ON-LINE SUPPLEMENTARY MATERIALS- Tables S1,2,3 and Appendix A
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ON-LINE SUPPLEMENTARY MATERIALS- Tables s1,2,3 and Appendix A
Table s1: Publication details, sample, intervention and methodology characteristics, and behavioral outcomes of intervention trials targeting physical activity in adults (published 2000-2009) First author, Sample Intervention (Ix) Outcomes: Between Groups Effects: year, country Intervention Characteristics Study Methods Characteristics Baseline; End of Ix; Follow-up p value End of Ix; Follow-up (Type) Basler, 2007 Group(n): Duration: 5wks C contact: 10 physiotherapy and PA mins/wk mean (SD): PA mins/wk: ns; ns Ix(86); C(84) placebo ultrasound sessions Ix: 16.0(21.1); 29.2(14.6); 29.6(24.2) Maintenance achieved: no Germany Delivery: 10 face-to-face C: 14.1(15.5); 24.7(16.3); 25.3(19.7) Sample: older counseling and physiotherapy PA measure: 7-day PA diary (SP) adults with sessions End of Ix: 6wks (94% retention) chronic lower Strategies: 4 (1,2,4,23) back pain (mean Follow-up: 6m post (90% age 70yrs; Relapse Prevention: topic in retention) gender 64% individual counseling session Methodological Quality Score: 3 female) Follow-up prompt: none Self-monitoring: none Other behaviors: none Bock, 2001 Group(n): Duration: 6m C contact: 4 self-help manuals PA mins/wk mean (SD): PA mins/wk: 0.001; 0.10 Ix(78); C(72) mailed at baseline,1,3 & 6m Ix: 6(15); 145(146); 187(216) Maintenance achieved: no USA Delivery: 4 self-help manuals C: 20(57); 102(98); 133(217) Sample: and individually tailored PA measure: 7-day PA recall PA guidelines: 0.01; 0.05 (PP) healthy inactive reports mailed at baseline,1,3 % meeting PA guidelines: Maintenance achieved: yes End of Ix: 6m (77% retention) adults (mean & 6m Ix: NR; 45; 42 age 44yrs; Follow-up: 6m post (62% C: NR; 18; 25 Strategies: 5 (1,5,8,13,19) gender 76% retention) female) Relapse Prevention: none Methodological Quality Score: 1 Follow-up prompt: none Self-monitoring: none Other behaviors: none Connell, 2009 Group(n): Duration: 6m C contact: received print Scale units mean (SD): Scale units: 0.01; 0.74 Ix(86); C(71) Ix: 5.2(2.2); 7.0(2.7); 6.1(2.5)
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks USA Sample: Delivery:14 telephone materials at end of study period C: 5.4(2.6); 5.8(2.7); 5.9(2.8) Maintenance achieved: no women caring counseling sessions; video (PP) PA measure: Lorig scale – for spouse with showing modeling behaviors; categorical scale of PA duration dementia (mean exercise video; print booklet; age 67 yrs; workbook; 2 newsletters End of Ix: 6m (87% retention) gender 100% Strategies: 12 (2,4,5,8,9,11, Follow-up: 6m post (83% female) 12,13,18,19,25,26) retention) Relapse Prevention: none Methodological Quality Score: 2 Follow-up prompt: 1 newsletter Self-monitoring: weekly log Other behaviors: none DeVet, 2009 Group(n): Duration: 1day (Ix1, Ix2), 3m C contact: asked to increase PA PA mins/wk mean (SD): PA mins/wk: ns, ns Ix1(161); (Ix3) in questionnaire by 2hrs/wk Ix 1: 500(490); 515(561); 562(516) Maintenance achieved: no Netherlands Ix2(172); Ix 2: 441(544); 453(481); 465(458) Delivery (Ix1): 1 PA measure: Dutch Short PA d/wk: ns, ns (SP) Ix3(170); Ix 3: 435(475); 450(456); 518 (542) Implementation Intention(II) Questionnaire to assess Health Maintenance achieved: no C(206) C: 519(657); 539(585); 562 (650) written for assigned activity Enhancing Physical Activity Sample: Dutch type (SQUASH) PA d/wk mean (SD): adults (18- Ix 1: 4.8(2.2); 5.1(2.0); 5.1(2.1) Delivery (Ix2): 1 II written for End of Ix: 2wks (85% retention) 65yrs) (mean Ix 2: 4.8(2.2); 4.8(2.3); 5.1(2.1) self-selected activity type age 46yrs; Follow-up: 6m post (79% Ix 3: 4.7(2.1); 5.0(2.1); 5.2(1.9) gender 67% Delivery (Ix3): 2 II written for retention) C: 4.6(2.1); 5.0(2.1); 5.1(2.1) female) self-selected activity type Methodological Quality Score: 3 Strategies: 2 (1,10) Relapse Prevention: none Follow-up prompt: none Self-monitoring: none Other behaviors: none Hughes, 2006 Group(n): Duration: 8wks C contact: Arthritis help book; PA mins/wk mean (SD): PA mins/wk: <0.001; 0.001 Ix(115); C(100) offered Ix at end of 12m period Ix: 135.3(145.1); 248.4 (150.5); 210.5 Maintenance achieved: yes USA Delivery: group exercises & (153.2) Sample: older counseling sessions 3/wk for PA measure: 6-item purpose- C: 122.6 (128.1); 126.7 (128.7); 115.7
