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Comparing strategies to assess multiple behavior change in behavioral intervention studies

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Translational Behavioral Medicine

ABSTRACT

Alternatives to individual behavior change methods have been proposed; however, little has been done to investigate how these methods compare. To explore the four methods that quantify change in multiple risk behaviors targeting four common behaviors, we utilized data from two cluster-randomized, multiple behavior change trials conducted in two settings: small businesses and health centers. Methods used were (1) summative, (2) z-score, (3) optimal linear combination, and (4) impact score. In the small business study, methods 2 and 3 revealed similar outcomes. However, physical activity did not contribute to method 3. In the health centers study, similar results were found with each of the methods. Multivitamin intake contributed significantly more to each of the summary measures than other behaviors. Selection of methods to assess multiple behavior change in intervention trials must consider study design and the targeted population when determining the appropriate method/s to use.

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Acknowledgments

This work was conducted with the support of a grant from the National Cancer Institute (grant P01 CA 75308). Dr. Drake was supported by funding by the Barnes-Jewish Hospital Foundation.

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Authors and Affiliations

  1. Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA

    Bettina F Drake PhD

  2. Department of General Internal Medicine, Boston University Medical Center, Boston, MA, USA

    Lisa M Quintiliani PhD

  3. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Yi Li PhD

  4. School of Public Health, University of Wisconsin, Milwaukee, WI, USA

    Amy E Harley PhD

  5. Center for Community-Based Research, Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA

    Amy L Sapp ScD, Karen M Emmons PhD & Glorian Sorensen PhD

Authors
  1. Bettina F Drake PhD
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  2. Lisa M Quintiliani PhD
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  3. Amy L Sapp ScD
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  4. Yi Li PhD
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  5. Amy E Harley PhD
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  6. Karen M Emmons PhD
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  7. Glorian Sorensen PhD
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Corresponding author

Correspondence to Bettina F Drake PhD.

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Implications

Practice: Multiple health behavior change interventions are effective in reducing risk behaviors for major chronic diseases, and the effectiveness of these interventions can be measured in a number of ways.

Policy Resources should be directed toward better measurement of health risk behaviors in order to more appropriately test and identify effective multiple health behavior change interventions.

Research: Research needs to be directed towards better understanding on methods used to assess multiple health behavior change interventions and aligning the methods they chosen with relevant public health, work place, or research goals.

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Drake, B.F., Quintiliani, L.M., Sapp, A.L. et al. Comparing strategies to assess multiple behavior change in behavioral intervention studies. Behav. Med. Pract. Policy Res. 3, 114–121 (2013). https://doi.org/10.1007/s13142-013-0195-2

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  • DOI: https://doi.org/10.1007/s13142-013-0195-2

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