Telephone-Delivered Interventions for Physical Activity and Dietary Behavior Change An Updated Systematic Review

Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, Queensland, Australia.
American journal of preventive medicine (Impact Factor: 4.53). 01/2012; 42(1):81-8. DOI: 10.1016/j.amepre.2011.08.025
Source: PubMed


Telephone-delivered interventions targeting physical activity and dietary change have potential for broad population reach and thus have a role to play in addressing increasing rates of lifestyle-related chronic diseases. The purpose of this systematic review is to update the evidence for their potential to inform translation, including effectiveness in promoting maintenance, reporting on implementation, and costs.
A structured search of PubMed, MEDLINE, and PsycINFO (January 2006 to April 2010) was conducted. Included studies reported on physical activity and/or dietary change in adults, delivered at least 50% of intervention contacts by telephone, and included a control group (except in dissemination studies). Detailed information on study design, intervention features, and behavioral outcomes was extracted, tabulated, and summarized.
Twenty-five studies (27 comparisons) were included: 16 for physical activity, two for diet, and seven for combined interventions. Twenty of 27 comparisons found evidence for initiation of behavior change (14 of 17 comparisons for physical activity; two of two for diet; four of eight for combined interventions). Ten of 25 studies evaluated post-intervention maintenance of change, with three reporting that maintenance was achieved for at least 50% of outcomes. Dissemination studies were rare (n=3), as were dose-response (n=2) and cost-effectiveness analyses (n=2).
Given the strength of evidence for telephone-delivered physical activity and dietary change interventions, greater emphasis on dissemination studies is warranted.

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    • "Systematic reviews [53, 60]; Position reviews [28, 56, 70, 101]. Potential adaptations to enhance the fıt within community contexts Stakeholders' documents [64] Systematic reviews [43, 47, 87]; Stakeholders' documents [124]. "

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    • "For implementation, our findings were consistent with previous reports [22-24]. Intervention dose delivered was almost always reported. "
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    ABSTRACT: The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3-14 (mean = 8.1 +/- 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice.
    Full-text · Article · Jun 2014 · International Journal of Behavioral Nutrition and Physical Activity
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    • "This suggests that the presence of these risk factors (overweight, abdominal obesity, raised blood pressure or abnormal lipid levels) did not enhance or reduce participants’ responses to the dietary interventions. Interventions delivered indirectly (for example, by telephone) were only slightly less effective than those delivered face-to-face; this finding is supported by recent reports on the effectiveness of telephone-based interventions on physical activity and diet [59,60]. "
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    ABSTRACT: Retirement from work involves significant lifestyle changes and may represent an opportunity to promote healthier eating patterns in later life. However, the effectiveness of dietary interventions during this period has not been evaluated. We undertook a systematic review of dietary interventions among adults of retirement transition age (54 to 70 years). Twelve electronic databases were searched for randomized controlled trials evaluating the promotion of a healthy dietary pattern, or its constituent food groups, with three or more months of follow-up and reporting intake of specific food groups. Random-effects models were used to determine the pooled effect sizes. Subgroup analysis and meta-regression were used to assess sources of heterogeneity. Out of 9,048 publications identified, 67 publications reporting 24 studies fulfilled inclusion criteria. Twenty-two studies, characterized by predominantly overweight and obese participants, were included in the meta-analysis. Overall, interventions increased fruit and vegetable (F&V) intake by 87.8 g/day (P <0.00001), with similar results in the short-to-medium (that is, 4 to 12 months; 85.6 g/day) and long-term (that is, 12 to 58 months; 87.0 g/day) and for body mass index (BMI) category. Interventions produced slightly higher intakes of fruit (mean 53.7 g/day) than of vegetables (mean 41.6 g/day), and significant increases in fish (7 g/day, P = 0.03) and decreases in meat intake (9 g/day, P <0.00001). Increases in F&V intakes were positively associated with the number of participant intervention contacts. Dietary interventions delivered during the retirement transition are therefore effective, sustainable in the longer term and likely to be of public health significance.
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