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks (SP) adults with 8wks; log book; Arthritis help made questionnaire (122.7) lower extremity book End of Ix: 8wks (64% retention) osteoarthritis Strategies: 9 (4,5,8,9,12,13, (mean age Follow-up: 10 m post (42% 16,18,19) 73yrs; gender retention) 81%(Ix) 86% Relapse Prevention: none Methodological Quality Score: 1 (C) female) Follow-up prompt: 3 telephone calls or face-to-face interviews Self-monitoring: daily log Other behaviors: none Jimmy, 2005 Group(n): Duration: 7wks C contact: GP feedback on PA PA sessions/wk mean (SD): PA sessions/wk: 0.69; 0.95 Ix(69); C(92) Ix: NR; NR; NR Maintenance achieved: no Switzerland Delivery: GP feedback on PA; PA measure: validated questions C: NR; NR; NR Sample: stage-matched leaflet; 1 on sessions of moderate-vigorous (PP) healthy inactive counseling session with PA PA/wk adults (mean specialist & 3 telephone End of Ix: 7wks (93% retention) age 47yrs(Ix), counseling sessions (3,6,& 50yrs(C); 12wks) (optional) Follow-up: 12m post (82% gender 58% retention) Strategies: 5 (1,2,4,5,8) female) Methodological Quality Score: 3 Relapse Prevention: none Follow-up prompt: none Self-monitoring: none Other behaviors: none Kirk, 2004 Group(n): Duration: 6m C contact: standard leaflet; PA mins/wk (recall) median change PA mins/wk (95% CI): Ix(35); C(35) telephone consultations (on topics from baseline (CI): 120-225; 80-170 Scotland Delivery: standard leaflet; 2 other than PA) at 7 & 9m Ix: NR; 153(113- 208);115(73-150) Maintenance achieved: yes Sample: face-to-face counseling (SP) C: NR; NR ;-15(-53- 13) healthy inactive sessions PA measure: 7 day PA Recall; PA guidelines: 0.001; 0.001 adults (mean CSA accelerometer % meeting PA guidelines (recall): Maintenance achieved: yes Strategies: 8 (1,2,4,5,11,18, age 58yrs; Ix: 20;73 ; 57 20,23) End of Ix: 6m (90% retention) Counts/wk (95% CI): gender 50% C: 29; 13; 10 -594501 to 1723539; female) Relapse Prevention: topic in Follow-up: 6m post (84% Counts/wk (CSA) mean change -1771560 to -400245 counseling sessions retention) from baseline (CI):
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Follow-up prompt: 2 Methodological Quality Score: 3 Ix: NR; NR; 416 632(-217 743-1 051 Maintenance achieved: yes telephone calls 007) C: NR; NR; -669 061(-1 292 285- -45 Self-monitoring: none 837) Other behaviors: none Marshall, 2003 Group (n): Duration: one-off contact C contact: no contact PA hrs/wk mean (SD): PA hrs/wk: 0.001; ns Ix(227); C(235) Ix: 3.0(3.4); 78 increase; NR Maintenance achieved: no Australia Delivery: 1 mailed letter & PA measure: previously validated C: 3.3(4.1); 12 increase; NR Sample: adults stage-matched booklets (for self-report questionnaire PA guidelines (95% CI): (PP) (mean age current stage & future stages) % meeting PA guidelines: 1.09-2.04; 0.98-2.18 End of Ix: 2m (92% retention) 49yrs; gender Ix: 26; 45; 40 Maintenance achieved: no Strategies: 1 (1) 53% (Ix) 62% Follow-up: 4m post (77% C: 28; 33; 31 (C) female) Relapse Prevention: none retention) Follow-up prompt: none Methodological Quality Score: 4 Self-monitoring: none Other behaviors: none Moore, 2006 Group(n): Duration: 11wks C contact: usual care – cardiac Time until discontinue PA (hazard Time until discontinue PA: Ix(119); rehabilitation ratio): 0.02 USA Delivery: 5 group counseling C(131) Ix: 1.76 Maintenance achieved: yes sessions wkly for 3wks then PA measure: wrist-worn heart (SP) C: 1.00 Sample: mnthly for 2m rate monitor worn for 12m; PA hrs/m: ns; ns outpatients with exercise diary PA hrs/m mean (SD): Maintenance achieved: no Strategies: 5 (4,5,12,19,23) recent cardiac Ix: NR; 9.5(7.4); 7.0(7.2) End of Ix: 11 wks (85% PA sessions/m: ns; ns event (mean age Relapse Prevention: topic in C: NR; 8.5(8.9); 6.4(9.2) retention) Maintenance achieved: no 63yrs(Ix) counseling sessions PA sessions/m mean (SD): 62yrs(C), Follow-up: 10m post (81% Follow-up prompt: none Ix: NR; 11.5(7.8); 7.6(7.0) gender 39% (Ix) retention) C: NR; 10.6(9.2); 7.1(8.2) 37% (C) Self-monitoring: daily log Methodological Quality Score: 3 female) Other behaviors: none Nour, 2007 Group(n): Duration: 6wks C contact: no contact ; wait list Total PA sessions/wk mean (SD) Total PA sessions/wk: Ix(65); (1yr later) Ix: 6.48 (6.37) ;10.02 (6.65);7.04(NR) <0.001; 0.05 Canada Delivery: 6 face-to-face C(48) C: 4.79 (5.11); 5.64 (5.81); 6.17(NR) Maintenance achieved: yes counseling sessions PA measure: frequency of total, (SP) Sample: older walking, stretching & Walking sessions/wk mean (SD) Walking sessions/wk: Strategies: 6 (1,8,10,11,20,24) adults with strengthening activity Ix: 2.04(NR); 2.57(NR); 2.76(NR) 0.02; 0.01 osteoarthritis or
