title: Multiple health behaviours: overview and implications.
abstract: BACKGROUND
  More remains unknown than known about how to optimize multiple health behaviour change.
  
  
  METHODS
  After reviewing the prevalence and comorbidities among major chronic disease risk behaviours for adults and youth, we consider the origins and applicability of high-risk and population strategies to foster multiple health behaviour change.
  
  
  RESULTS
  Findings indicate that health risk behaviours are prevalent, increase with age and co-occur as risk behaviour clusters or bundles.
  
  
  CONCLUSIONS
  We conclude that both population and high-risk strategies for health behaviour intervention are warranted, potentially synergistic and need intervention design that accounts for substitute and complementary relationships among bundled health behaviours. To maximize positive public health impact, a pressing need exists for bodies of basic and translational science that explain health behaviour bundling. Also needed is applied science that elucidates the following: (1) the optimal number of behaviours to intervene upon; (2) how target behaviours are best selected (e.g. greatest health impact; patient preference or positive effect on bundled behaviours); (3) whether to increase healthy or decrease unhealthy behaviours; (4) whether to intervene on health behaviours simultaneously or sequentially and (5) how to achieve positive synergies across individual-, group- and population-level intervention approaches.
authors.affiliation: Department of Preventive Medicine, Northwestern University, 680 North Lakeshore Drive, Suite 1220, Chicago, IL 60611, USA. bspring@northwestern.edu
authors.forename: Bonnie
authors.initials: B
authors.lastname: Spring
authors.forename: Arlen C
authors.initials: AC
authors.lastname: Moller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Coons
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002908:Chronic Disease / Q000453:epidemiology / Q000517:prevention & control*; D005247:Feeding Behavior; D005260:Female; D014943:Global Health; D015438:Health Behavior; D006801:Humans; D008297:Male; D011322:Primary Prevention / Q000379:methods* / Q000592:standards; D012309:Risk-Taking; D057185:Sedentary Behavior; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D047568:Unsafe Sex; D055815:Young Adult