© 2011, Crown Copyright.
Included under terms of UK Non-commercial Government License.
Bookshelf ID: NBK109530
< PrevNext >
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
< PrevNext >
An Evidence Synthesis of Qualitative and Quantitative Research on Component Intervention Techniques, Effectiveness, Cost-Effectiveness, Equity and Acceptability of Different Versions of Health-Related Lifestyle Advisor Role in Improving Health
Health Technology Assessment, No. 15.9
SM Carr, M Lhussier, N Forster, L Geddes, K Deane, M Pennington, S Visram, M White, S Michie, C Donaldson, and A Hildreth.
Author Information and AffiliationsSouthampton (UK): NIHR Journals Library; 2011 Feb.
Abstract
Background:
There is a need to identify and analyse the range of models developed to date for delivering health-related lifestyle advice (HRLA), or training, for effectiveness and cost-effectiveness in improving the health and well-being of individuals and communities in the UK, with particular reference to the reduction of inequalities.
Objectives:
To identify the component intervention techniques of lifestyle advisors (LAs) in the UK and similar contexts, and the outcomes of HRLA interventions.
Data sources:
Stakeholder views, secondary analysis of the National Survey of Health Trainer Activity, telephone survey of health trainer leads/coordinators. A search of a range of electronic databases was undertaken [including the Applied Social Sciences Index and Abstracts (ASSIA), EMBASE, NHS Economic Evaluation Database (NHS EED), MEDLINE, Psyc INFO, etc.], as well searching relevant journals and reference lists, conducted from inception to September 2008.
Review methods:
Identified studies were scanned by two reviewers and those meeting the following criteria were included: studies carrying out an evaluation of HRLA; those taking place in developed countries similar to the UK context; those looking at adult groups; interventions with the explicit aim of health improvement; interventions that involved paid or voluntary work with an individual or group of peers acting in an advisory role; advice delivered by post, online or electronically; training, support or counselling delivered to patients, communities or members of the public. After quality assessment, studies were selected for inclusion in the review. Data were abstracted from each study according to an agreed procedure and narrative, and realist and economic approaches were used to synthesise the data. Cost-effectiveness analysis of interventions was undertaken.
Results:
In total, 269 studies were identified but 243 were excluded. The 26 included studies addressing chronic care, mental health, breastfeeding, smoking, diet and physical activity, screening and human immunodeficiency virus (HIV) infection prevention. Overall, there was insufficient evidence to either support or refute the use of LAs to promote health and improve quality of life (QoL), and thus uncertainty about the interventions' cost-effectiveness. However, the economic analysis showed that LA interventions were cost-effective in chronic care and smoking cessation, inconclusive for breastfeeding and mental health and not cost-effective for screening uptake and diet/physical activity. LA interventions for HIV prevention were cost-effective, but not in a UK context.
Limitations:
The wide variety of LA models, delivery settings and target populations prevented the reviewers from establishing firm causal relationships between intervention mode and study outcomes.
Conclusions:
Evidence was variable, giving only limited support to LAs having a positive impact on health knowledge, behaviours and outcomes. Levels of acceptability appeared to be high. LAs acted as translational agents, sometimes removing barriers to prescribed behaviour or helping to create facilitative social environments. Reporting of processes of accessing or capitalising on indigenous knowledge was limited. Ambiguity was apparent with respect to the role and impact of lay and peer characteristics of the interventions. A future programme of research on HRLA could benefit from further emphasis on identification of needs, the broadening of population focus and intervention aims, the measurement of outcomes and the reviewing of evidence.
Funding:
This study was funded by the Health Technology Assessment programme of the National Institute for Health Research.
Contents
- NIHR Health Technology Assessment programme
- List of abbreviations
- Executive summary
- 1. Introduction
- 2. Methods
- 3. Results of the review
- 4. Discussion
- 5. Conclusions
- Acknowledgements
- References
- Appendix 1 Review of reviews
- Appendix 2 Original protocol
- Appendix 3 Multidimensional nature of the HRLA format
- Appendix 4 Project Advisory Group
- Appendix 5 Interview schedule
- Appendix 6 Search strategies for electronic databases
- Appendix 7 Search strategy for Google
- Appendix 8 Results returned for each Google search string
- Appendix 9 Website search results
- Appendix 10 Table of excluded studies
- Appendix 11 Intervention intensity rating
- Appendix 12 Studies success rating
- Appendix 13 Use of ICERs in the analysis of cost-effectiveness
- Health Technology Assessment programme
Suggested citation:
Carr SM, Lhussier M, Forster N, Geddes L, Deane K, Pennington M, et al. An evidence synthesis of qualitative and quantitative research on component intervention techniques, effectiveness, cost-effectiveness, equity and acceptability of different versions of health-related lifestyle advisor role in improving health. Health Technol Assess 2011;15(9).
Declared competing interests of authors: none
The research reported in this issue of the journal was commissioned by the HTA programme as project number 07/26/03. The contractual start date was in November 2007. The draft report began editorial review in October 2009 and was accepted for publication in February 2010. As the funder, by devising a commissioning brief, the HTA programme specified the research question and study design. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the referees for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.
The views expressed in this publication are those of the authors and not necessarily those of the HTA programme or the Department of Health.
- NLM CatalogRelated NLM Catalog Entries
- Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia.[Med J Aust. 2020]Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia.Osborne SR, Alston LV, Bolton KA, Whelan J, Reeve E, Wong Shee A, Browne J, Walker T, Versace VL, Allender S, et al. Med J Aust. 2020 Dec; 213 Suppl 11:S3-S32.e1.
- Review Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis.[Health Technol Assess. 2015]Review Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis.Jordan RE, Majothi S, Heneghan NR, Blissett DB, Riley RD, Sitch AJ, Price MJ, Bates EJ, Turner AM, Bayliss S, et al. Health Technol Assess. 2015 May; 19(36):1-516.
- Review Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.[Health Technol Assess. 2012]Review Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.Chen YF, Madan J, Welton N, Yahaya I, Aveyard P, Bauld L, Wang D, Fry-Smith A, Munafò MR. Health Technol Assess. 2012; 16(38):1-205, iii-v.
- Review IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis[ 2016]Review IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesisHowarth E, Moore THM, Welton NJ, Lewis N, Stanley N, MacMillan H, Shaw A, Hester M, Bryden P, Feder G. 2016 Dec
- Review Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.[Health Technol Assess. 2014]Review Systematic reviews of and integrated report on the quantitative, qualitative and economic evidence base for the management of obesity in men.Robertson C, Archibald D, Avenell A, Douglas F, Hoddinott P, van Teijlingen E, Boyers D, Stewart F, Boachie C, Fioratou E, et al. Health Technol Assess. 2014 May; 18(35):v-vi, xxiii-xxix, 1-424.
- An Evidence Synthesis of Qualitative and Quantitative Research on Component Inte...An Evidence Synthesis of Qualitative and Quantitative Research on Component Intervention Techniques, Effectiveness, Cost-Effectiveness, Equity and Acceptability of Different Versions of Health-Related Lifestyle Advisor Role in Improving Health
Your browsing activity is empty.
Activity recording is turned off.
See more...