be enhanced through face-to-face contact immediately after testing, and that theory-based content and BCTs drawn from ‘goals and planning’ and ‘identity’ groups are important. All evidence collated in the review was synthesised to develop a candidate intervention. Experts highlighted overall acceptability of the intervention and outlined key ways that the candidate intervention could be optimised to enhance UK implementation.LimitationsThere was a limited number of primary studies. All were from outside the UK and were subject to considerable clinical, methodological and statistical heterogeneity. The findings of the meta-analysis must therefore be treated with caution. The lack of detailed intervention manuals limited the assessment of intervention content, delivery and fidelity.ConclusionsEvidence regarding the effectiveness of behaviour change interventions suggests that they are effective in changing behaviour associated with HIV transmission. Exploratory stratified meta-analyses suggested that interventions should be delivered face to face and immediately after testing. There are uncertainties around the generalisability of these findings to the UK setting. However, UK experts found the intervention acceptable and provided ways of optimising the candidate intervention.Future workThere is a need for well-designed, UK-based trials of individual behaviour change interventions that clearly articulate intervention content and demonstrate intervention fidelity.Study registrationThe study is registered as PROSPERO CRD42014009500.FundingThe National Institute for Health Research Health Technology Assessment programme.

Public health approaches to tackling obesity in the UK

2019 ◽  
Vol 30 (6) ◽  
pp. 294-298
Author(s):  
Hilda Mulrooney
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Behaviour Change ◽  
Population Based ◽  
Dietary Intakes ◽  
Obesogenic Environment ◽  
Individual Behaviour ◽  
Adults And Children ◽  
The Uk ◽  
Individual Behaviour Change

Being obese and overweight affects an increasing number of adults and children in the UK. Hilda Mulrooney presents an overview of the population-based approaches to improving public health and enabling more people to lose weight Obesity is a serious condition that is highly prevalent in UK adults and children. A number of population-based approaches to improve the ‘obesogenic’ environment have been put into place while more are being proposed. Many of these approaches have the advantage of potentially altering dietary intakes without individual behaviour change, and they are taking place in a wider context that encourages physical activity and partnership working. Approaches to obesity and progress made towards targets will be discussed.

scholarly journals Using the Theoretical Domains Framework to investigate clinicians’ behavioural determinants of antimicrobial prescribing in Qatar

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i20-i22
Author(s):  
H Talkhan ◽  
D Stewart ◽  
T McIntosh ◽  
H Ziglam ◽  
P V Abdulrouf ◽  
...  
Keyword(s):  
Systematic Review ◽  
Scale Score ◽  
Behaviour Change ◽  
Theoretical Domains Framework ◽  
Free Text ◽  
Behaviour Change Interventions ◽  
Antimicrobial Prescribing ◽  
Behavioural Determinants ◽  
Inferential Analysis ◽  
Determinants Of Implementation

Abstract Introduction A recent systematic review by Talkhan et al demonstrated the need for theoretically based behaviour change interventions in this area. [1] For development of such complex interventions, emphasis should be placed on using theory to systematically identify behavioural determinants of antimicrobial prescribing. Aim To identify and quantify clinicians’ behavioural determinants of antimicrobial prescribing in Qatar. Methods This cross-sectional survey is part of a multi-phase explanatory, sequential mixed methods PhD project in Qatar. Questionnaires were distributed (online and paper based) to all doctors (~4,000) and pharmacists (~400) within Hamad Medical Corporation (HMC, the main healthcare provider). The questionnaire was developed with reference to the Determinants of Implementation Behaviour Questionnaire (a generic questionnaire derived from the 14 theoretical domains of the Theoretical Domains Framework, TDF). [2] Each item was presented as a 5-point Likert scale (scored 5=Strongly agree to 1=Strongly disagree). Personal and practice demographics were also collected for data contextualisation. The draft questionnaire was reviewed for face/content validity by an expert panel of six researchers in Qatar and the UK with experience in the use of the TDF, followed by ‘Think aloud’ testing and piloting. Analysis investigated the behavioural determinants and influential factors through descriptive, principal component analysis (PCA) and inferential analysis. Ethics approval was granted from a UK university and HMC. Results In total, 535 responses were received, 339 (63.4%) from doctors and 196 (36.6%) from pharmacists. Respondents were predominantly male, 346 (64.7%). Just over half (n=285, 53.3%) had ≤ 5 years’ experience as health professionals. PCA showed a three component (C) solution with components incorporating a number of questionnaire items labelled: ‘Guidelines compliance’ (C1 with 8 items), ‘Influences on prescribing’ (C2 with 7 items) and ‘Self-efficacy’ (C3 with 5 items) in prescribing/recommendation activity. A scale score for each respondent was calculated through summation of Likert scores for the relevant questionnaire items within each component. These scales had high internal reliability (Cronbach’s alpha all >0.7) showing consistency in response between component items indicating statistical appropriateness for developing scales. The median score (possible scale range, midpoint) for each scale was C1, 32 (8 to 40, 24), C2, 26 (7 to 35, 21) and C3, 20, (5 to 25, 15). By way of example Table 1 shows levels of agreement for items in C2. This shows lower levels of agreement than C1 scale with the median scale score (26) closer to the midpoint (21) indicating that respondents had less positive views. Inferential analysis using these scale scores and free text analysis is in progress. Conclusion A theoretical basis was used throughout providing insights to behavioural determinants for the development of a theory-based behaviour change intervention. Preliminary results suggest that social influences, staff development and quality monitoring may be useful targets for behaviour change interventions to improve antimicrobial prescribing practice. Limitations include potential social desirability bias and focus on one healthcare organisation/country in the Middle East which may limit generalisability of findings. More in-depth exploration is required to select and test appropriate linked theory-based behaviour change techniques. References 1. Talkhan H, Stewart D, McIntosh T, Ziglam H Palli Valapila, A; Moza Sulaiman H, Diab M, Cunningham S. The use of theory in the development and evalu​ation of behaviour change interventions to improve antimicrobial prescribing: a systematic review. J Antimicrob Chemother. 2020;75(9):2394–2410, Available from https://doi.org/10.1093/jac/dkaa154 [Accessed 12 Oct 2020]. 2. Huijg JM, Gebhardt WA, Dusseldorp E, Verheijden MW, van der Zouwe N, Middelkoop BJ, Crone MR. Measuring determinants of implementation behaviour: psychometric properties of a questionnaire based on the Theoretical Domains Framework. Implement. Sci. 2014;9(1):33.

