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Interventions for multiple risk behaviors show modest diet and physical activity improvements. However, addressing smoking simultaneously with other behaviors may hinder progress, suggesting a sequential approach may be more effective.

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Area of Science:

  • Public Health
  • Behavioral Science
  • Chronic Disease Prevention

Background:

  • Multiple risk behaviors are prevalent and contribute to chronic diseases like heart disease, cancer, and Type 2 diabetes.
  • Understanding the effectiveness of interventions targeting these behaviors is crucial for public health strategies.

Purpose of the Study:

  • To systematically review and meta-analyze the effectiveness of non-pharmacologic interventions aimed at multiple risk behaviors in general adult populations.
  • To explore factors influencing intervention effectiveness through meta-regression.

Main Methods:

  • A systematic search of six electronic databases (MEDLINE, EMBASE, PsycINFO) was conducted up to August 2016.
  • Sixty-nine randomized controlled trials (RCTs) involving 73,873 participants were included.
  • Intervention content and context were analyzed using the Behaviour Change Wheel and Oxford Implementation Index.

Main Results:

  • Interventions, primarily education and skills training, yielded modest improvements in diet (increased fruit/vegetable intake, reduced fat intake) and physical activity.
  • Smoking reductions were observed, but appeared negatively associated with improvements in other behaviors.
  • Preliminary evidence suggests sequential targeting of smoking alongside other behaviors may be more effective than simultaneous targeting.

Conclusions:

  • Interventions combining education and skills training for multiple risk behaviors show small positive effects on diet and physical activity.
  • Simultaneous intervention for smoking alongside other risk behaviors may be suboptimal, potentially hindering progress in those other areas.
  • Further research is needed to compare sequential versus simultaneous intervention strategies for multiple risk behaviors.