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ARE INTERVENTIONS FOR LOW-INCOME GROUPS EFFECTIVE IN CHANGING HEALTHY EATING, PHYSICAL ACTIVITY AND SMOKING BEHAVIOURS? A SYSTEMATIC REVIEW AND META-ANALYSIS

Sunday, 17th of May 2015

ARE INTERVENTIONS FOR LOW-INCOME GROUPS EFFECTIVE IN CHANGING HEALTHY EATING, PHYSICAL ACTIVITY AND SMOKING BEHAVIOURS? A SYSTEMATIC REVIEW AND META-ANALYSIS

Bull ER , et al.

Abstract below; full text is at http://bmjopen.bmj.com/content/4/11/e006046.long

 

OBJECTIVE:

To conduct a systematic review and meta-analysis examining the effectiveness of behavioural interventions targeting diet, physical activity or smoking in low-income adults.

DESIGN:

Systematic review with random effects meta-analyses. Studies before 2006 were identified from a previously published systematic review (searching 1995-2006) with similar but broader inclusion criteria (including non-randomised controlled trials (RCTs)). Studies from 2006 to 2014 were identified from eight electronic databases using a similar search strategy.

DATA SOURCES:

MEDLINE, EMBASE, PsycINFO, ASSIA, CINAHL, Cochrane Controlled Trials, Cochrane Systematic Review and DARE.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES:

RCTs and cluster RCTs published from 1995 to 2014; interventions targeting dietary, physical activity and smoking; low-income adults; reporting of behavioural outcomes.

MAIN OUTCOME MEASURES:

Dietary, physical activity and smoking cessation behaviours.

RESULTS:

35 studies containing 45 interventions with 17,000 participants met inclusion criteria. At postintervention, effects were positive but small for diet (standardised mean difference (SMD) 0.22, 95% CI 0.14 to 0.29), physical activity (SMD 0.21, 95% CI 0.06 to 0.36) and smoking (relative risk (RR) of 1.59, 95% CI 1.34 to 1.89). Studies reporting follow-up results suggested that effects were maintained over time for diet (SMD 0.16, 95% CI 0.08 to 0.25) but not physical activity (SMD 0.17, 95% CI -0.02 to 0.37) or smoking (RR 1.11, 95% CI 0.93 to 1.34).

CONCLUSIONS:

Behaviour change interventions for low-income groups had small positive effects on healthy eating, physical activity and smoking. Further work is needed to improve the effectiveness of behaviour change interventions for deprived populations.

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