Multiple Behavior Interventions Research Articles

Longer-term Effect of Physical Activity Intervention on Sleep Quality: A Secondary Analysis of Cluster Randomized Controlled Trial.

To examine the longer-term effect of physical activity (PA) intervention on sleep quality and whether the effect was heterogeneous between daytime nappers and non-nappers. This study was a secondary analysis of a cluster randomized controlled trial in China. Eight villages were randomized 1:1 to intervention or control group. The intervention group received an 8-week PA intervention, while the control group did not. The primary outcome of this study was the change in the Pittsburgh Sleep Quality Index (PSQI) global score at 24 months. The 511 participants had a mean age of 70.94 years (SD 5.73) and 55.6% were female. The intervention showed improvements in the PSQI global score at 8 weeks (adjusted mean difference -1.05; P=0.002), and the effect diminished at 24 months (-0.64; P=0.06). There were statistically significant improvements in the PSQI global score for daytime nappers, but not for non-nappers at 8 weeks (adjusted mean difference -0.98; P=0.01 vs -1.27; P=0.05), 12 months (-0.86; P=0.03 vs -0.84; P=0.21), and 24 months (-0.80; P=0.04 vs -0.14; P=0.84), although these improvements were below the minimum detectible level of the PSQI which is 1 point. The 8-week PA intervention was effective in improving sleep quality, while the effect was diminished and below the minimum detectible level of the PSQI which is 1 point after 24 months. The effect of PA intervention on sleep quality was more pronounced in daytime nappers. Additional interventions (e.g., focusing on multiple behavioral interventions such as PA and healthy diet) are needed to maintain the beneficial effect of PA on sleep quality in the general older populations. Further research is required to confirm the mechanisms of the effect of napping and develop tailored interventions.

Health-promotion interventions targeting multiple behaviors: A meta-analytic review of general and behavior-specific processes of change.

Although health-promotion interventions that recommend changes across multiple behavioral domains are a newer alternative to single-behavior interventions, their general efficacy and their mechanisms of change have not been fully ascertained. This comprehensive meta-analysis (6,878 effect sizes from 803 independent samples from 364 research reports, N = 186,729 participants) examined the association between the number of behavioral recommendations in multiple-behavior interventions and behavioral and clinical change across eight domains (i.e., diet, smoking, exercise, HIV [Human Immunodeficiency Virus] prevention, HIV testing, HIV treatment, alcohol use, and substance use). Results showed a positive, linear effect of the number of behavioral recommendations associated with behavioral and clinical change across all domains, although approximately 87% of the samples included between 0 and 4 behavioral recommendations. This linear relation was mediated by improvements in the psychological well-being of intervention recipients and, in several domains (i.e., HIV, alcohol use, and drug use), suggested behavioral cuing. However, changes in information, motivation, and behavioral skills did not mediate the impact of the number of recommendations on behavioral and clinical change. The implications of these findings for theory and future intervention design are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"Simply complicated": Uncovering the processes of lifestyle behavior change among college and university students with access to a digital multiple lifestyle intervention.

One approach to promoting healthy lifestyle behaviors is to target students with digital interventions. One of these is the digital intervention Buddy. This study aimed to understand why college and university students' chose to participate in a digital multiple lifestyle behavior intervention trial (Buddy), and their subsequent experiences of the behavior-change process. College and university students taking part in a trial of the Buddy intervention were individually interviewed after completing the 4-month intervention. Participants were guided to narrate their experiences and actions that followed signing up. Altogether, 50 interviews were conducted via telephone. The verbatim transcribed texts were analyzed qualitatively. The analysis generated seven personas, which illustrated the students' different levels of engagement with the intervention and the behavior-change process. These were: the Occupied, the Kickstarter, the Aimless, the Reflective, the Goal-oriented, the Compliant, and the Personally developed. Buddy worked best for students who had clear ideas about what they wanted to change and why, and who were aware of their needs, and those who could translate information and reflection into action and had the mental and physical energy needed to make changes. The progress of behavior change depends on the interaction between the digital mode of delivery, the intervention materials of Buddy, the individual's expectations, needs, and skills, and their current life situation. This suggests that designing lifestyle interventions could benefit from more often considering the various personas' different intentions, knowledge, and contexts. By doing so, interventions are likely to emerge that can better match different needs in the target population.

