期刊
HEALTH PSYCHOLOGY
卷 33, 期 7, 页码 577-587出版社
AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/a0033080
关键词
asthma self-care; behavior change techniques; taxonomy; systematic review
资金
- Great Western Research Initiative (GWRI)
- U.K.'s National Institute for Health Research program
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula
- National Institute for Health Research [PDA/02/06/031] Funding Source: researchfish
- National Institutes of Health Research (NIHR) [PDA/02/06/031] Funding Source: National Institutes of Health Research (NIHR)
Objectives: The purpose of this study is to update previous systematic reviews of interventions targeting asthma self-care in adults with asthma, and to use meta-regression to examine the association between the use of specific behavior change techniques and intervention effectiveness. Methods: Electronic bibliographies were searched systematically to identify randomized controlled trials of interventions targeting asthma self-care. Intervention content was coded using a published taxonomy of behavior change techniques. For trials with a low-to-moderate risk of bias, study outcomes were pooled using random effects meta-analysis. Associations between intervention content and effect size were explored using meta-regression. Results: Meta-analysis of 38 trials (7883 patients) showed that interventions targeting asthma self-care reduced symptoms (standardized mean difference [SMD] = -0.38 [-0.52, -0.24]) and unscheduled health care use (odds ratio [OR] = 0.71 [0.56 to 0.90]) and increased adherence to preventive medication (OR = 2.55 [2.11 to 3.10]). meta-regression analyses found that active involvement of participants was associated with a reduction in unscheduled health care use (OR = 0.50 vs. 0.79). Inclusion of stress management techniques was associated with an increase in asthma symptoms (SMD = 0.01 vs. -0.44). Existing recommendations about the optimal content of asthma self-care interventions were tested but were not supported by the data. Conclusions: Interventions targeting asthma self-care are effective. Active involvement of participants is associated with increased intervention effectiveness, but the use of stress management techniques may be counterproductive. Taxonomy-based systematic reviews using meta-regression have potential for identifying techniques associated with increased effectiveness in behavioral interventions.
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