title: Are interventions for low-income groups effective in changing healthy eating, physical activity and smoking behaviours? A systematic review and meta-analysis.
abstract: OBJECTIVE
  To conduct a systematic review and meta-analysis examining the effectiveness of behavioural interventions targeting diet, physical activity or smoking in low-income adults.
  
  
  METHODS
  Systematic review with random effects meta-analyses. Studies before 2006 were identified from a previously published systematic review (searching 1995-2006) with similar but broader inclusion criteria (including non-randomised controlled trials (RCTs)). Studies from 2006 to 2014 were identified from eight electronic databases using a similar search strategy.
  
  
  METHODS
  MEDLINE, EMBASE, PsycINFO, ASSIA, CINAHL, Cochrane Controlled Trials, Cochrane Systematic Review and DARE.
  
  
  METHODS
  RCTs and cluster RCTs published from 1995 to 2014; interventions targeting dietary, physical activity and smoking; low-income adults; reporting of behavioural outcomes.
  
  
  METHODS
  Dietary, physical activity and smoking cessation behaviours.
  
  
  RESULTS
  35 studies containing 45 interventions with 17,000 participants met inclusion criteria. At postintervention, effects were positive but small for diet (standardised mean difference (SMD) 0.22, 95% CI 0.14 to 0.29), physical activity (SMD 0.21, 95% CI 0.06 to 0.36) and smoking (relative risk (RR) of 1.59, 95% CI 1.34 to 1.89). Studies reporting follow-up results suggested that effects were maintained over time for diet (SMD 0.16, 95% CI 0.08 to 0.25) but not physical activity (SMD 0.17, 95% CI -0.02 to 0.37) or smoking (RR 1.11, 95% CI 0.93 to 1.34).
  
  
  CONCLUSIONS
  Behaviour change interventions for low-income groups had small positive effects on healthy eating, physical activity and smoking. Further work is needed to improve the effectiveness of behaviour change interventions for deprived populations.
authors.affiliation: NHS Grampian Public Health Directorate, Aberdeen, UK.
authors.forename: Eleanor R
authors.initials: ER
authors.lastname: Bull
authors.affiliation: Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, UK.
authors.forename: Stephan U
authors.initials: SU
authors.lastname: Dombrowski
authors.affiliation: Aberdeen Health Psychology Group, Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: McCleary
authors.affiliation: Aberdeen Health Psychology Group, Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK.
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D002677:Chile; D004032:Diet / Q000379:methods / Q000706:statistics & numerical data*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000379:methods / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D006113:United Kingdom; D014481:United States; D055815:Young Adult
keywords: PREVENTIVE MEDICINE; PUBLIC HEALTH; SOCIAL MEDICINE