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks rheumatoid Relapse Prevention: none End of Ix: 6wks (86% retention) C: 1.77(NR); 1.72(NR); 1.93(NR) Maintenance achieved: yes arthritis (mean Follow-up prompt: none Follow-up: 8m post (71% Stretching sessions/wk mean (SD) Stretching sessions/wk: age 78yrs; retention) Ix: 2.56(2.92); 4.57(2.94);2.80(NR) <0.001;0.50 gender 90% Self-monitoring: none C: 2.06(2.80); 2.30(3.00);3.03(NR) Maintenance achieved: no female) Methodological Quality Score: 2 Other behaviors: none Strength sessions/wk mean (SD) Strength sessions/wk: Ix: 1.87(NR); 2.88(NR); 1.48(NR) 0.10; 0.51 C: 0.96(NR); 1.61(NR); 1.90(NR) Maintenance achieved: no Pinto, 2008 Group(n): Duration: 12wks C contact: 12 wkly then 3 mnthly PA mins/wk mean change from PA mins/wk: 0.007; 0.019 Ix(43); telephone calls (about symptoms baseline (SE): Maintenance achieved: yes USA Delivery: 1 face-to-face C(43) management) Ix: NR, -84.7(30.0); 96.5(33.1) counseling session; pedometer; PA guidelines: 0.001; ns (SP) C: NR; -18.3(30.6); 2.5(31.2) Sample: PA log; 12 wkly telephone PA measure: 7 day PA Recall Maintenance achieved: no women treated counseling sessions & tip % meeting PA guidelines: End of Ix: 12wks (95% retention) for early-stage sheets Ix: 2; 35; NR breast cancer Follow-up: 6m post (92% C: 0; 0; NR Strategies: 7 (1,5,7,8,11, (mean age retention) 12,18) 52yrs(Ix&C); Methodological Quality Score: 4 gender 100% Relapse Prevention: none female) Follow-up prompt: 2 telephone calls Self-monitoring: daily log Other behaviors: none Rejeski, 2009 Group(n): Duration: 12m C contact: wkly group meetings PA mins/wk mean (SE): PA mins/wk: <0.001; 0.042 Ix(55); for 26wks; then mnthly for 26wks; Ix:119.7(NR);233.5(24.5);165.5(22.2) Maintenance achieved: yes USA Delivery: 1 face-to-face C(51) (NB: 424 some diet and PA topics covered C: 119.7(NR); 103.1(25.5); 99.3(23.1) individual counseling session; (PP) originally centre-based exercise sessions PA measure: CHAMPS randomized- 3/wk & group counseling Questionnaire but only one session 1/wk for 2m; centre- center followed- End of Ix: 12m (96% retention) based exercise sessions 2/wk up) & home-based tasks for 4m; Follow-up: 2yrs post (75% Sample: older home-based exercise sessions retention) adults (70- with optional centre-based Methodological Quality Score: 4 89yrs) (mean sessions 1-2/wk & mnthly age 77yrs; telephone contact for 6m gender 69%
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks female) Strategies: 4 (1,8,9,19) Relapse Prevention: none Follow-up prompt: none Self-monitoring: none Other behaviors: none Rogers, 2009 Group(n): Duration: 12wks C contact: written material about PA mins/wk mean (SD): PA mins/wk: 0.01; 0.04 Ix(21); PA Ix: 96.2(NR); 165.8(73.2); 174.9(NR) Maintenance achieved: yes Canada Delivery: 6 group sessions C(20) C: 113.4(NR); 116.5(131.5);92.0(NR) with clinical psychologist, 15 PA measure: GT1M Activity counts/day: (SP) Sample: individual PA sessions with accelerometer worn for 7 days Activity counts/day mean (SD): 0.06;0.01 inactive women PA specialist; daily PA log Ix: 194 968(NR); 252 191 (91 893); Maintenance achieved: yes End of Ix: 12wks (93% retention) with breast 241 050(NR) Strategies: 14 (1,4,5,7,8,9,11, cancer (mean Follow-up: 3m post (88% C: 224 944(NR); 210 917 (64 078); 12,14,17,19,20,24,26) age 53yrs; retention) 209 375(NR) gender 100% Relapse Prevention: none Methodological Quality Score: 3 female) Follow-up prompt: none Self-monitoring: daily log Other behaviors: none Vallance, 2008 Group(n): Duration: 3m C contact: PA recommendation PA mins/wk mean (SD): PA mins/wk: IxPM(94); via telephone PM: 126(159); 197(159); 165(170) COM 0.02; 0.21 Canada Delivery PM: print materials; IxPED(94); PED:123(154); 214(178); 192(218) Maintenance achieved: no 1 telephone call PA measure: Godin Leisure time (SP) IxCOM(93); COM:119(163); 211(169); 175(182) PED 0.02, 0.11 exercise questionnaire C(96) Delivery PD: pedometer & C: 133(144); 163(121); 142(126) Maintenance achieved: no step calendar; 1 telephone call End of Ix: 3m (90% retention) PM 0.12; 0.43 Sample: breast Maintenance achieved: no cancer survivors Delivery COM: print Follow-up: 6m post (71% (mean age 58 materials; pedometer & step retention) yrs; gender calendar; 1 telephone call Methodological Quality Score: 4 100% female) Strategies: 3 (1,8,12) Relapse Prevention: none Follow-up prompt: none Self-monitoring: step calendar
