title: Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews.
abstract: BACKGROUND
  The assessment and communication of disease risk that is personalised to the individual is widespread in healthcare contexts. Despite several systematic reviews of RCTs, it is unclear under what circumstances that personalised risk estimates promotes change in four key health-related behaviours: smoking, physical activity, diet and alcohol consumption.
  
  
  OBJECTIVE
  The present research aims to systematically identify, evaluate and synthesise the findings of existing systematic reviews.
  
  
  METHODS
  This systematic review of systematic reviews followed published guidance. A search of four databases and two-stage screening procedure with good reliability identified nine eligible systematic reviews.
  
  
  RESULTS
  The nine reviews each included between three and 15 primary studies, containing 36 unique studies. Methods of personalising risk feedback included imaging/visual feedback, genetic testing, and numerical estimation from risk algorithms. The reviews were generally high quality. For a broad range of methods of estimating and communicating risk, the reviews found no evidence that risk information had strong or consistent effects on health-related behaviours. The most promising effects came from interventions using visual or imaging techniques and with smoking cessation and dietary behaviour as outcomes, but with inconsistent results. Few interventions explicitly used theory, few targeted self-efficacy or response efficacy, and a limited range of Behaviour Change Techniques were used.
  
  
  CONCLUSIONS
  Presenting risk information on its own, even when highly personalised, does not produce strong effects on health-related behaviours or changes which are sustained. Future research in this area should build on the existing knowledge base about increasing the effects of risk communication on behaviour.
authors.affiliation: Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Manchester, M13 9PL, England. david.french@manchester.ac.uk.
authors.forename: David P
authors.initials: DP
authors.lastname: French
authors.affiliation: Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Manchester, M13 9PL, England.
authors.forename: Elaine
authors.initials: E
authors.lastname: Cameron
authors.affiliation: Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Manchester, M13 9PL, England.
authors.forename: Jack S
authors.initials: JS
authors.lastname: Benton
authors.affiliation: School of Clinical Medicine, Forvie Site, University of Cambridge, Cambridge, CB2 0SR, England.
authors.forename: Christi
authors.initials: C
authors.lastname: Deaton
authors.affiliation: Nightingale Centre, University Hospital South Manchester, Manchester, M23 9LT, England.
authors.forename: Michelle
authors.initials: M
authors.lastname: Harvie
mesh_terms: D000428:Alcohol Drinking; D003142:Communication; D015444:Exercise; D005247:Feeding Behavior; D015438:Health Behavior; D006801:Humans; D012307:Risk Factors; D012907:Smoking
keywords: Behaviour; Behaviour change; Risk communication; Systematic review