title: Evidence from interventions based on theoretical models for lifestyle modification (physical activity, diet, alcohol and tobacco use) in primary care settings: A systematic review.
abstract: OBJECTIVE
  To determine the effectiveness of health promotion interventions based on theoretical models of behavioral change to modify the main lifestyle factors (physical activity, diet, alcohol and tobacco) in adults receiving primary health care (PHC).
  
  
  METHODS
  We searched the MEDLINE and Cochrane Database of Systematic Reviews from January 2000 to December 2012. Two reviewers independently performed the first screening of titles and abstracts, the methodological quality assessment using the lecturacritica.com tool, and the extraction of necessary data to systematize the available information.
  
  
  RESULTS
  Only few studies met the inclusion criteria (17 studies from 30 articles). Thirteen were randomized controlled trials, three systematic reviews, and one observational study. The transtheoretical model was the most frequent (13 studies), and obtained strong evidence of its effectiveness for dietary interventions in the short-term and for smoking cessation interventions in the long-term as compared to usual PHC practice. Limited evidence was found for smoking cessation interventions based in the social cognitive theory.
  
  
  CONCLUSIONS
  There are few studies that explicitly link intervention strategies and theories of behavioral change. A rigorous evaluation of the theoretical principles could help researchers and practitioners to understand how and why interventions succeed or fail.
authors.affiliation: Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Spain. Electronic address: paola.bullygaray@osakidetza.net.
authors.forename: Paola
authors.initials: P
authors.lastname: Bully
authors.affiliation: Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Spain.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Sánchez
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona Spain.
authors.forename: Edurne
authors.initials: E
authors.lastname: Zabaleta-del-Olmo
authors.affiliation: Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Spain.
authors.forename: Haizea
authors.initials: H
authors.lastname: Pombo
authors.affiliation: Primary Care Research Unit of Bizkaia, Basque Health Service-Osakidetza, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Grandes
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001521:Behavior Therapy / Q000379:methods*; D004032:Diet; D015444:Exercise; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008962:Models, Theoretical; D011320:Primary Health Care; D016540:Smoking Cessation
keywords: Health promotion; Life style; Primary health care; Systematic review; Theoretical models