title: When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change.
abstract: A meta-analysis of 150 research reports summarizing the results of multiple behavior domain interventions examined theoretical predictions about the effects of the included number of recommendations on behavioral and clinical change in the domains of smoking, diet, and physical activity. The meta-analysis yielded 3 main conclusions. First, there is a curvilinear relation between the number of behavioral recommendations and improvements in behavioral and clinical measures, with a moderate number of recommendations producing the highest level of change. A moderate number of recommendations is likely to be associated with stronger effects because the intervention ensures the necessary level of motivation to implement the recommended changes, thereby increasing compliance with the goals set by the intervention, without making the intervention excessively demanding. Second, this curve was more pronounced when samples were likely to have low motivation to change, such as when interventions were delivered to nonpatient (vs. patient) populations, were implemented in nonclinic (vs. clinic) settings, used lay community (vs. expert) facilitators, and involved group (vs. individual) delivery formats. Finally, change in behavioral outcomes mediated the effects of number of recommended behaviors on clinical change. These findings provide important insights that can help guide the design of effective multiple behavior domain interventions.
authors.affiliation: Annenberg School for Communication, University of Pennsylvania.
authors.forename: Kristina
authors.initials: K
authors.lastname: Wilson
authors.affiliation: Department of Psychology, Istanbul Sehir Universitesi.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Senay
authors.affiliation: School of Social Work, University of Illinois at Urbana-Champaign.
authors.forename: Marta
authors.initials: M
authors.lastname: Durantini
authors.affiliation: Departamento de Psicología Social y Metodología, Universidad Autónoma de Madrid.
authors.forename: Flor
authors.initials: F
authors.lastname: Sánchez
authors.affiliation: Annenberg Public Policy Center, University of Pennsylvania.
authors.forename: Michael
authors.initials: M
authors.lastname: Hennessy
authors.affiliation: Department of Preventive Medicine, Northwestern University.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Spring
authors.affiliation: Department of Psychology.
authors.forename: Dolores
authors.initials: D
authors.lastname: Albarracín
mesh_terms: D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D009042:Motivation