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Cited by 2,229Behavioral Health and InterventionsPhysical Activity and HealthBehavioral and Psychological Studies

Effective techniques in healthy eating and physical activity interventions: A meta-regression.

Open access
Michie, Susan, Abraham, Charles, Whittington, Craig, McAteer, John, Gupta, Sunjai·2009·Health Psychology
DOI 10.1037/a0016136
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Abstract

OBJECTIVE: Meta-analyses of behavior change (BC) interventions typically find large heterogeneity in effectiveness and small effects. This study aimed to assess the effectiveness of active BC interventions designed to promote physical activity and healthy eating and investigate whether theoretically specified BC techniques improve outcome. DESIGN: Interventions, evaluated in experimental or quasi-experimental studies, using behavioral and/or cognitive techniques to increase physical activity and healthy eating in adults, were systematically reviewed. Intervention content was reliably classified into 26 BC techniques and the effects of individual techniques, and of a theoretically derived combination of self-regulation techniques, were assessed using meta-regression. MAIN OUTCOME MEASURES: Valid outcomes of physical activity and healthy eating. RESULTS: The 122 evaluations (N = 44,747) produced an overall pooled effect size of 0.31 (95% confidence interval = 0.26 to 0.36, I(2) = 69%). The technique, "self-monitoring," explained the greatest amount of among-study heterogeneity (13%). Interventions that combined self-monitoring with at least one other technique derived from control theory were significantly more effective than the other interventions (0.42 vs. 0.26). CONCLUSION: Classifying interventions according to component techniques and theoretically derived technique combinations and conducting meta-regression enabled identification of effective components of interventions designed to increase physical activity and healthy eating.

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Crossref · 10.1037/a0016136

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143 of 143 references verified0 citation errors · 0 not checkable

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  • The BCTs were identified based on the authors' understanding of the features described in published articles, which may have introduced bias.

    “Therefore, the BCTs were identified based on the authors’ understanding based on the features described in published articles, 22 which may have introduced bias.”

    From Effective behavioral change techniques in m-health app supported interventions for glycemic control among patients with type 2 diabetes: A meta-analysis and meta-regression analysis of randomized controlled trials (2025) · cites this paper as [22]

    The ‘Coding of study characteristics’ section (page unavailable) says the authors coded interventions for 26 behavior-change techniques and checked identification across published evaluation papers. It reports coder disagreements, but does not say that reliance on the authors’ interpretation of the articles introduced, or may have introduced, bias; it describes the coding as highly reliable. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Nutrition and weight loss interventions that include self-regulation components tend to be more effective.

    “This is also in line with recent evidence suggesting that nutrition and weight loss interventions that include self-regulation components tend to be more effective [33, 34].”

    From The role of self-regulatory skills and automaticity on the effectiveness of a brief weight loss habit-based intervention: secondary analysis of the 10 top tips randomised trial (2017) · cites this paper as [33]

    The Discussion reports that healthy-eating interventions combining self-monitoring with another self-regulation technique were more effective than those without that combination. The paper evaluates healthy eating and physical activity, not weight-loss effectiveness specifically; it also does not establish that any self-regulation component alone improves effectiveness. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • An examination of BCTs used in self-management approaches to increasing physical activity and healthy eating, and in behavioural support for smoking cessation, shows that these BCTs serve five of the intervention functions: education, persuasion, incentivisation, training, and enablement.

    “An examination of BCTs used in self-management approaches to increasing physical activity and healthy eating [46], and in behavioural support for smoking cessation [47,48], shows that these BCTs serve five of the intervention functions: education, persuasion, incentivisation, training, and enablement.”

    From The behaviour change wheel: A new method for characterising and designing behaviour change interventions (2011) · cites this paper as [46]

  • This results in an unstructured approach usually lacking in key behaviour change techniques such as goal setting and self-monitoring.

    “This results in an unstructured approach usually lacking in key behaviour change techniques such as goal setting and self-monitoring such as keeping a food diary [90,96].”

