A systematic review of lifestyle counseling for diverse patients in primary care.
Prior research and systematic reviews have examined strategies related to weight management, less is known about lifestyle and behavioral counseling interventions optimally suited for implementation in primary care practices generally, and among racial and ethnic patient populations. Primary care practitioners may find it difficult to access and use available research findings on effective behavioral and lifestyle counseling strategies and to assess their effects on health behaviors among their patients. This systematic review compiled existing evidence from randomized trials to inform primary care providers about which lifestyle and behavioral change interventions are shown to be effective for changing patients' diet, physical activity and weight outcomes. Searches identified 444 abstracts from all sources (01/01/2004-05/15/2014). Duplicate abstracts were removed, selection criteria applied and dual abstractions conducted for 106 full text articles. As of June 12, 2015, 29 articles were retained for inclusion in the body of evidence. Randomized trials tested heterogeneous multi-component behavioral interventions for an equally wide array of outcomes in three population groups: diverse patient populations (23 studies), African American patients only (4 studies), and Hispanic/Mexican American/Latino patients only (2 studies). Significant and consistent findings among diverse populations showed that weight and physical activity related outcomes were more amenable to change via lifestyle and behavioral counseling interventions than those associated with diet modification. Evidence to support specific interventions for racial and ethnic minorities was promising, but insufficient based on the small number of studies.
Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, United States; Medical University of South Carolina, Department of Public Health Sciences, Charleston, SC, United States. Electronic address: melvinc@musc.edu.
Cathy L
CL
Melvin
Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, United States; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, United States.
Melanie S
MS
Jefferson
Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, United States; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, United States.
LaShanta J
LJ
Rice
Medical University of South Carolina, Department of Nursing, Charleston, SC, United States.
Lynne S
LS
Nemeth
Medical University of South Carolina, Department of Family Medicine, Charleston, SC, United States.
Andrea M
AM
Wessell
Medical University of South Carolina, Department of Public Health Sciences, Charleston, SC, United States.
Paul J
PJ
Nietert
Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, United States; Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Hospital, Health Equity and Rural Outreach Innovation Center, Charleston, SC, United States.
Chanita
C
Hughes-Halbert
D015992:Body Mass Index; D003376:Counseling / Q000379:methods*; D005006:Ethnicity / Q000523:psychology*; D015444:Exercise; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic
Behavioral counseling; Behavioral interventions; Diet or weight outcomes; Ethnic populations; Implementation; Lifestyle counseling; Lifestyle interventions; Physical activity outcomes; Primary care practices; Primary care providers; Racial populations