The impact of multiple-behavior HIV interventions as a function of regional disadvantages: An analysis of syndemics.

Disadvantaged populations, including inhabitants of developing countries as well as racial/ethnic and sexual minorities in the United States, are disproportionally burdened by human immunodeficiency virus (HIV) infection, delayed HIV diagnosis, and unfavorable HIV-treatment outcomes. HIV interventions targeting single behaviors (e.g., testing) in these populations have shown to be efficacious at producing behavioral and clinical change but have been unable to eliminate the social health disparities associated with syndemics (i.e., a set of connected risks, interacting synergistically, and contributing to excess burden of disease in a population). This meta-analysis of 331 reports (clusters; number of effect sizes [k] = 1,364) assessed whether multiple-behavior interventions that target clusters of syndemic risks are more efficacious for those in disadvantaged regions and social groups. Across the board, multiple-behavior interventions were more efficacious than single-behavior ones as well as passive control groups among samples from countries with lower log gross domestic product (GDP), lower Human Development Index (HDI), and lower Healthcare Access and Quality (HAQ) Index. Within the United States, the efficacy of multiple-behavior interventions was similar across different levels of representation of racial/ethnic and sexual minorities. The analyses used robust variance estimation with small-sample corrections to assess the differential effects of multiple-behavior interventions and Egger Sandwich test with the multilevel meta-analysis approach to detect selection biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) cancer survivor health: program project protocols for remote lifestyle intervention and assessment in 3 inter-related randomized controlled trials among survivors of obesity-related cancers

BackgroundScalable, multiple behavior change interventions are needed to address poor diet, inactivity, and excess adiposity among the rising number of cancer survivors. Efficacy-tested diet (RENEW) and exercise (BEAT Cancer) programs were adapted for web delivery among middle-aged and older cancer survivors for the AMPLIFI study, a National Cancer Institute-funded, multi-site, program project.MethodsThroughout the continental U.S., survivors of several obesity-related cancers are being recruited for three interconnected randomized controlled trials (RCTs). Projects 1 and 2 test 6-month diet or exercise interventions versus a wait-list control condition. Upon completion of the 6-month study period, the intervention participants receive the next behavior change sequence (i.e., diet receives exercise, exercise receives diet) and the wait-list control arm initiates a 12-month combined diet and exercise intervention. Project 3 tests the efficacy of the sequential versus simultaneous interventions. Assessments occur at baseline and semi-annually for up to 2-years and include: body mass index, health behaviors (diet quality, accelerometry-assessed physical activity/sleep), waist circumference, D3 creatine-assessed muscle mass, physical performance, potential mediators/moderators of treatment efficacy, biomarkers of inflammation and metabolic regulation, health care utilization, cost, and overall health. Four shared resources support AMPLIFI RCTs: 1) Administrative; 2) Adaptation, Dissemination and Implementation; 3) Recruitment and Retention; and 4) Assessment and Analysis.DiscussionRepresenting a new generation of RCTs, AMPLIFI will exclusively use remote technologies to recruit, intervene and assess the efficacy of the newly-adapted, web-based diet and exercise interventions and determine whether sequential or combined delivery works best for at-risk (older, rural, racial minority) cancer survivors.Trial registrationClinicalTrials.gov, NCT04000880. Registered 27 June 2019.

Multiple versus single risk behaviour interventions for people with severe mental illness: a network meta-analysis and qualitative synthesis

