Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul:100:67-75.
doi: 10.1016/j.ypmed.2017.03.020. Epub 2017 Mar 23.

A systematic review of lifestyle counseling for diverse patients in primary care

Cathy L Melvin  1 , Melanie S Jefferson  2 , LaShanta J Rice  2 , Lynne S Nemeth  3 , Andrea M Wessell  4 , Paul J Nietert  5 , Chanita Hughes-Halbert  6
Affiliations

A systematic review of lifestyle counseling for diverse patients in primary care

Cathy L Melvin et al. Prev Med. 2017 Jul.

Abstract

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.

Keywords: 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.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement

Authors reported no conflict of interest.

No financial disclosures or conflicts of interest were reported by the authors.

Figures

Fig. 1
Fig. 1
PRISMA 2009 flow diagram.
See this image and copyright information in PMC

References

    1. AMA. Proceedings of the 2012 annual meeting of the house of delegates. Resolutions, Policy H-425.972. Virtual Mentor. 2013 Apr;:15. doi: 10.1002/14651858.CD003054.pub3. - DOI
    1. Angermayr L, Melchart D, Linde K. Multifactorial lifestyle interventions in the primary and secondary prevention of cardiovascular disease and type 2 diabetes mellitus–a systematic review of randomized controlled trials. Ann. Behav. Med. 2010;40(1):49–64. doi: 10.1007/s12160-010-9206-4. - DOI - PubMed
    1. Appel LJ, Clark JM, Yeh HC, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N. Engl. J. Med. 2011;365(21):1959–1968. doi: 10.1056/NEJMoa050156. - DOI - PMC - PubMed
    1. Befort CA, Nollen N, Ellerbeck EF, Sullivan DK, Thomas JL, Ahluwalia JS. Motivational interviewing fails to improve outcomes of a behavioral weight loss program for obese African American women: a pilot randomized trial. J. Behav. Med. 2008;31(5):367–377. doi: 10.1007/s10865-008-9161-8. - DOI - PubMed
    1. Bennett GG, Herring SJ, Puleo E, Stein EK, Emmons KM, Gillman MW. Web-based weight loss in primary care: a randomized controlled trial. Obesity (Silver Spring) 2010;18(2):308–313. doi: 10.7326/0003-4819-150-4-200902170-00006. - DOI - PMC - PubMed

Publication types