Effective behavior change techniques in asthma self-care interventions: Systematic review and meta-regression

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Effective behavior change techniques in asthma self-care interventions : Systematic review and meta-regression. / Denford, S.; Taylor, R.S.; Campbell, J.L.; Greaves, C.J.

In: Health Psychology, Vol. 33, No. 7, 01.07.2014, p. 577-587.

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@article{7c6f826a64284832acfecf4c494b67de,
title = "Effective behavior change techniques in asthma self-care interventions: Systematic review and meta-regression",
abstract = "Objectives: The purpose of this study is to update previous systematic reviews of interventions targeting asthma self-care in adults with asthma, and to use meta-regression to examine the association between the use of specific behavior change techniques and intervention effectiveness. Methods: Electronic bibliographies were searched systematically to identify randomized controlled trials of interventions targeting asthma self-care. Intervention content was coded using a published taxonomy of behavior change techniques. For trials with a low-to-moderate risk of bias, study outcomes were pooled using random effects meta-analysis. Associations between intervention content and effect size were explored using meta-regression. Results: Meta-analysis of 38 trials (7883 patients) showed that interventions targeting asthma self-care reduced symptoms (standardized mean difference [SMD] = -0.38 [-0.52, -0.24]) and unscheduled health care use (odds ratio [OR] = 0.71 [0.56 to 0.90]) and increased adherence to preventive medication (OR = 2.55 [2.11 to 3.10]). meta-regression analyses found that {"}active involvement of participants{"} was associated with a reduction in unscheduled health care use (OR = 0.50 vs. 0.79). Inclusion of {"}stress management{"} techniques was associated with an increase in asthma symptoms (SMD = 0.01 vs. -0.44). Existing recommendations about the {"}optimal{"} content of asthma self-care interventions were tested but were not supported by the data. Conclusions: Interventions targeting asthma self-care are effective. Active involvement of participants is associated with increased intervention effectiveness, but the use of stress management techniques may be counterproductive. Taxonomy-based systematic reviews using meta-regression have potential for identifying techniques associated with increased effectiveness in behavioral interventions",
keywords = "Asthma self-care, Behavior change techniques, Systematic review, Taxonomy",
author = "S. Denford and R.S. Taylor and J.L. Campbell and C.J. Greaves",
year = "2014",
month = jul,
day = "1",
doi = "10.1037/a0033080",
language = "English",
volume = "33",
pages = "577--587",
journal = "Health Psychology",
issn = "0278-6133",
publisher = "American Psychological Association",
number = "7",

}

RIS

TY - JOUR

T1 - Effective behavior change techniques in asthma self-care interventions

T2 - Systematic review and meta-regression

AU - Denford, S.

AU - Taylor, R.S.

AU - Campbell, J.L.

AU - Greaves, C.J.

PY - 2014/7/1

Y1 - 2014/7/1

N2 - Objectives: The purpose of this study is to update previous systematic reviews of interventions targeting asthma self-care in adults with asthma, and to use meta-regression to examine the association between the use of specific behavior change techniques and intervention effectiveness. Methods: Electronic bibliographies were searched systematically to identify randomized controlled trials of interventions targeting asthma self-care. Intervention content was coded using a published taxonomy of behavior change techniques. For trials with a low-to-moderate risk of bias, study outcomes were pooled using random effects meta-analysis. Associations between intervention content and effect size were explored using meta-regression. Results: Meta-analysis of 38 trials (7883 patients) showed that interventions targeting asthma self-care reduced symptoms (standardized mean difference [SMD] = -0.38 [-0.52, -0.24]) and unscheduled health care use (odds ratio [OR] = 0.71 [0.56 to 0.90]) and increased adherence to preventive medication (OR = 2.55 [2.11 to 3.10]). meta-regression analyses found that "active involvement of participants" was associated with a reduction in unscheduled health care use (OR = 0.50 vs. 0.79). Inclusion of "stress management" techniques was associated with an increase in asthma symptoms (SMD = 0.01 vs. -0.44). Existing recommendations about the "optimal" content of asthma self-care interventions were tested but were not supported by the data. Conclusions: Interventions targeting asthma self-care are effective. Active involvement of participants is associated with increased intervention effectiveness, but the use of stress management techniques may be counterproductive. Taxonomy-based systematic reviews using meta-regression have potential for identifying techniques associated with increased effectiveness in behavioral interventions

AB - Objectives: The purpose of this study is to update previous systematic reviews of interventions targeting asthma self-care in adults with asthma, and to use meta-regression to examine the association between the use of specific behavior change techniques and intervention effectiveness. Methods: Electronic bibliographies were searched systematically to identify randomized controlled trials of interventions targeting asthma self-care. Intervention content was coded using a published taxonomy of behavior change techniques. For trials with a low-to-moderate risk of bias, study outcomes were pooled using random effects meta-analysis. Associations between intervention content and effect size were explored using meta-regression. Results: Meta-analysis of 38 trials (7883 patients) showed that interventions targeting asthma self-care reduced symptoms (standardized mean difference [SMD] = -0.38 [-0.52, -0.24]) and unscheduled health care use (odds ratio [OR] = 0.71 [0.56 to 0.90]) and increased adherence to preventive medication (OR = 2.55 [2.11 to 3.10]). meta-regression analyses found that "active involvement of participants" was associated with a reduction in unscheduled health care use (OR = 0.50 vs. 0.79). Inclusion of "stress management" techniques was associated with an increase in asthma symptoms (SMD = 0.01 vs. -0.44). Existing recommendations about the "optimal" content of asthma self-care interventions were tested but were not supported by the data. Conclusions: Interventions targeting asthma self-care are effective. Active involvement of participants is associated with increased intervention effectiveness, but the use of stress management techniques may be counterproductive. Taxonomy-based systematic reviews using meta-regression have potential for identifying techniques associated with increased effectiveness in behavioral interventions

KW - Asthma self-care

KW - Behavior change techniques

KW - Systematic review

KW - Taxonomy

UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-84903512600&partnerID=MN8TOARS

U2 - 10.1037/a0033080

DO - 10.1037/a0033080

M3 - Article

VL - 33

SP - 577

EP - 587

JO - Health Psychology

JF - Health Psychology

SN - 0278-6133

IS - 7

ER -