Background People with severe mental illness die 15–20 years earlier than the general population. Reasons why include that people with severe mental illness are more likely to smoke and be physically inactive as a result of social inequalities. Objectives (1) Evaluate the clinical effectiveness of multiple risk behaviour interventions on behaviour change (e.g. smoking abstinence), and outcomes affected by behaviours (e.g. weight loss). (2) Compare the clinical effectiveness of interventions targeting multiple and single risk behaviours. (3) Examine the factors affecting outcomes (e.g. intervention content). (4) Assess the factors affecting experiences of interventions (e.g. barriers and facilitators). Data sources The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE™ (Elsevier, Amsterdam, the Netherlands), MEDLINE, PsycInfo® (American Psychological Association, Washington, DC, USA) and Science Citation Index (Clarivate Analytics, Philadelphia, PA, USA) were searched from inception to October 2018, and an updated search was conducted in March 2020. An Applied Social Sciences Index and Abstracts (ASSIA) search and an updated Cochrane Central Register of Controlled Trials search were undertaken in September 2020. Study selection Randomised controlled trials targeting single or multiple health risk behaviours among people with severe mental illness were included. Qualitative evidence on factors affecting the effectiveness of risk behaviour interventions was included. Study appraisal Network meta-analyses were conducted to compare the effectiveness of multiple and single risk behaviour interventions. The mean differences were estimated for continuous outcomes; if this was not possible, standardised mean differences were calculated. Thematic syntheses of qualitative studies were conducted. Results A total of 101 studies (67 randomised controlled trials and 34 qualitative studies) were included. Most outcomes were smoking abstinence, weight and body mass index. Just over half of studies were rated as having a high overall risk of bias. Trials focusing on smoking alone led to greater abstinence than targeting smoking and other behaviours. However, heterogeneity means that other explanations cannot be ruled out. For weight loss and body mass index, single risk behaviour (e.g. physical activity alone) and multiple risk behaviour (e.g. diet and physical activity) interventions had positive but modest benefits. For example, any risk behaviour intervention led to a 2 kg greater weight loss (–2.10 kg, 95% credible interval –3.14 to –1.06 kg) and approximately half a point (i.e. 0.5 kg/m2) greater body mass index reduction (–0.49 kg/m2, 95% credible interval –0.97 to –0.01 kg/m2) than treatment as usual. There were potential synergies for targeting multiple health behaviours for reduction in systolic and diastolic blood pressure. No evidence was found of a deterioration in mental health for people with severe mental illness engaging in interventions to reduce health risk behaviours. Qualitative studies found that people with severe mental illness favoured interventions promoting physical and mental health together, and that took their condition into account. However, trials focused mainly on promoting physical health. Limitations Most quantitative studies focused on weight and body mass index; few assessed behavioural outcomes. Qualitative studies often addressed different aims. Conclusions Multiple and single risk behaviour interventions were associated with positive but modest benefits on most outcomes. Interventions seeking to promote physical health were not associated with deterioration in mental health. There was a lack of overlap between quantitative and qualitative studies. Future work Further research is needed to investigate whether or not health behaviour changes are maintained long term; tailoring weight-loss interventions for people with severe mental illness; and in terms of methods, co-production and mixed-methods approaches in future trials. Study registration This study is registered as PROSPERO CRD42018104724. Funding This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 6. See the NIHR Journals Library website for further project information.

Willingness to change diet and exercise behavior is associated with better lifestyle in dialysis patients close to a kidney transplant.

Evidence suggests that multiple-behavior interventions (with a specialist) have a greater impact on public health than single-behavior interventions, particularly in a chronic patient. However, there is little understanding of some very basic principles concerning multiple health behavior change, especially in situations such as kidney transplantation, which requires a great willingness to change negative lifestyle behaviors to achieve intermediate and long-term success. We compared healthy lifestyles and nutritional status according to the willingness to change dietary and exercise behavior in dialysis patients from a living donor kidney transplant program. 400 dialysis patients had a dietetic, anthropometric, protein-energy wasting [subjective global assessment (SGA)] and biochemical evaluation. Lifestyle was evaluated with an adapted instrument to measure lifestyle in chronic disease. Willingness to change behaviors was evaluated by the trans-theoretical model; 2 groups were formed: willingness to change dietary and exercise behaviors and unwillingness to change. Willingness to change dietary behavior was 50% and exercise 25%. Patients with willingness to change dietary and exercise behaviors had better healthy lifestyle scores, and higher frequency of healthy food consumption. Healthy lifestyle score (R2=0.37, p<0.0001) was predicted by older age, higher educational degree, shorter time on dialysis, and the highest willingness to change dietary and exercise behaviors. Willingness to change dietary and exercise behaviors was associated with healthy lifestyle, as well as with higher frequency of healthy food consumption and with lower frequency of unhealthy food consumption.

