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Effective techniques in healthy eating and physical activity interventions: A meta-regression.
Open accessAbstract
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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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“Assessments of published interventions have found that those that employed BCT groups were more effective than those that used only one BCT [48–50].”
In the citing paper
“For example, interventions that combine self-monitoring with other self-regulatory BCTs (such as goal setting or action planning) have been associated with improved effectiveness [48].”
In the citing paper
“Effective BCTs have been identified for interventions to increase physical activity and healthy eating, 23,48 and to support smoking cessation, 27,46 reduce excessive alcohol consumption, 29 prevent sexually transmitted infections 19,30 and change professional behaviour.49”
In the citing paper
“Since Abraham and Michie's 20 initial paper, intercoder reliability has been demonstrated for various subsequent BCT taxonomies.20,23,27,28,30,48”
In the citing paper
“An alternative method of combining BCTs is to use CARTs, referred to as Meta-CART, 39 to analyse meta-analytic data.This has been used to identify groups of BCTs to predict intervention effects in a reanalysis of data from Michie et al. 23”
In the citing paper
“Previous research demonstrated that physical-activity interventions that support self-regulatory processes have been found to be significantly more effective than other interventions (13)”
From Which Components of a Smartphone Walking App Help Users to Reach Personalized Step Goals? Results From an Optimization Trial (2020) · cites this paper as [13]
In the citing paper
“Moreover, healthy eating interventions that use self-monitoring combined with other self-regulation techniques from control theory, such as feedback [4], appear to be more effective than interventions that do not include these techniques [5].”
From Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study (2014) · cites this paper as [5]
In the citing paper
“Finally, the app utilized self-regulation techniques of self-monitoring and feedback, but lacked other techniques derived from control theory [4,5].”
From Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: retrospective cohort study (2014) · cites this paper as [5]
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“…identified to be related with intervention effectiveness resonate with the findings of previous reviews with adult populations (Avery et al., 2012; Michie et al., 2009; Williams & French, 2011), where BCTs related to self-regulation have been shown to be effective in changing PA. Based on our…”
BackgroundResultDEBATE: Do interventions based on behavioral theory work in the real world?
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Metadata
- 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)
- Venue
- Health Psychology
- Published
- 2009
- Volume
- 28
- Issue
- 6
- Pages
- 690-701
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- 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
- green
- hdl.handle.net
- 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 › Public Health, Environmental and Occupational Health › 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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