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Other behaviors: none Van der Ploeg, Group(n): Ix Duration: 8wks C contact: usual care in KJ/kg/day mean (SD): KJ/kg/day: 2006 R&S(315); rehabilitation centre R&S: 59.9(49.8); 61.9(49.6); R&S 0.94; 0.45 Delivery (R&S): 1 face-to- AaR(284); 63.9(54.7) Maintenance achieved: no Netherlands face counseling session with PA measure: Physical activity C(603) AaR: 61.5(45.8); 67.3(57.7); AaR 0.28; 0.05 sport counselor; 1 telephone scale for individuals with physical (SP) 71.3(64.2) Maintenance achieved: no Sample: counseling session disabilities (PASIPD) C: 67.4(55.5); 67.2(57.9); 63.7(53.1) rehabilitation PA guidelines: Delivery (AaR): 1 face-to- End of Ix: 9wks (83% retention) patients with % meeting PA guidelines: R&S 0.16; 0.98 face counseling session with physical Follow-up: 43wks post (69% R&S: 57; 52; 59 Maintenance achieved: no PA counselor; 3 telephone conditions retention) AaR: 60; 64; 67 AaR 0.02; 0.02 counseling sessions; tailored (mean age C: 48; 54; 55 Maintenance achieved: yes print materials Methodological Quality Score: 2 46yrs(R&S & C), 47yrs Strategies: 4 (4,5,8,18) (AaR); gender Relapse Prevention: none 46%(R&S), 49% (AaR & C) Follow-up prompt: 1 female) telephone call Self-monitoring: none Other behaviors: none
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Table s2: Publication details, sample, methodology and intervention characteristics, and behavioral outcomes of intervention trials targeting dietary behaviors in adults (published 2000-2009)
First author, Sample Intervention Outcomes: Between Groups Effects: year, country Intervention Characteristics Methods Characteristics Baseline; End of Ix; Follow-up p value End of Ix; Follow-up (Aim) Elder, 2006 Group(n): Duration: 12wks C contact: 12 mailed off-the-shelf Total energy Kcal mean (SE): Total energy: IxP(120); print materials IxP: NR; 1288.7 (39.0); 1453.7 (47.1) IxP <0.05; ns USA Delivery (IxP): 12 wkly IxT(118); IxT: NR; 1420.6 (40.5); 1430.5 (39.0) Maintenance achieved: no counseling sessions from lay Diet measure: 24-hr dietary recall (PP) C(119) C: NR; 1430.5(39.0);1459.6 (46.0) IxT 0.06; 0.001 health advisors (Promotora) (Nutrition Data System NDS) Maintenance achieved: no Sample: either by home visit or phone; Total fat g mean (SE): End of Ix: 12wks (91% retention) American 12 wkly mailed print material IxP: NR; 43.1(1.9); 50.4 (2.3) Total fat: Latino women Follow-up: 12m post (79% IxT: NR; 49.8(2.0); 45.3 (2.4) IxP <0.10; ns Delivery (IxT): 12 wkly (mean age retention) C: NR; 49.1(1.9); 51.9 (2.3) Maintenance achieved: no mailed print material 40yrs; gender IxT 0.006; 0.0001 Methodological Quality Score: 3 Saturated fat g mean (SE): 100% female) Strategies: 7 (4,5,8,12,13,20) Maintenance achieved: no IxP: NR; 14.5 (0.7); 17.2 (1.0) Relapse Prevention: none IxT: NR; 16.9 (0.8); 15.6 (1.0) Saturated fat: C: NR; 16.5 (0.7); 18.4 (1.0) IxP <0.10; ns Follow-up prompt: none Maintenance achieved: no Self-monitoring: daily log IxT 0.001; 0.001 Maintenance achieved: no Other behaviors: none Elder, 2000 Group(n): Duration: 1-2wks C contact: 5 classes (3hrs) on Fat avoidance score mean (SD): Fat avoidance: <0.001; Ix(NR); C(NR); stress management Ix: 3.9(NR); 4.3(NR); 4.4(NR) <0.001 USA Delivery: 5 group education 732 C: 3.8(NR); 3.9(NR); 3.9(NR) Maintenance achieved: yes classes Diet measure: Fat avoidance (PP) Sample: Latino questionnaire Strategies: 5 (1,4,8,17,19) adult students End of Ix: 3m (89% retention) (mean age Relapse Prevention: none 31yrs;gender Follow-up: 3m post (72% Follow-up prompt: none 59% female) retention) Self-monitoring: none Methodological Quality Score: 2 Other behaviors: none Fries, 2005 Group(n): Duration: 4wks C contact: delayed Ix after Fat behavior score mean(SD): Fat behavior score: <0.001; Ix(377); C(377) Ix: 2.03(0.4); 1.85(0.3); 1.87(0.4) 0.003
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks USA Sample: healthy Delivery: 1 mailed dietary follow-up C: 2.05(0.3); 1.98(0.3); 1.95(0.3) Maintenance achieved: yes adults (mean feedback; 4 wkly mailed low- (PP) Diet measure: Fat and fiber Fiber behavior score mean(SD): Fiber behavior score: age 48yrs (Ix, literacy self-help booklets; 1 behavior-related questionnaire Ix: 2.24(0.35); 2.06(0.4); 2.12(0.4) 0.001; 0.086 f/u), 45yrs (Ix, brief telephone counseling call (FFB) C: 2.24(0.36); 2.19(0.4); 2.16(0.4) Maintenance achieved: no no f/u), 48yrs Strategies: 4 (1,4,8,13) (C, f/u), 45yrs End of Ix: 4wks (69% retention) (C, no f/u); Relapse Prevention: none Follow-up: 12m post (68% gender 65%(Ix), Follow-up prompt: none retention) 66%(C) female) Self-monitoring: none Methodological Quality Score: 3 Other behaviors: none Prochaska, 2005 Group(n): Duration: 12m C contact: assessment only Fat substitution score mean (SD): Fat substitution: 0.0001; Ix(2667);C(274 Ix: 14.3(5.0); 16.1(5.1); 16.1(5.3) 0.0001 USA Delivery: 3 mailed tailored Diet measure: Diet Behavior 0) C: 14.2(4.3); 15.0(5.1); 15.1(5.2) Maintenance achieved: yes computer reports at baseline, 6 