Identifying active ingredients in complex behavioural interventions for obese adults with obesity-related co-morbidities or additional risk factors for co-morbidities: a systematic review
Open accessAbstract
Reducing obesity is an important preventive strategy for people who are at increased risk of major disabling or life-threatening conditions. Behavioural treatments for obesity are complex and involve several components aiming to facilitate behaviour change. Systematic reviews need to assess the components that moderate intervention effects. Electronic databases and journals were searched for randomised controlled trials of behavioural interventions targeting dietary and/or physical activity change for obese adults (mean BMI≥30, mean age≥40 years) with risk factors and follow-up data≥12 weeks. A reliable taxonomy of theory-congruent behaviour change techniques (BCTs; Abraham & Michie, 2008) was used to identify programme components. Meta-regression suggested that increasing numbers of identified BCTs are not necessarily associated with better outcomes. The BCTs provision of instructions (β =− 2.69, p=0.02), self-monitoring (β = − 3.37, p<0.001), relapse prevention (β = − 2.63, p=0.02) and prompting practice (β = − 3.63, p<0.001) could be linked to more successful interventions. Studies including more BCTs aimed at dietary change that are congruent with Control Theory were associated with greater weight loss (β = − 1.13, p=0.04). Post-hoc ratings of intervention components in published trials can lead to the identification of components and theories for behaviour change practice and research.
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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 [72]
With a reliable BCT coding scheme, instruction, self-monitoring and practice were found to be effective techniques.
“For example, using a reliable BCT coding scheme, Dombrowski et al. (2012) found that instruction, self-monitoring and practice were effective techniques.”
From Theories and techniques of behaviour change: Developing a cumulative science of behaviour change (2012) · cites this paper as Dombrowski et al. (2012)
The apparent effectiveness of an intervention depends on which outcome type is chosen.
“the evidence of effectiveness of interventions depends on which type of outcome is specified (Dombrowski, Sniehotta, Avenell, MacLennon, & Aray `jo-Soares, 2012).”
From Theories and techniques of behaviour change: Developing a cumulative science of behaviour change (2012) · cites this paper as Dombrowski, Sniehotta, Avenell, MacLennon, & Aray `jo-Soares, 2012
Whether an intervention had a theoretical basis predicted efficacy, whereas the count of techniques used did not.
“Both Dombrowski et al. (2012) and Taylor et al. (2012) found that the number of BCTs used did not predict efficacy but having a theoretical basis for the intervention did.”
From Theories and techniques of behaviour change: Developing a cumulative science of behaviour change (2012) · cites this paper as Dombrowski et al. (2012)
Effective BCTs have been identified for interventions to increase physical activity and healthy eating, and to support smoking cessation, reduce excessive alcohol consumption, prevent sexually transmitted infections and change professional behaviour.
“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”
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“These features included interactive surveys and graphs (designed to provide feedback, increase adolescents’ awareness of their changes over time, and help with goal setting [95-97]), and video clips showing in-vivo exposure and diaphragmatic breathing (designed to provide step-by-step peer simulations of therapeutic a…”
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- Authors
- Dombrowski, S. U., Sniehotta, F. F., Avenell, A., Johnston, M., MacLennan, G., & Araújo-Soares, V.
- Affiliations
- University of Aberdeen (GB)
- Newcastle University (GB)
- Newcastle University
- Corresponding author
- Dombrowski, Stephan U.
- Venue
- Health Psychology Review
- Publisher
- Informa UK Limited
- Published
- 2010-12-13
- Volume
- 6
- Issue
- 1
- Pages
- 7-32
- ISSN
- 1743-7199 (ISSN-L)
- 1743-7202
- OpenAlex
- W2171316716
- Cited by
- 504
- References
- 103
- Citations by year
- 2026: 15 · 2025: 22 · 2024: 21 · 2023: 24 · 2022: 30 · 2021: 34 · 2020: 91 · 2019: 33 · 2018: 39 · 2017: 44 · 2016: 32 · 2015: 39 · 2014: 26 · 2013: 26 · 2012: 15
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Health Psychology Review (publishedVersion)
- Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Economic and Social Research Council (ES/G007470/1)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- obesity, behavioral interventions, behaviour change techniques, active ingredients, obesity-related comorbidities, weight loss, dietary change, physical activity, self-monitoring, relapse prevention, control theory, intervention moderators
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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