The effect of choice interventions on retention-related, behavioural and mood outcomes: a systematic review with meta-analysis
Open accessAbstract
The provision of choice within interventions has been associated with increased motivation, engagement and interest, as well as improved clinical outcomes. Existing reviews are limited by their wide inclusion criteria or by not assessing behaviour change and mood outcomes. This review examines whether participant-driven choice-based interventions specifically are more likely to be enjoyed and accepted by participants compared to no-choice interventions, and whether this impacts on intervention outcomes in terms of behaviour change or mood. Forty-four randomised controlled trials were identified for inclusion. Random effects meta-analyses were performed for retention-related outcomes (drop-out, adherence and satisfaction), and aggregate behaviour change and mood outcomes. Choice-based interventions resulted in significantly less participant drop-out and increased adherence compared to interventions not offering choice. Results for the behaviour change and mood analyses were mixed. This meta-analytic review demonstrates that choice-based interventions may enhance participant retention and adherence, thus researchers and clinicians alike should consider the provision of choice when designing research and interventions. The evidence for the role of choice in behaviour change and mood is less convincing, and there is a need for more, higher quality research in this area.
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Giving users autonomy and choice over intervention parameters leads to greater adherence and better clinical outcomes.
“a recent meta-analysis suggests that giving users autonomy and choice over intervention parameters leads to greater adherence and better clinical outcomes [35]”
From Feasibility and Preliminary Efficacy of Digital Interventions for Depressive Symptoms in Working Adults: Multiarm Randomized Controlled Trial (2023) · cites this paper as [35]
The Effects of choice-based interventions section reports significantly better adherence with choice. It also says the review’s evidence for improved mood was not convincing and its findings for behaviour change were mixed, so the claim of better clinical outcomes overstates this meta-analysis. The Importance of choice section reports that earlier reviews found better clinical outcomes, but that is not a firm finding of this review. (LLM, conf=0.88)
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“…of participants who reported experiencing bad effects or lasting bad effects from the intervention (as described in the study by Carlisle et al [35]) and the proportion of participants whose PHQ-8 scores increased above the minimally clinically important difference for the PHQ-8 ( ≥ 5 points…”
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- Authors
- Carlisle, S., Ayling, K., Jia, R., Buchanan, H., & Vedhara, K.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Carlisle, Sophie
- Venue
- Health Psychology Review
- Publisher
- Informa UK Limited
- Published
- 2021-09-16
- Volume
- 16
- Issue
- 2
- Pages
- 220-256
- ISSN
- 1743-7199 (ISSN-L)
- 1743-7202
- OpenAlex
- W3195780421
- Cited by
- 32
- References
- 108
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 10 · 2023: 5 · 2022: 2 · 2021: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Health Psychology Review (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Funders
- University of Nottingham
- National Institute for Health Research School for Primary Care Research
- Department of Health
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- participant choice, participant retention, dropout, medication adherence, participant satisfaction, behavior change, motivation, intervention design
- MeSH terms
- Affect, Humans, Motivation
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