Questionnaire (DBQ) (PP) Sample: & 12m; stage-matched self- Diet modification score mean (SD): Diet modification: 0.0001; End of Ix: 12m (75% (Ix), 82% primary care help manual; feedback on Ix: 20.0(3.5); 20.5(3.3); 20.6(3.3) 0.0001 (C) retention) patients at risk assessments C: 19.9(3.7); 19.9(3.5); 19.9(3.6) Maintenance achieved: yes for 1 or more of Follow-up: 12m post (71% (Ix), Strategies: 6 (2,4,5,8,13,19) Fat avoidance score mean (SD): Fat avoidance: 0.0001; the targeted 78% (C) retention) Ix: 15.9(3.4); 16.8 (3.4); 17.0(3.4) 0.0001 behaviors (mean Relapse Prevention: none Methodological Quality Score: 3 C: 15.9 (3.4); 16.0 (3.4); 16.1(3.3) Maintenance achieved: yes age 45yrs; Follow-up prompt: none gender 70% Fruit & vegetable score mean (SD): Fruit & veg: 0.0001; 0.0001 female) Self-monitoring: none Ix: 22.5(5.0); 23.5(4.9); 23.5(5.0) Maintenance achieved: yes C: 22.2 (5.0); 22.4(5.1); 22.4(5.1) Other behaviors: sun exposure, mammograms Prochaska, 2004 Group(n): Duration: 12m C contact: assessment and Fat substitution score mean (SD): Fat substitution: 0.0001; Ix(1209);C(125 feedback Ix: 14.1(4.7); 15.8 (5.0); 16.4(5.1) 0.0001 USA Delivery: 3 mailed tailored 1) C: 13.9(4.8);14.8(4.9); 15.2(5.0) Maintenance achieved: yes computer reports at baseline, 6 Diet measure: Diet Behavior (PP) Sample: parents & 12m; stage-matched self- Questionnaire (DBQ) Diet modification score mean (SD): Diet modification: 0.006; of 9th graders help manual; feedback on Ix: 20.1(3.7); 20.6(3.7); 20.5(3.5) 0.002 End of Ix: 12m (71% (Ix), 78% enrolled in assessments C: 19.9(3.7); 20.1(3.6); 20.0(3.6) Maintenance achieved: yes (C) retention) previous study Strategies: 6 (2,4,5,8,13,19) Fat avoidance score mean (SD): Fat avoidance: 0.0009; (mean age Follow-up: 12m post (67% (Ix), Ix: 15.6(3.3); 16.6(3.4); 16.9(3.2) 0.0001 43yrs; gender Relapse Prevention: none 74% (C) retention) C: 15.7(3.4); 16.1(3.4); 16.3(3.5) Maintenance achieved: yes 75% female)
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Follow-up prompt: none Methodological Quality Score: 2 Fruit & vegetable score mean (SD): Fruit & vegetable: 0.014; Ix: 22.5(4.7); 23.2(5.1); 23.9(5.0) 0.0007 Self-monitoring: none C: 22.2(4.9); 22.6(5.0); 23.1(5.0) Maintenance achieved: yes Other behaviors: smoking cessation, sun exposure Sallit, 2009 Group(n): Duration: 12wks C contact: assessment only HEI score mean (SD): HEI score: <0.001; <0.001 Ix(125); C(91) Ix: 60.4(13.4); 75.9(9.6); 71.8(12.3) Maintenance achieved: yes USA Delivery: 12 face-to-face- Diet measure: 3-Day Food C: 58.5(16.0); 64.8(11.7); 59.5(15.5) Sample: counseling sessions Records (analyzed by Healthy (SP) weight- Eating Index, HEI) Strategies: 8 (1,4,8,12,15,19, concerned 20,24) End of Ix: 12wks (NR) female smokers (mean age Relapse Prevention: none Follow-up: 9m post (59% 36yrs(Ix), 33yrs retention) Follow-up prompt: none (C); gender Methodological Quality Score: 2 100% female) Self-monitoring: format not specified Other behaviors: smoking cessation Stevens, 2003 Group(n): Duration: 6-9wks C contact: breast self-examination % energy from fat mean (SD): % energy fat: 0.009; <0.001 Ix(308); C(308) (BSE) Ix, 1 face-to-face Ix: 40.6(7.3); 30.3(NR); 34.9(6.6) Maintenance achieved: yes USA Delivery: 2 face-to-face counseling session, videotape on C: 39.4(6.3); 32.7(NR); 38.6(6.6) Sample: counseling sessions (aided by Fruit & vegetable: <0.001; (PP) BSE, pamphlets on BSE, 2 brief women, with interactive computer Fruit & vegetable serves/day mean <0.001 telephone calls cholesterol program); 2 brief telephone (SD): Maintenance achieved: yes values ≥ 200 calls Diet measure: Block Food Ix: 3.1(1.8); 5.5(NR); 4.3(1.9) Kristal FFB score: <0.001; mg/dl (mean Frequency Questionnaire; Kristal C: 3.2(1.9); 4.5(NR); 3.4(1.9) Strategies: 7 (4,5,8,11,13, <0.001 age 53yrs(Ix), Fat & Fiber Behavior (FFB) 18,25) Kristal FFB score mean (SD): Maintenance achieved: yes 54yrs (C); questionnaire Ix:2.0(0.5); 1.6(NR); 1.7(0.3) gender 100% Relapse Prevention: none End of Ix: 4m (94%(Ix), 91% (C) C: 1.9(0.4); 1.9(NR); 1.9(0.3) female) Follow-up prompt: 2 retention) telephone calls Follow-up: 12m post (89% (Ix), Self-monitoring: none 85% (C) retention) Other behaviors: none Methodological Quality Score: 2
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Table s3: Publication details, sample, methodology and intervention characteristics, and behavioral outcomes of intervention trials targeting physical activity and dietary behaviors in adults (published 2000-2009)
