what do we know about brief interventions to increase ... · laura lamming behavioural science...
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What do we know about brief interventions to increase physical activity?
A systematic review of reviews
Laura Lamming Behavioural Science Group,
The Primary Care Unit, University of Cambridge, UK.
Dan Mason, Katie Morton, Sally Pears, Maaike Bijker, Stephen Sutton, Wendy Hardeman on behalf of the VBI Programme Team
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Background
Low levels of physical activity (PA) are associated with significant disease burden (1)
Primary care providers have access to large proportion of public BUT have time constraints
PA interventions may be easier to integrate into routine primary care if they were brief
Recent policy initiatives and guidance encourage use of brief interventions
But, NO agreed definition of a brief intervention
1 – Lee, I., Shiroma, E. J., et al. (2012). “Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.” The Lancet 380 (9838): 219-229.
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Objectives
What do we know about brief interventions (BIs) to increase PA that could be delivered in a primary care setting? How are BIs defined? Do BIs increase physical activity levels, and
compared to what? Which factors influence their effectiveness? Who are they effective for? Are they feasible and acceptable?
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Standard systematic review methodology
Criteria
PA interventions only
Systematic review/Meta-analysis
Adults, no PA rehabilitation
PA outcome
Individual level
Findings/Discussion of BIs
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Descriptive data
Narrative Synthesis
Data extraction
Double checked
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Results
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Study selection
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Records after duplicates removed N=5803
Records identified from ineligible comments: N=3
Excluded: N=5561
Excluded: N= 145
Excluded: N=88
Records identified from authors collection: N=4
For Title screening N=5803
For Abstract screening* N=242
For Full Text screening*: N=154
For Synthesis N= 10
Records identified from electronic databases: N=11993
Additional records identified: N=1
* Double screened
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1. Definitions of brief interventions
3/10 reviews gave definitions of BIs
Agreed that BIs, at their most minimal, could include advice, verbal or otherwise, of a short duration
One review specified a maximum duration (30 minutes), and two included interventions of up to 30 or 40 minutes
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2. Effectiveness of brief interventions
Reviews support the effectiveness of BIs on self-reported physical activity in the short-term (6 weeks-12 months)
Lack of evidence/support for their effectiveness in the long term and their impact on objectively measured physical activity
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3. Factors that impact on the effectiveness of brief interventions
Reviews support the use of high quality supplementary written materials
Lack of/inconclusive evidence for the impact of duration, type of provider, setting and theoretical basis
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4. Population characteristics
Inconclusive and limited evidence for the impact of targeting BIs at participants on the basis of various characteristics, e.g.:
– Age
– Gender
– Current activity level
– Health status
– Socio-economic status
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5. Feasibility and acceptability of brief interventions
Reviews report that the following factors can impact feasibility and acceptability of BIs for patients and practitioners:
practitioner
patient
intervention content
structural factors (e.g. time constraints)
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Key Conclusions
2/3 of the reported definitions of BIs include interventions too long for routine primary care consultations
Future research should develop and evaluate very brief interventions (VBIs) that could fit into a routine primary care consultation
More evidence is needed about the long–term effectiveness of BIs for objectively measured and self-reported physical activity
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Thanks & Questions?
Special thanks:
Isla Kuhn (Librarian)
Sophie Attwood
Author: [email protected]
VBI programme: [email protected]
VBI webpage: http://tiny.cc/VBIprog
This presentation presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0608-10079). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
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