PROMOTING INDIVIDUAL BEHAVIOUR CHANGE

A systematic review of the effectiveness of interventions based on a stages-of-change approach to promote individual behaviour change

Background

Over recent years, interest in reducing early mortality and preventing morbidity through lifestyle changes has grown exponentially. Interventions (or methods) used within health care settings to modify risky behaviours have increasingly been based on stage theories or staged approaches to behaviour change. The attraction of stage-based models lies in their ability to explain why interventions aimed at large groups or the general public, such as mass media or community interventions, are rarely universally effective. Stage-based models propose that 'tailored' interventions, which take into account the current stage an individual has reached in the change process, will be more effective than 'one size fits all' interventions.

Despite the widespread use of stage-based models, it has been suggested that there is little evidence available about the effectiveness of this approach in changing behaviour. This review aimed to draw together information about the effectiveness of interventions based on the stages-of-change approach from different settings and different population groups and to systematically assess the effectiveness of those interventions in bringing about positive changes in health-related behaviour.

Findings

Overall there appears to be little evidence to suggest that stage-based interventions are more effective compared to non-stage-based interventions. Similarly there is little evidence that stage-based interventions are more effective when compared to no intervention or usual-care.

Given the limited evidence for the effectiveness of interventions tailored to the stages-of-change approach, practitioners and policy makers need to recognise that this approach has a status which appears to be unwarranted when it is evaluated in a systematic way.

Conducted by: RP Riemsma1, J Pattenden2, C Bridle1, AJ Sowden1, L Mather1, IS Watt2, A Walker3

1. NHS Centre for Reviews and Dissemination; 2. Department of Health Sciences, University of York; 3. Health Services Research Unit, University of Aberdeen

Further details

Project page on HTA Programme website

Publications

Riemsma RP, Pattenden J, Bridle C, Sowden AJ, Mather L, Watt IS, Walker A. A systematic review of the effectiveness of interventions based on a stages-of-change approach to promote individual behaviour change. Health Technol Assess. 2002;6(24):1-242

Riemsma RP, Pattenden J, Bridle C, Sowden AJ, Mather L, Watt IS, Walker A. Systematic review of the effectiveness of stage based interventions to promote smoking cessation. BMJ. 2003;326:1175-7

Presentations

Riemsma R, Sowden A, Pattenden G. Interventions to promote individual behaviour change. UKPHA 9th Annual Public Health Forum; 2001 March; Bournemouth, UK

Funding

Commissioned by the HTA Programme