First author, Sample Intervention Outcomes: Between Groups Effects: year, country Intervention Characteristics Methods Characteristics Baseline; End of Ix; Follow-up p value End of Ix; Follow-up (Type) Burke, 2003 Group(n): Duration: 4m C contact: assessment only PA mins/wk change from baseline, PA mins/wk: IxH(47); mean (SD): IxH 0.34; 0.69 Australia Delivery (IxH): 6 printed PA measure: 7-day PA recall and IxL(47);C(43) IxH: NR; 40(12); 14(12) Maintenance achieved: no modules (3/6 mailed, 3/6 14-day recall (PP) IxL: NR; 21(16); 31(17) IxL 0.34; 0.69 Sample: healthy delivered in group session) Diet measure: short food C: NR; 13(14), 27 (14) Maintenance achieved: no adult couples Delivery (IxL): 6 printed frequency questionnaire focused (mean age PA d/wk mean (SD): PA d/wk: modules (5/6 mailed, 1/6 on fat intake 29yrs(f), IxH: NR; NR; NR IxH ns; ns delivered in group session) 31yrs(m); End of Ix: 4m (78% retention) IxL: NR; NR; NR Maintenance achieved: no gender 50% Strategies: 8 (2,4,5,8,9,19, C: NR; NR; NR IxL ns; ns Follow-up: 8m post (57% female) 24,26) Maintenance achieved: no retention) % meeting PA guidelines: Relapse Prevention: none IxH: 41; 51; 42 PA guidelines: Methodological Quality Score: 3 IxL: 30; 33; 35 IxH ns; ns Follow-up prompt: none C: 36; 49; 42 Maintenance achieved: no Self-monitoring: none IxL ns; ns High-fat food serves/day change Maintenance achieved: no Other behaviors: smoking from baseline, mean (SD): cessation, alcohol IxH: NR; 1.2(0.4); 1.9(0.4) High-fat foods: consumption IxL: NR; 2.9(0.4); 2.4(0.6) IxH: 0.24; 0.048 C: NR;1.1(0.4); 0.6(0.4) Maintenance achieved: no IxL 0.004; 0.009 Fruit & vegetable serves/day Maintenance achieved: yes change from baseline, mean (SD): IxH: NR; 1.1(0.3); 0.1(0.4) Fruit & vegetable: IxL: NR;-0.1(0.3); 0.0 (0.3) IxH 0.001; ns C:NR; 0.4(0.3); -0.1(0.3) Maintenance achieved: no IxL 0.001; ns Energy MJ mean (CI): Maintenance achieved: no IxH: [men] 10.8(10.3-11.3); 9.2(8.5- 9.8); 9.3(8.6-10.0);[women] 8.0(7.5- Energy MJ: 8.6); 6.8(6.2-7.3); 6.5(5.8-7.1) IxH ns; ns IxL: [men] 10.2(9.6-10.9); 9.4(8.5- Maintenance achieved: no
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks 10.0); 9.1(8.2-10.1); [women]7.9(7.4- IxL ns; ns 8.4); 7.2 (6.6-7.9); 7.0(6.1-8.1) Maintenance achieved: no C: [men]10.4(9.6-11.2); 9.6(8.7- Total fat % energy: 10.4); 9.4(8.2-10.7); [women]8.2(7.6- IxH 0.009; 0.013 8.7); 7.1(6.6-7.6); 7.6(7.0-8.1) Maintenance achieved: yes Total fat % energy mean (CI): IxL 0.04; 0.16 IxH: [men] 32.9(31.9-35.3); Maintenance achieved: no 28.6(27.1-31.3); 30.2(27.0-31.4); Saturated fat % energy: [women]32.9(30.9-34.8); 28.6(26.4- IxH 0.001; 0.012 30.8); 30.2(27.5-32.8) Maintenance achieved: yes IxL: [men] 33.0(30.9-35.7); IxL 0.001; 0.001 30.2(28.5-32.6); 31.2(30.3-35.3); Maintenance achieved: yes [women]33.0(31.3-34.7); 30.2(27.8- 32.7); 31.2(28.3-34.1) Fiber: C: [men] 31.2(29.8-33.9); 30.2(29.9- IxH ns; ns 34.1); 32.0(29.3-33.8); [women] Maintenance achieved: no 31.2(29.0-33.4); 30.2(28.2-32.3); IxL 0.014; ns 32.0(30.1-33.9) Maintenance achieved: no Saturated fat % energy mean (CI): IxH: [men]13.8(12.8-14.4); 11.2(10.0-12.5); 11.7(10.3-13.0) ; [women] 13.8(12.8-14.9); 11.2(10.0- 12.5); 11.7(10.3-13.0) IxL: [men]14.5(13.6-15.4); 12.3(10.9- 13.6); 12.6(10.8-14.4);[women] 14.5(13.6-15.4); 12.3(10.9-13.6); 12.6(10.8-14.4) C: [men] 13.3(12.1-14.5); 12.4(11.4- 13.4; 13.1(12.1-13.1); [women]13.3(12.1-14.5); 12.4(11.4- 13.4); 13.1(12.1-14.1) Fiber g/day mean (CI): IxH: [men] 24.8(23.2-29.9); 26.5(23.9-30.0); 26.4(22.2-27.4); [women] 21.6(19.2-22.7); 22.6(20.0- 25.2); 20.4(17.6-23.1) IxL: [men] 23.0(20.9-25.1);
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks 25.4(22.1-28.7); 22.3(18.8-25.9); [women] 20.2(17.9-22.5); 22.8(20.0- 25.6); 20.4(16.1-24.7) C: [men] 23.6(20.6-25.4); 23.9(21.1- 26.8); 25.0(21.8-28.3); [women] 20.7(18.4-22.9); 20.5(18.5-22.5); 22.1(19.8-24.3) Clark, 2004 Group(n): Duration: 12wks C contact: usual care- assessment PASE score mean (SD): PASE score: ns; ns Ix(50); C(50) only Ix: 254.3(95.2); 275.8(110.1); Maintenance achieved: no UK Delivery: 1 face-to-face 281.4(114.8) Sample: interview; telephone calls at PA measure: Physical Activity DSAS-PA: 0.037; 0.021 (SP) C: 260.1(100.3); 241.4(85.6); patients with 1,3 & 7wks; face-to-face Scale for the Elderly (PASE); Maintenance achieved: yes 246.6(92.8) Type 2 diabetes sessions at 12, 24 & 52wks Diabetes Self-care Activities DSAS-Diet: ns; ns (mean age Survey PA(DSAS-PA) DSAS-PA score mean (SD): Strategies: 9 (1,2,5,10,11,13, Maintenance achieved: no 59yrs; gender Ix: 2.4(1.2); 3.4(1.1); 3.2(1.5) 18,23,25) Diet measure: DSAS-Diet; 42% female) C: 2.5(1.3); 2.8(1.2); 2.6(1.4) Kristal FHQ (substitute): Kristal Food Habits Questionnaire Relapse Prevention: