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Meta-Analysis
. 2014 Nov 28;4(11):e006046.
doi: 10.1136/bmjopen-2014-006046.

Are interventions for low-income groups effective in changing healthy eating, physical activity and smoking behaviours? A systematic review and meta-analysis

Eleanor R Bull  1 , Stephan U Dombrowski  2 , Nicola McCleary  3 , Marie Johnston  3
Affiliations
Meta-Analysis

Are interventions for low-income groups effective in changing healthy eating, physical activity and smoking behaviours? A systematic review and meta-analysis

Eleanor R Bull et al. BMJ Open. .

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.

Design: 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.

Data sources: MEDLINE, EMBASE, PsycINFO, ASSIA, CINAHL, Cochrane Controlled Trials, Cochrane Systematic Review and DARE.

Eligibility criteria for selecting studies: RCTs and cluster RCTs published from 1995 to 2014; interventions targeting dietary, physical activity and smoking; low-income adults; reporting of behavioural outcomes.

Main outcome measures: 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.

Keywords: PREVENTIVE MEDICINE; PUBLIC HEALTH; SOCIAL MEDICINE.

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Figures

Figure 1
Figure 1
Study selection flow diagram (italics signify numbers from July 2014 updated search).
Figure 2
Figure 2
Standardised mean differences immediately postintervention for studies focusing on dietary change (ordered by effect size).
Figure 3
Figure 3
Standardised mean differences immediately postintervention for studies focusing on physical activity change (ordered by effect size).
Figure 4
Figure 4
Relative risk of smoking abstinence immediately postintervention for studies focusing on smoking interventions (ordered by effect size).
See this image and copyright information in PMC

References

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    1. Department of Health. Choosing health. London: Stationery Office, 2004. (White paper)
    1. Scottish Government. Equally well: report of the ministerial task force on health inequalities. Edinburgh: The Stationery Office, 2008.

MeSH terms