A Rapid Review of the Effectiveness of Interventions, Approaches and Models at Individual, Community and Population Level that are aimed at Changing Health Outcomes through Changing Knowledge, Attitudes and Behaviour

Cancer Care Research Centre, University of Stirling. Alliance for Self Care Research, University of Abertay (2006)

NICE - N/A

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Evidence Categories

• Care setting: Community setting
• Care setting: Workplace setting
• Care setting: School Setting
• Population group: Adults
• Population group: Children & Adolescents
• Population group: Older adults
• Intervention: Media Intervention
• Intervention: Exercise programmes
• Intervention: Transport / Active Travel
• Intervention: Behaviour Change Interventions
• Intervention: Advice/guidance
• Intervention: Whole system interventions
• Outcome: Change in physical activity

Type of Evidence

NICE Underpinning Review

Overview

"This document is the summary of a ‘review of reviews’, which aims to bring together a large body of evidence and provide a critical and structured overview of the effectiveness of interventions and models to change attitudes, knowledge and behaviours in six different areas. This overview will provide researchers, policy and decision-makers, and practitioners with accessible, good quality evidence in these topic areas. The six health behaviours considered here are:

• Cigarette smoking

• Alcohol drinking (excluding alcohol dependency)

• Physical activity

• Healthy eating (excluding diet for weight loss)

• Illicit drug use (excluding drug dependency)

• Sexual risk taking in young people

The main objectives were to evaluate:

• Which are the most effective interventions to change knowledge, attitudes and health behaviours in each of these six areas?

• Is there any evidence to suggest that some interventions are effective / ineffective across the range of health behaviours?

• Which are the most effective models and approaches used in these interventions?

• What is the evidence for the effectiveness of interventions in targeting health inequalities within particular population sub-groups?

• What are the gaps in the evidence base?"

Recommendations

"Evidence statement for interventions targeting individuals:

All adults:

There is evidence of good quality (1++, A), that shows moderate evidence of effectiveness of individualised physical activity interventions for increasing (in the short term) self reported physical activity levels. However, other evidence of good quality (1 & 2+, A) indicates that most studies have no effect at the first follow-up (three months or more after the end of intervention).

There is evidence of good quality (1++, A), that shows a non-significant effect for reaching a predetermined threshold of physical activity (e.g., meeting current public health recommendations).

There is evidence of variable quality (1-, B), that shows an inconclusive effect of biomarker feedback or brief motivational interventions on physical activity.

There is evidence of good quality (1++, C), that show no effect of ‘stage of change’ based interventions on physical activity. There is evidence of good quality (1&2+, C), that shows a mixed and inconclusive effect of counselling interventions on physical activity.

Older People:

There is evidence of from two reviews (1++, A; 1-, C), that shows a small but shortlived effect of home-based, group-based, and educational physical activity interventions on increasing physical activity among older people."