written 0.01; 0.04 (substitute, modify meat); The DSAS-diet score mean (SD): materials on relapse Maintenance achieved: yes Block Fat Screener Ix: 3.7(0.6); 4.1(0.6); 3.8(0.5) Follow-up prompt: 2 face-to- C: 3.8(0.6); 3.8(0.5); 3.6(0.9) Kristal FHQ(modify meat): End of Ix: 12wks (99% retention) face sessions ns; ns Kristal FHQ(substitute) mean (SD): Follow-up: 9m post (94% Maintenance achieved: no Self-monitoring: none Ix: 2.6(0.6); 1.4(0.6); 1.4(0.6) retention) C: 2.4(0.7); 1.7(0.7); 1.6(0.7) Block fat screener: 0.52; Other behaviors: none Methodological Quality Score: 4 0.01 Kristal FHQ(modify meat) mean Maintenance achieved: no (SD): Ix: 1.9(0.9); 1.1(0.5); 1.2(0.6) C: 1.7(0.9); 1.4(0.7); 1.4(0.7) Block fat screener mean (SD): Ix: 34.4(18.8); 23.6(14.1); 21.0(13.0) C: 31.7(23.3); 26.0(18.8); 31.2(23.1) Greaney, 2008 Group(n): Ix Duration: 12m C contact: contact-control group YPAS score mean (SD): YPAS score: 0.81; 0.92 Fruit & received information on falls Ix: 46(1.4); 46(1.2); 47(1.3) Maintenance achieved: no USA Delivery: 3 telephone vegetable only prevention C: 46(1.3); 47(1.1); 47(1.2) counseling calls, manual at NCIP: 0.0001; 0.005 (PP) (410); Ix PA baseline, mnthly newsletters, 3 PA measure: Yale Physical NCIP serves/day mean (SD): Maintenance achieved: yes only(470) tailored reports Activity Survey (YPAS) Ix:8.0(4.1); 10.1(4.6); 10.2(4.5) NCIF: 0.0001; 0.0025 Sample: older C: 7.7(4.0); 8.5(3.8); 9.3(4.5) Diet measure: NCI Fruit &
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks adults (≥60yrs) Strategies: 5 (5,8,13,19,25) vegetable screener (with NCIF serves/day mean (SD): Maintenance achieved: yes (mean age participant-assessed portion size Ix: 5.7(2.2); 6.6(2.2); 6.7(2.2) Relapse Prevention: none FAD: 0.001; 0.0002 75yrs; gender (NCIP) and without (NCIF)); 5 A C: 5.5(2.2); 5.8(2.0); 6.3(2.3) Maintenance achieved: yes 70% female) Follow-up prompt: none Day (FAD) measure; single-item FAD serves/day mean (SD): fruit & vegetable screener Single-item: 0.0003; 0.06 Self-monitoring: none Ix: 5.6(2.6); 6.7(2.4); 6.8(2.3) Maintenance achieved: no End of Ix: 12m (81% retention) C: 5.3(2.3); 5.7(2.0); 6.2(2.1) Other behaviors: none Follow-up: 12m post (76% Single-item serves/day mean (SD): retention) Ix: 4.8(1.1); 5.2(0.8); 5.2(0.8) C: 4.7(1.2); 4.9(1.0); 5.0(1.0) Methodological Quality Score: 3 Lindsay, 2009 Group(n): Duration: 6m C contact: new home computer & PA d/wk change from baseline PA d/wk: 0.37; 0.70 Ix(54); C(54) 1yr broadband subscription mean (SD): Maintenance achieved: no UK Delivery: new home Ix: NR; 2.6(1.8); 1.7(1.2) Sample: adults computer & 1yr broadband PA measure: study specific single Bad foods: 0.01; 0.52 (SP) C:NR; 2.3(1.6); 1.9(1.0) with coronary subscription; 1 face-to-face question about exercise frequency Maintenance achieved: no heart disease introductory session; access to Frequency of bad foods change Diet measure: Health Survey for (mean age website with forums from baseline mean (SD): England questions (food frequency 63yrs; gender moderated by researchers Ix: NR; 13.8(2.5); 13.6(6.3) questions for a selected range of 34% female) C: NR; 14.5(2.6); 13.7(7.0) Strategies: 3 (1,8,19) foods measured on Likert scale of frequency) Relapse Prevention: none End of Ix: 6m (95% retention) Follow-up prompt: none Follow-up: 3m post (95% Self-monitoring: none retention) Other behaviors: none Methodological Quality Score: 1 Sternfeld, 2009 Group(n): Duration: 16wks C contact: assessment only MET-min/wk median (IQR): MET-min/wk: 0.004; 0.04 Ix PA(195); Ix Ix: 1915(1020-2926); NR; NR Maintenance achieved: yes USA Delivery: tailored emails wkly PA measure: adaptation of the fats/sugars(99); C: 1575(830-2723); NR; NR for 2m, fortnightly for 2m Cross-Cultural activity patterns Saturated fat: 0.01; 0.03 (PP) Ix fruit & Ix over C change beta(SE): Questionnaire Maintenance achieved: yes vegetable(57); Strategies: 7 (1,2,4,5,8,12,19) 205.8(68.1); 203.5(99.8) C(436) Diet measure: adaptation of the Fruit & vegetable: 0.030; Relapse Prevention: none Saturated fat g/day median (IQR): Block Food Frequency 0.001 Sample: adult Ix: 12.2(8.7-17.3); NR; NR Follow-up prompt: none Questionnaire Maintenance achieved: yes workplace C: 12.0(7.7-16.6); NR; NR employees Self-monitoring: on-line End of Ix: 16wks (70% retention) Ix over C change beta(SE): -1.0(0.4); (mean age tracking tool -0.8(0.4) Follow-up: 4m post (55% 45yrs(Ix),