Associations of positive and negative affect on health risk behaviors among Latinos.

Negative affect is widely emphasized in behavior modification interventions. However, positive affect is associated with smoking cessation, physical activity, and healthy dietary habits and may be an important treatment target. Few studies have examined the relationship between positive affect and health behaviors among Latinos, who disproportionately experience modifiable health risk behaviors. This study examined the independent associations of positive affect and negative affect on modifiable health risk behaviors among Latino adults. Data came from 432 persons who participated in one of two studies examining determinants of modifiable health risk behaviors among Latino adults. Primary outcomes were current smoking, at-risk drinking, insufficient physical activity, and insufficient fruit and vegetable consumption. Predictors were positive and negative affect as measured by the Positive and Negative Affect Schedule. Associations between positive and negative affect and health risk behaviors were examined using multiple logistic regression. Positive affect was associated with lower odds of insufficient physical activity and insufficient fruit and vegetable consumption and lower odds of engaging in multiple health risk behaviors. Negative affect was associated with higher odds of at-risk drinking and current smoking. Emphasis on increasing positive affect may be warranted for multiple health risk behavior interventions targeting Latinos. Intervention development efforts may also consider prioritizing positive affect for physical activity and dietary interventions, and negative affect for at-drinking and smoking cessation interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patients’ Experiences of a Nurse-Led Self-Management Intervention After Kidney Transplantation

Self-management after kidney transplantation is challenging. Therefore, current guidelines recommend education programs, but little is known about patients' experiences of such programs. With a qualitative design, we explored patients' experiences of either multiple behavioral interventions or a single educational intervention in the firstyear post-transplant. Patients were struggling to master changes before reassuming normal life post-transplant. They learned to have confidence in their new situation and resumed their social roles. In a therapeutic sense, they were open to information, wanted to recover normal weight, and engaged in physical activity and consistent medication intake. Those who had undergone the behavioral interventions tackled these challenges with more consistency and vigor. Individualized behavioral self-management interventions were well accepted and have the potential to guide patients towards better outcomes.

Complex solutions for a complex problem: A meta-analysis of the efficacy of multiple-behavior interventions on change in outcomes related to HIV.

The purpose of this meta-analysis was to examine the success of multiple-behavior interventions and to identify whether the efficacy of such programs depends on the number of recommendations prescribed and the type of outcomes measured. We conducted a synthesis of 136 research reports (N = 59,330) using a robust variance estimate model (Tanner-Smith et al., 2016) to study change between baseline and the first follow-up across multiple-behavior interventions, single-behavior interventions, and passive controls. Multiple-behavior interventions were more efficacious than their single-behavior counterparts (multiple-behaviors: d = .44 [95% confidence interval, CI [.27, .60]); single-behavior: d = .21 [95% CI [.00, .43]), with efficacy varying based on the type of outcomes measured. Publication bias analysis revealed a small asymmetry but controlling for it did not eliminate these effects. There was a strong linear relation between the number of recommendations prescribed by an intervention and intervention efficacy (B = .07, SE = .01, p < .001), with strongest improvements observed for interventions making five or more recommendations. These patterns remained when controlling for other intervention and population characteristics. Multiple-behavior interventions are successful in the HIV domain and increasing the number of recommendations made in the intervention generally maximizes improvements. These findings provide insights that may guide the design and implementation of integrated interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Community mobilisation approaches to preventing and reducing adolescent multiple risk behaviour: a realist review protocol