Hauora Tãne: Mãori Men, Health Behaviours, and the Stages of Change Model

2005 ◽  
Vol 11 (2) ◽  
pp. 136-145
Author(s):  
Jo Paddison ◽  
Hemi Heta ◽  
Ross Flett
Keyword(s):  
Behaviour Change ◽  
Stages Of Change ◽  
Sun Exposure ◽  
Health Behaviours ◽  
Public Health Programs ◽  
High Fibre Diet ◽  
Fibre Diet ◽  
High Fibre ◽  
Men Health ◽  
Managing Stress

Understanding the distribution of Mãori across stages of health behaviour change (precontemplation, contemplation, preparation, action, maintenance) may inform the development of public health programs. In a replication and extension of a study by Nigg et al. (1999) we described the distribution of 73 Mãori male questionnaire respondents (age 18 to 59 years) across these stages for 8 healthy behaviours (avoiding dietary fat, eating fibre, reducing weight, regularly exercising, reducing stress, reducing sun exposure, using sunblock, and conducting cancer self-examinations). Respondents were also asked to rate their general health, health worries, and health locus of control. Evidence found of a continuum of change for ‘ignoring’, to ‘thinking about1 to ‘performing’ healthy behaviour provides moderate support for the idea that behaviour change is not an all-or-nothing event. There were no significant age effects. Respondents who rated their health more positively were more likely to report using sunblock, exercising regularly, and eating a high fibre diet. Respondents who felt they had more control over their health were more likely to eat a diet high in fibre. Eating a high fibre diet, exercising and managing stress were most strongly associated with the other health behaviours which may illustrate the concept of gateway behaviours proposed by Nigg et al. (1999).

A systematic review of mobile health interventions in China: Identifying gaps in care

2019 ◽  
pp. 1357633X1985674 ◽  
Author(s):  
Xiaoshi Yang ◽  
Carrie L Kovarik
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Mobile Health ◽  
Urban Areas ◽  
Healthcare Services ◽  
Text Messages ◽  
Health Interventions ◽  
Health System Strengthening ◽  
World Health ◽  
Common Disease

Introduction Mobile health has a promising future in the healthcare system in most developed countries. China’s rapidly developing mobile technology infrastructure offers an unprecedented opportunity for wide adoption of mobile health interventions in the delivery of effective and timely healthcare services. However, there is little data on the current extent of the mobile health landscape in China. The aim of this study was to systematically review the existing mobile health initiatives in China, characterise the technology used, disease categories targeted, location of the end user (urban versus rural), and examine the potential effects of mobile health on health system strengthening in China. Furthermore, we identified gaps in development and evaluation of the effectiveness of mobile health interventions. Methods A systematic review of the literature published from 18 December 2015–3 April 2019 was conducted and yielded 2863 articles from English and Chinese retrieval database and trial registries, including PubMed, EMBASE, China National Knowledge of Infrastructure and World Health Organization International Clinical Trials Registry Platform. Studies were included if they used mobile health to support patient healthcare outcomes. Results A total of 1129 full-text articles were assessed and 338 were included in this study. The review found that most studies targeted client education and behaviour change via applications (apps) (65.4%), including WeChat, and text messaging (short text messages) (19.8%) to improve patient medical treatment outcomes such as compliance and appointment reminders. The most common disease-specific mobile health interventions focused primarily on chronic disease management and behaviour change in cardiology (13.3%), endocrinology/diabetes (12.1%), behavioural health (11.8%), oncology (11.2%) and neurology (6.8%). The mobile health interventions related to nutrition (0.6%) and chronic respiratory diseases (1.6%) are underrepresented in mobile health in comparison to the burden of disease in China. The majority (90.0%) of the mobile health interventions were conducted exclusively in urban areas, with few opportunities reaching rural populations. Conclusions Overall, mobile health has a promising future in China, with recent rapid growth in initiatives. The majority are focused on education and behaviour change in the realm of chronic diseases and target patients in urban areas. The imbalance in mobile health between the urban and rural areas, as well as between population disease spectrum and health service delivery, pose substantial dilemmas. However, mobile health may be redirected to correct this imbalance, possibly improving access to healthcare services, and filling the gaps in order to improve health equity for the underserved populations in China.

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