A new study from the United Kingdom on the effectiveness of behavioral programs to improve health in low-income adults indicates the programs do not have a substantial effect, especially long-term. The researchers found a small effect in improving behaviors among participants, but over time, only dietary interventions remained effective long-term.
The researchers looked at 35 studies with 45 interventions that were conducted at some point from 1995 to 2014. They explain that they conducted the study to determine how well behavioral interventions work in low-income participants, who “are more likely to smoke, be sedentary, and eat a poor diet,” they write.
The researchers note that “major improvements in public health will be brought about through behavior changes in the population,” and that “targeting behavior change efforts at people at the other end of the income spectrum is seen as a major means to reducing health inequalities.”
In total, there were 17,000 participants. Those who completed one of the interventions had a “positive but small” effect on diet, physical activity, and smoking. However, effects of the interventions were maintained over time only for diet, but not physical activity or smoking.
The interventions ranged from self-help reading materials to individual counseling to group programs; some interventions only occurred once, and others last for up to two years. The programs were led by a nurse, psychologist, dietician, or other healthcare provider.
The researchers evaluated various outcomes in the studies to determine whether programs had been successfully followed, ranging from self-reporting by participants to filling out a “dietary risk assessment score” to determine saturated fat and cholesterol intake.
The scope of their analysis had “limitations,” because the studies differed from one another and some comparisons could not be made, according to the researchers. Different studies used different definitions for “low-income,” for example.
The bottom line is that the programs appeared to help participants somewhat, but that more research is needed to determine which programs work best.
“Behavior change interventions for low-income groups had small positive effects on healthy eating, physical activity and smoking,” they conclude. “Further work is needed to improve the effectiveness of behavior change interventions for deprived populations.”