BackgroundAdolescent multiple risk behaviour (MRB) continues to be a global health issue. Most interventions have focused on the proximal causes of adolescent MRB such as peer or family influence, rather than targeting the wider environmental or structural context. There is increasing recognition that community mobilisation approaches could be beneficial for adolescent health. Despite this, there are gaps in the current literature, theory and implementation that would benefit from a realist approach due to the suitability of this methodology to analysing complex interventions. The objective of this study is to understand ‘how, why, for whom and in what circumstances and time periods’ do community mobilisation interventions work to prevent and/or reduce adolescent multiple risk behaviour.MethodsThis is a protocol for a realist review. The review will use a six-stage iterative process, guided by the RAMESES framework. We will systematically search PubMed, MEDLINE, PsycINFO, Web of Science, CINAHL and Sociological s, from their inception to 2021. Studies will be screened for relevance to the programme theory and included based on a priori eligibility criteria including (1) reporting a community mobilisation intervention (2) targeting two health risk behaviors (3) for adolescent populations. Two independent reviewers will select, screen and extract data related to the program theory from all relevant sources. A realist logic of analysis will be used to identify all context-mechanism-outcome configurations that contribute to our programme theory. The findings will be synthesised to produce a refined programme theory model.DiscussionThe goal of this realist review is to identify and refine a programme theory for community mobilisation approaches to the prevention and/or reduction of adolescent multiple risk behaviour. Our aim is that the findings surrounding the programme theory refinement can be used to develop and implement adolescent multiple risk behaviour interventions and maintain collaboration between local policy makers, researchers and community members.Systematic review registrationThis realist review is registered on the PROSPERO database (registration number: CRD42020205342).

The Effectiveness of Multiple Risk Behaviour Interventions for People with Severe Mental Illness (HEALTH Study): Systematic Review and Component Network Meta-Analysis

Background: People with severe mental illness die 15-20 years earlier than the general population. This excess mortality is explained largely by preventable physical health conditions. Evaluating the effectiveness of interventions that target risk behaviours in people with SMI is a global health priority. Interventions focussing on single behaviours may be ineffective in changing health outcomes. No systematic review has compared the effectiveness of targeting multiple or single risk behaviours in this population. Methods: We searched Cochrane Central Register of Controlled Trials (CENTRAL), Embase, MEDLINE, PsycINFO and Science Citation Index in March 2020 and Applied Social Science Index and Abstracts (ASSIA) in September 2020. We included randomised controlled trials of single or multiple health risk behaviour interventions in people with SMI. The study is registered on PROSPERO (CRD42018104724). We conducted network meta-analyses to compare effectiveness of interventions targeting multiple and single risk behaviours. Findings: We included 67 RCTs. Just over half of studies had high overall risk of bias. Trials focusing on smoking alone led to greater smoking abstinence than targeting smoking and other behaviours. However, heterogeneity means we cannot rule out other interpretations explanations. For weight loss (e.g. any risk behaviour intervention: -2.10 kg, 95% CrI -3.14, -1.06) and BMI (e.g. any risk behaviour intervention: -0.49, 95% CrI -0.97, -0.01) all risk behaviour interventions had positive but modest benefits compared with treatment as usual. There were potential synergies for targeting multiple health behaviours for reduction in systolic blood pressure. We found no evidence of a deterioration in mental health for people with SMI engaging in these interventions. Interpretation: Multiple and single risk behaviour interventions were associated with positive but modest benefits. Targeting smoking alone appeared to be more effective, but few studies assessed behavioural outcomes. Interventions were not associated with deterioration in mental health. Funding: National Institute for Health Research Declaration of Interest: We declare no competing interests.

Lifestyle Risk Factors, Quality of Life, and Intervention Preferences of Barrett's Esophagus Patients: A Prospective Cohort Study.

Background and AimsLifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett’s Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population.MethodsPatients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported on lifestyle risk factors, adherence determinants (e.g., perceived benefits/barriers, risk, intentions), QOL, and intervention preferences.ResultsMost patients (56%) had uncontrolled reflux, were overweight/obese (65.1%), and had low dietary fiber intake (91%). Many (45%) reported poor QOL. Patients’ perceived risk of developing esophageal cancer was high, but their behavior change intentions were low. Despite receiving lifestyle counseling from physicians, there were no significant changes in patients’ QOL or lifestyle risk factors over time. Nonetheless, patients indicated strong interest in internet (62.6%) and multimedia programs (57.9%) addressing acid reflux and weight control.ConclusionBE patients reported uncontrolled reflux, poor QOL, and multiple lifestyle risk factors that did not change over time. Despite low levels of intention for making lifestyle changes, patients were interested receiving more information about controlling acid reflux, suggesting a potential teachable moment and opportunity for web-based and multimedia multiple behavior interventions that seek to control acid reflux symptoms through weight loss and a high fiber diet.

