201 lines
6.1 KiB
YAML
201 lines
6.1 KiB
YAML
abstract: 'Background: There is a need to identify and analyse the range of models
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developed to date for delivering health-related lifestyle advice (HRLA),
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or training, for effectiveness and cost-effectiveness in improving the
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health and well-being of individuals and communities in the UK, with
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particular reference to the reduction of inequalities.
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Objectives: To identify the component intervention techniques of
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lifestyle advisors (LAs) in the UK and similar contexts, and the
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outcomes of HRLA interventions.
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Data sources: Stakeholder views, secondary analysis of the National
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Survey of Health Trainer Activity, telephone survey of health trainer
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leads/coordinators. A search of a range of electronic databases was
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undertaken {[}including the Applied Social Sciences Index and Abstracts
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(ASSIA), EMBASE, NHS Economic Evaluation Database (NHS EED), MEDLINE,
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Psyc INFO, etc.], as well searching relevant journals and reference
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lists, conducted from inception to September 2008.
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Review methods: Identified studies were scanned by two reviewers and
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those meeting the following criteria were included: studies carrying out
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an evaluation of HRLA; those taking place in developed countries similar
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to the UK context; those looking at adult groups; interventions with the
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explicit aim of health improvement; interventions that involved paid or
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voluntary work with an individual or group of peers acting in an
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advisory role; advice delivered by post, online or electronically;
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training, support or counselling delivered to patients, communities or
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members of the public. After quality assessment, studies were selected
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for inclusion in the review. Data were abstracted from each study
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according to an agreed procedure and narrative, and realist and economic
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approaches were used to synthesise the data. Cost-effectiveness analysis
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of interventions was undertaken.
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Results: In total, 269 studies were identified but 243 were excluded.
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The 26 included studies addressing chronic care, mental health,
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breastfeeding, smoking, diet and physical activity, screening and human
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immunodeficiency virus (HIV) infection prevention. Overall, there was
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insufficient evidence to either support or refute the use of LAs to
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promote health and improve quality of life (QoL), and thus uncertainty
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about the interventions'' cost-effectiveness. However, the economic
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analysis showed that LA interventions were cost-effective in chronic
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care and smoking cessation, inconclusive for breastfeeding and mental
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health and not cost-effective for screening uptake and diet/physical
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activity. LA interventions for HIV prevention were cost-effective, but
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not in a UK context.
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Limitations: The wide variety of LA models, delivery settings and target
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populations prevented the reviewers from establishing firm causal
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relationships between intervention mode and study outcomes.
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Conclusions: Evidence was variable, giving only limited support to LAs
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having a positive impact on health knowledge, behaviours and outcomes.
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Levels of acceptability appeared to be high. LAs acted as translational
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agents, sometimes removing barriers to prescribed behaviour or helping
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to create facilitative social environments. Reporting of processes of
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accessing or capitalising on indigenous knowledge was limited. Ambiguity
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was apparent with respect to the role and impact of lay and peer
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characteristics of the interventions. A future programme of research on
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HRLA could benefit from further emphasis on identification of needs, the
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broadening of population focus and intervention aims, the measurement of
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outcomes and the reviewing of evidence.'
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affiliation: 'Carr, SM (Corresponding Author), Northumbria Univ, Newcastle Upon Tyne
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NE1 8ST, Tyne \& Wear, England.
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Carr, S. M.; Lhussier, M.; Forster, N.; Geddes, L.; Visram, S.; Hildreth, A., Northumbria
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Univ, Newcastle Upon Tyne NE1 8ST, Tyne \& Wear, England.
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Deane, K.; Pennington, M.; White, M.; Donaldson, C., Newcastle Univ, Newcastle Upon
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Tyne NE1 7RU, Tyne \& Wear, England.
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Deane, K., Univ E Anglia, Norwich NR4 7TJ, Norfolk, England.
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Michie, S., UCL, London, England.'
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author: Carr, S. M. and Lhussier, M. and Forster, N. and Geddes, L. and Deane, K.
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and Pennington, M. and Visram, S. and White, M. and Michie, S. and Donaldson, C.
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and Hildreth, A.
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author_list:
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- family: Carr
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given: S. M.
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- family: Lhussier
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given: M.
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- family: Forster
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given: N.
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- family: Geddes
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given: L.
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- family: Deane
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given: K.
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- family: Pennington
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given: M.
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- family: Visram
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given: S.
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- family: White
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given: M.
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- family: Michie
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given: S.
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- family: Donaldson
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given: C.
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- family: Hildreth
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given: A.
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da: '2023-09-28'
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doi: 10.3310/hta15090
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eissn: 2046-4924
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files: []
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issn: 1366-5278
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journal: HEALTH TECHNOLOGY ASSESSMENT
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keywords-plus: 'RANDOMIZED CONTROLLED-TRIAL; AFRICAN-AMERICAN WOMEN; DISEASE
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SELF-MANAGEMENT; SMOKING TREATMENT SERVICES; PSYCHIATRIC SYMPTOM INDEX;
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BREAST-FEEDING PRACTICES; HIV PREVENTION; PUBLIC-HEALTH; LOW-INCOME;
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PHYSICAL-ACTIVITY'
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language: English
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month: FEB
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number: '9'
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number-of-cited-references: '394'
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orcid-numbers: 'Deane, Katherine/0000-0002-0805-2708
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Pennington, Mark/0000-0002-1392-8700
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Lhussier, Monique/0000-0001-9383-2356
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Carr, Susan/0000-0003-4722-985X
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Michie, Susan/0000-0003-0063-6378
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Donaldson, Cam/0000-0003-4670-5340
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Visram, Shelina/0000-0001-9576-2689
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Forster, Natalie/0000-0001-8039-7017'
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pages: 1+
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papis_id: a2c6d6a9d433cff30fcd3f855edd168e
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ref: Carr2011evidencesynthesis
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researcherid-numbers: 'White, Martin J. R./G-2410-2010
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Deane, Katherine/E-4030-2010
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Pennington, Mark/AAS-9946-2020
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Michie, Susan/A-1745-2010
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'
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times-cited: '44'
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title: An evidence synthesis of qualitative and quantitative research on component
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intervention techniques, effectiveness, cost-effectiveness, equity and acceptability
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of different versions of health-related lifestyle advisor role in improving health
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type: article
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unique-id: WOS:000289592700001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '51'
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volume: '15'
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web-of-science-categories: Health Care Sciences \& Services
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year: '2011'
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