Improving behavioral interventions in medicine

Abstract

Background Changing human behavior is of major importance in the prevention and management of noncommunicable diseases, such as such as heart disease, stroke, cancer, diabetes, chronic lung disease and arthritis. Tobacco use, the harmful use of alcohol and unhealthy diets need to be reduced, while physical activity and adherence to medical advice need to be improved. The effectiveness of current behavioral interventions is somewhat limited, however. Objective To explore how the effectiveness of behavioral interventions can be improved by using theory on behavior change and by using knowledge on biomedical determinants of behavior. Methods This is a selective review of authoritative literature. Results First, the opportunities and barriers for behavior change in noncommunicable diseases are illustrated taking secondary prevention in stroke as an example. Second, if interventions are carefully planned using theory on behavior change, the effectiveness of behavioral interventions can be improved. This is illustrated using behavior change in diabetes. Third, biomedical determinants of behavior need to be taken into account, to ensure that behavioral interventions are effective and safe. Physical exercise in osteoarthritis is cited as an example. Conclusion The effectiveness of behavioral interventions can be improved (i) if interventions are carefully planned using theory on behavior change, and (ii) if knowledge on biomedical determinants of behavior is taken into account. Instead of an isolated application behavioral and biomedical knowledge needs to be integrated in order to develop more effective behavioral interventions. Key words: Behavioral intervention; Theory on behavior change; Effectiveness