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks 44yrs(C); Other behaviors: none retention) Fruit & vegetable cups/day median gender73%(Ix), (IQR): Methodological Quality Score: 2 76% (C) Ix: 2.5(1.6-3.7); NR; NR female) C: 2.4(1.5-3.7); NR; NR Ix over C change beta(SE): 0.2(0.1); 0.4(0.1) Thoolen, 2009 Group(n): Duration: 3m C contact: usual care; brochure on DSCA-PA score mean (SD): DSCA-PA: 0.001; 0.003 Ix(89); C(108) diabetes self-management Ix: 3.2(2.0); 4.6(1.8); 4.1(1.8) Maintenance achieved: yes Netherlands Delivery: 2 face-to-face C: 3.3(2.0); 3.3(1.9); 3.3(1.9) Sample: Type 2 individual sessions, 4 group PA measure: Diabetes Self-Care PASE: 0.009; 0.014 (SP) diabetes patients sessions; written daily log of Activities Survey-PA (DSAS-PA); PASE score mean(SD): Maintenance achieved: yes (mean age goal-attainment for 2wks Physical Activity Scale for the Ix: 125(60); 162(75); 152(76) DSCA-Diet: 0.001; 0.001 62yrs; gender Elderly (PASE) C: 132(64); 135(69); 127(66) Strategies: 8 (4,5,10,12,13, Maintenance achieved: yes 36%(Ix), 45% 17,19,20) Diet measure: DSAS-Diet; DSCA-Diet score mean(SD) (C) female) Kristal FHQ: 0.001; 0.001 Kristal Food Habits Questionnaire Ix: 5.0(1.2); 5.6(1.0); 5.5(1.0) Relapse Prevention: none Maintenance achieved: yes (FHQ); Dutch Fat Consumption C: 5.1(1.3); 4.9(1.2); 4.9(1.1) Follow-up prompt: none Questionnaire(DFCQ) DFCQ: 0.001; 0.001 Kristal FHQ score mean(SD): Maintenance achieved: yes Self-monitoring: daily log End of Ix: 3m (93% retention) Ix: 2.5(0.4); 2.8(0.4); 2.8(0.4) C: 2.5(0.4); 2.5(0.4); 2.5(0.4) Other behaviors: none Follow-up: 9m post (79% retention) DFCQ score mean(SD): Ix:28.0(0.6); 25.9(0.6); 25.3(0.6) Methodological Quality Score: 4 C:27.1(0.6); 27.1(0.6);26.4(0.6) Von Gruenigen, Group(n): Duration: 6m C contact: usual care, weight Leisure index mean (SD): Leisure index: 0.025; 0.007 2008 Ix(23); C(22) control information brochure, 3 Ix: 17.0(13.6); 33.7(23.5); 32.8(23.6) Maintenance achieved: yes Delivery: 11 face-to-face standard visits with staff at 3,6 C: 18.9(15.3); 20.6(15.6); 17.5(15.1) USA Sample: group counseling sessions; Total Kcals: 0.50; 0.57 &12 m Overweight or telephone call and newsletter Total Kcals mean (SD): Maintenance achieved: no (SP) obese wkly for 6wks, bi-wkly for PA measure: Godin Leisure-time Ix: NR; 1501.2(385.6); 1458.3(541.4) endometrial 1m, mnthly for 3m: pedometer Exercise Questionnaire C: NR; 1599.5(571.2); 1547.5(500.3) cancer survivors for tracking; counseling at 3,6 Diet measure: 3-day food record (mean age 54yrs & 12m (Ix), 56yrs (C); End of Ix: 6m (72% retention) Strategies: 11 (1,4,7,8,11,12, gender 100% 13,18, 19,23,26) Follow-up: 6m post (78% female) retention) Relapse Prevention: Relapse prevention as group session Methodological Quality Score: 3 topic
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Follow-up prompt: 1 face-to- face session Self-monitoring: weekly log Other behaviors: none
PP= primary prevention; SP= secondary prevention, Ix= intervention, C= control, NR= not reported, ns= not significant, PA= physical activity, m=month, wks= weeks Appendix A: List of intervention strategies defined by Abraham and Michie (2008)
Strategy % Authors’ identification of strategies Cohen’s SE agreement Kappa pos/pos pos/neg neg/pos neg/neg 1 Provide general information 100 18 0 0 11 1.0 0.19 on behavior-health link 2 Provide information on 100 9 0 0 20 1.0 0.19 consequences 3 Provide information about 100 0 0 0 29 NA NA others’ approval 4 Prompt intention formation 100 19 0 0 10 1.0 0.19 5 Prompt barrier identification 100 19 0 0 10 1.0 0.19 6* Provide general ------encouragement 7 Set graded tasks 83 2 1 4 22 0.36† 0.17 8 Provide instruction 86 19 3 1 6 0.66 0.18 9 Model/demonstrate the 100 5 0 0 24 1.0 0.19 behavior 10 Prompt specific goal setting 100 4 0 0 25 1.0 0.19 11 Prompt review of behavioral 93 7 1 1 20 0.83 0.19 goals 12 Prompt self-monitoring of 97 10 1 0 18 0.93 0.18 behavior 13 Provide feedback on 93 12 0 2 15 0.86 0.18 performance 14 Provide contingent rewards 93 0 1 1 27 -0.04† 0.19 15 Teach to use prompts/cues 100 1 0 0 28 1.0 0.19 16 Agree on behavioral contract 97 1 0 1 27 0.65 0.17 17 Prompt practice 97 3 0 1 25 0.84 0.18 18 Use of follow-up prompts 86 6 1 3 19 0.66 0.18 19 Provide opportunities for 90 13 3 0 13 0.79 0.18 social comparison 20 Plan social support/social 90 7 0 3 19 0.75 0.18 change 21 Prompt identification as role 100 0 0 0 29 NA NA model/position advocate 22 Prompt self talk 100 0 0 0 29 NA NA 23 Relapse prevention 100 5 0 0 24 1.0 0.19 24 Stress management 100 4 0 0 25 1.0 0.19 25 Motivational interviewing 100 4 0 0 25 1.0 0.19 26 Time management 100 4 0 0 25 1.0 0.19 *this strategy was not used in coding based on recommendations from Abraham and Michie regarding the poor reliability of coding for this technique † Kappa is estimated on very few positives