Evidence mapPaperPMID 38721982Full record

SynthesisAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2024

Effectiveness of Interventions for Changing More Than One Behavior at a Time to Manage Chronic Conditions: A Systematic Review and Meta-analysis.

Carolina C Silva, Justin Presseau, Zack van Allen, Paulina M Schenk, Maiara Moreto, John Dinsmore, Marta M Marques

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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  7. Review
  8. Involving Societal Stakeholders in Dementia Risk Reduction: An Explorative Study.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article
  9. Article
  10. Article
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  12. Article
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  15. IMI-Interventions for Controlling Myopia Onset and Progression 2025.Investigative ophthalmology & visual science · 2025
    Review
  16. Article
  17. Article
  18. Review
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Carolina C SilvaTrinity Centre for Practice and Healthcare Innovation (TCPHI), School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.ORCID 0000-0003-1814-032X
Justin PresseauClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-2132-0703
Zack van AllenClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-5778-6441
Paulina M SchenkCentre for Behaviour Change, University College London, London, England, UK.ORCID 0000-0002-5239-1977
Maiara MoretoISPA - Instituto Universitário, Lisbon, Portugal.ORCID 0009-0004-2223-733X
John DinsmoreTrinity Centre for Practice and Healthcare Innovation (TCPHI), School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.ORCID 0000-0001-8387-3496
Marta M MarquesNOVA National School of Public Health, Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, Lisbon, Portugal.ORCID 0000-0002-4797-9557

Funding

Fundação para a Ciência e a Tecnologia SFRH/BD/146762/2019
6 · The paper itself

Abstract

backgroundHealth 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.

methodsFive 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.

resultsSixty-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).

conclusionsTargeting 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.

Indexed as

Health BehaviorBehavior TherapyChronic DiseaseHumansRandomized Controlled Trials as TopicBehavior changeHealth behaviorMeta-analysisNoncommunicable diseasesSystematic review

Identifiers

PMID38721982
PMCPMC11112274

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.