Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials

Erica James; Megan Freund; Angela Booth; Mitch J Duncan; Natalie Johnson; Camille E Short; Luke Wolfenden; Fiona G Stacey; Frances Kay-Lambkin; Corneel Vandelanotte

doi:10.1016/j.ypmed.2016.06.012

Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials

Prev Med. 2016 Aug:89:211-223. doi: 10.1016/j.ypmed.2016.06.012. Epub 2016 Jun 13.

Authors

Affiliations

¹ School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. Electronic address: erica.james@newcastle.edu.au.
² School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
³ School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
⁴ School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
⁵ Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
⁶ School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia; Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW, Australia; Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.
⁷ National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
⁸ Physical Activity Research Group, The Central Queensland University, North Rockhampton, QLD, Australia.

PMID: 27311332
DOI: 10.1016/j.ypmed.2016.06.012

Abstract

Background: Growing evidence points to the benefits of addressing multiple health behaviors rather than single behaviors.

Purpose: This review evaluates the relative effectiveness of simultaneous and sequentially delivered multiple health behavior change (MHBC) interventions. Secondary aims were to identify: a) the most effective spacing of sequentially delivered components; b) differences in efficacy of MHBC interventions for adoption/cessation behaviors and lifestyle/addictive behaviors, and; c) differences in trial retention between simultaneously and sequentially delivered interventions.

Methods: MHBC intervention trials published up to October 2015 were identified through a systematic search. Eligible trials were randomised controlled trials that directly compared simultaneous and sequential delivery of a MHBC intervention. A narrative synthesis was undertaken.

Results: Six trials met the inclusion criteria and across these trials the behaviors targeted were smoking, diet, physical activity, and alcohol consumption. Three trials reported a difference in intervention effect between a sequential and simultaneous approach in at least one behavioral outcome. Of these, two trials favoured a sequential approach on smoking. One trial favoured a simultaneous approach on fat intake. There was no difference in retention between sequential and simultaneous approaches.

Conclusions: There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876.

Keywords: Effectiveness; Multiple health behavior change; Preventive care; Sequential; Simultaneous.

Publication types

Review
Systematic Review

MeSH terms

Diet
Exercise
Health Behavior*
Humans
Life Style*
Randomized Controlled Trials as Topic*
Smoking