Supplemental Material for Complex Solutions for a Complex Problem: A Meta-Analysis of the Efficacy of Multiple-Behavior Interventions on Change in Outcomes Related to HIV

Supplemental Material for Complex Solutions for a Complex Problem: A Meta-Analysis of the Efficacy of Multiple-Behavior Interventions on Change in Outcomes Related to HIV

For older adults prescribed multiple medications, do educational and behavioral interventions improve medication-taking ability and adherence?

For older adults prescribed multiple medications, do educational and behavioral interventions improve medication-taking ability and adherence?

Multiple risk behaviour intervention to prevent depression in primary care.

Primary care is the ideal setting for promotion and prevention intervention. Multiple risk behaviour interventions present several advantages over single-risk lifestyle interventions. Multiple risk behaviour interventions could be easily implemented in primary care to prevent non-communicable disease and depression. To test the effectiveness of a multiple risk behaviour intervention to promote Mediterranean diet, physical activity, and/or smoking cessation in people attending Spanish primary health care with incidence of depression and symptoms of depression. This was a secondary analysis of the EIRA study that aims to test the effectiveness of a multiple risk behaviour intervention to promote healthy lifestyles. Twenty-six primary care centres were randomised to receive multiple risk behaviour intervention or usual care. The multiple risk behaviour intervention included individual sessions, group sessions, communitarian activities, and SMS reception. Participants were followed for 10-14 months. The primary outcomes of this study were incidence of depression and reductions of depressive symptoms. Three thousand and sixty-seven participants were included. Females accounted for 45.13% and 93.88% were Spanish. Age varied between 45 and 75 years old. The effectiveness of the intervention will be calculated using the Patient Health Questionnaire (PHQ-9) and the Composite International Diagnostic Interview (‎CIDI)‎ depression section. Linear and logistic regression will be used to create predictive models. Primary care is the most accessible service in the health system for patients. Hence primary care is the ideal setting for health education, promotion, and prevention interventions. This study will provide high-quality evidence about the effectiveness of multiple risk behaviour interventions over depression prevention.

The Mobile Health Multiple Lifestyle Behavior Interventions Across the Lifespan (MoBILE) Research Program: Protocol for Development, Evaluation, and Implementation

BackgroundClustering of multiple lifestyle risk behaviors has been associated with a greater risk of noncommunicable diseases and mortality than one lifestyle risk behavior or no lifestyle risk behaviors. The National Board of Health and Welfare in Sweden reported in 2018 that it is important to provide additional support to individuals with multiple lifestyle risk behaviors, as risks from these behaviors are multiplicative rather than additive. However, the same report emphasized that there is a lack of knowledge regarding interventions that support changes to unhealthy lifestyle behaviors.ObjectiveThe MoBILE (Mobile health Multiple lifestyle Behavior Interventions across the LifEspan) research program has brought together two Swedish research groups supported by international collaborators. Through this collaboration, we aim to design and evaluate a number of novel and tailored mobile health (mHealth) multiple lifestyle behavior interventions across the life span of different health care populations. In addition, the MoBILE research program will extend ongoing research to include mHealth interventions for migrant pregnant women and children.MethodsEach project within the MoBILE program will focus on a specific group: pregnant women, preschool children, high school and university students, and adults in primary and clinical care. All the projects will follow the same 4 phases: requirements, development, evaluation, and implementation. During the requirements phase, implementers and end users will aid the design of content and functionality of the interventions. In the development phase, findings from the first phase will be synthesized with expert domain knowledge and theoretical constructs to create interventions tailored to the target groups. The third phase, evaluation, will comprise randomized controlled trials conducted to estimate the effects of the interventions on multiple lifestyle risk behaviors (eg, alcohol, nutrition, physical activity, and smoking). The final phase will investigate how the interventions, if found effective, can be disseminated into different health care contexts.ResultsThe research program commenced in 2019, and the first results will be available in 2020. Projects involving pregnant women, preschool children, and high school and university students will be completed in the first 3 years, with the remaining projects being planned for the program’s final 3 years.ConclusionsThe development of evidence-based digital tools is complex, as they should be guided by theoretical frameworks, and requires large interdisciplinary teams with competence in technology, behavioral science, and lifestyle-specific areas. Individual researchers or smaller research groups developing their own tools is not the way forward, as it means reinventing the wheel over and over again. The MoBILE research program therefore aims to join forces and learn from the past 10 years of mHealth research to maximize scientific outcomes, as well as the use of financial resources to expand the growing body of evidence for mHealth lifestyle behavior interventions.International Registered Report Identifier (IRRID)PRR1-10.2196/14894

Relationship between multiple lifestyle behaviors and health-related quality of life among elderly individuals with prediabetes in rural communities in China: A STROBE-compliant article.

