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.Research output: Contribution to journal › Article › peer-review
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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 -