    From Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success (2021) · cites this paper as [96]

  • Self-monitoring tools are most effective when they also provide feedback on users' performance or progress.

    “Our experiences are consistent with findings from reviews showing that self-monitoring tools are most effective when they also provide feedback on users’ performance or progress [72,73].”

    From The Person-Based Approach to Intervention Development: Application to Digital Health-Related Behavior Change Interventions (2015) · cites this paper as [73]

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Cites

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1 of the 144 references couldn’t be matched to a known paper.

Research works printed but not linked: 8

  1. [29]29. Hedges, L. V., & Olkin, I. (1985). Statistical Methods for Meta-Analysis. Orlando, FL: Academic Press.
  2. [72]72. Rodearmel, S. J., Wyatt, H. R., Barry, M. J., Dong, F., Pan, D., Israel, R. G., et al. (2006). A family based approach to preventing excessive weight gain. Obesity, 14(8), 1392-401.
  3. [85]85. Ball, K., Salmon, J., Leslie, E., Owen, N., King, A. C. (2005). Piloting the feasibility and effectiveness of print-and telephone-mediated interventions for promoting the adoption of physical activity in Australian adults. Journal of Science and Medicine in Sport, 8(2),134-142.
  4. [86]86. Bradbury, J., Thomason, J. M., Jepson, N. J., Walls, A. W., Allen, P. F., & Moynihan, P. J. (2006). Nutrition counseling increases fruit and vegetable intake in the edentulous. Journal of Dental Research, 85(5), 463-468.
  5. [88]88. Brand, R., Schlicht, W., Grossman, K., & Duhnsen, R. (2006). Effects of a physical exercise intervention on employees'perceptions quality of life: a randomized controlled trial. Soz Praventivmed, 51(1), 14-23.
  6. [89]89. No appropriate intervention Brug, J., Steenhuis, I., Van Assema, P., Glanz, K., & De Vries, H. (1999). Computer-tailored nutrition education: differences between two interventions. Health Education Research, 14(2), 249-256. Comparison of two active interventions
  7. [90]90. Burke, L. E., Dunbar-Jacob, J., Orchard, T. J., & Sereika, S. M. (2005). Improving adherence to a cholesterol-lowering diet: a behavioral intervention study. Patient Education and Counseling, 57(1), 134-142. Participants already engaged in a diet
  8. [93]93. Haber, D., & Lacy, M. G. (1993). Evaluation of a socio-behavioral intervention for changing health behaviors of older adults. Behavior, Health and Aging, 3(2), 73-85.

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Authors
Michie, S., Abraham, C., Whittington, C., McAteer, J., & Gupta, S.
Affiliations
  • University College London (GB)
  • University of Sussex (GB)
  • Department of Health and Social Care (GB)
ORCID
Venue
Health Psychology
Publisher
American Psychological Association (APA)
Published
2009
Volume
28
Issue
6
Pages
690-701
ISSN
  • 0278-6133 (ISSN-L)
  • 1930-7810
DOI
10.1037/a0016136
OpenAlex
W2101965199
Semantic Scholar
f317a254ebb5c6d0339b5eebc70bd63d2b8db37f
Cited by
2,229
References
144
Citations by year
2026: 73 · 2025: 106 · 2024: 120 · 2023: 123 · 2022: 169 · 2021: 201 · 2020: 247 · 2019: 181 · 2018: 196 · 2017: 149 · 2016: 161 · 2015: 136 · 2014: 125 · 2013: 103 · 2012: 64
FWCI
54.47
Type
journal article
Language
en
Open access
Locations
  • Health Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Open Research Exeter (University of Exeter) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Figshare (submittedVersion)
Topics
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords
behaviour change techniques, physical activity interventions, healthy eating interventions, self-monitoring, self-regulation, control theory, intervention effectiveness, adults
MeSH terms
Feeding Behavior, Female, Health Promotion, Humans, Male, Health Behavior, Exercise

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