Evidence of the effect of lifestyle behaviors on health-related quality of life (HRQoL) is scarce or ambiguous. The objective of the present study was to explore the associations between multiple lifestyle behaviors and HRQoL among the elderly individuals with prediabetes.Four hundred thirty-four elderly individuals with prediabetes were included in this cross-sectional study. The Medical Outcomes Study 36-Item Short Form Health Survey Questionnaire (SF-36) was used to assess HRQoL. Multiple lifestyle behaviors, including smoking, alcohol consumption, physical activity, dietary habits, daily sedentary time and sleep duration were self-reported. The associations between HRQoL and multiple lifestyle behaviors were examined using a multivariate linear regression analysis.Lower-risk physical activities (β =3 .19, 95% CI: 1.32, 5.64), dietary habits (β = 2.60, 95% CI: 1.50, 4.72), and sedentary time (β = 2.49, 95% CI: 1.21, 4.81) were positively associated with the physical health component score (PCS) for HRQoL. Meanwhile, a lower-risk behavior, such as sleep duration (β = 2.64, 95% CI: 1.77, 4.51), was associated with a higher mental health component score (MCS) for HRQoL after adjusting for socio-demographic factors, chronic diseases, anthropometric data and all other lifestyle behaviors. Engaging in a greater number of lower-risk lifestyle behaviors was positively correlated with a better HRQoL.Multiple lifestyle behaviors were associated with HRQoL among the elderly individuals with prediabetes in rural areas. These results highlight the need for multiple lifestyle behavioral interventions to maintain and improve HRQoL in the elderly individuals with prediabetes.

Clustering of lifestyle risk behaviours and its determinants among school-going adolescents in a middle-income country: a cross-sectional study

BackgroundLifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases. Such behaviours are usually instigated in adolescence and tend to persist into adulthood. Studies on the clustering of lifestyle risk behaviours among adolescents are scarce, particularly in developing countries. Therefore, the present paper aimed to determine the clustering of lifestyle risk behaviours and its determinants among school-going adolescents in Malaysia.MethodsData were extracted from a cross-sectional study, the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study, which was conducted from May to September 2013 across 11 states in Peninsular Malaysia. A two-stage proportionate-to-size sampling method was employed to select a total of 3578 school-going adolescents aged 16–17 years from 20 selected schools in urban and rural settlements, respectively. The MyAHRB study adopted a set of self-administered questionnaires adapted from the Global School-based Student’s Health Survey (GSHS) and the Youth Risk Behaviour Surveillance.ResultsThe results from the analysis of 2991 school-going adolescents aged 16–17 years showed that 16 (in boys) and 15 (in girls) out of 32 combinations of lifestyle risk behaviours clustered. Girls (aOR 2.82, 95% CI: 2.32–3.43) were significantly more likely to have clustered risk behaviours than boys; however, no significant associated factors were observed among girls. In contrast, boys of Malay descent (aOR 0.64, 95% CI: 0.46–0.89) or boys who had at least three friends (aOR 0.65, 95% CI: 0.43–0.99) were less likely to engage in multiple risk behaviours.ConclusionThe present study demonstrated the clustering of multiple risk behaviours that occurred in both genders; these results suggest that multiple behaviour intervention programmes, instead of programmes based on siloed approaches, should be advocated and targeted to the high-risk sub-populations identified in the present study.

Adapting Multiple Behavior Interventions That Effectively Improve Cancer Survivor Health Cancer Survivor Health

Adapting Multiple Behavior Interventions That Effectively Improve Cancer Survivor Health Cancer Survivor Health