Review and special article
Telephone-Delivered Interventions for Physical Activity and Dietary Behavior Change: An Updated Systematic Review

https://doi.org/10.1016/j.amepre.2011.08.025Get rights and content

Context

Telephone-delivered interventions targeting physical activity and dietary change have potential for broad population reach and thus have a role to play in addressing increasing rates of lifestyle-related chronic diseases. The purpose of this systematic review is to update the evidence for their potential to inform translation, including effectiveness in promoting maintenance, reporting on implementation, and costs.

Evidence acquisition

A structured search of PubMed, MEDLINE, and PsycINFO (January 2006 to April 2010) was conducted. Included studies reported on physical activity and/or dietary change in adults, delivered at least 50% of intervention contacts by telephone, and included a control group (except in dissemination studies). Detailed information on study design, intervention features, and behavioral outcomes was extracted, tabulated, and summarized.

Evidence synthesis

Twenty-five studies (27 comparisons) were included: 16 for physical activity, two for diet, and seven for combined interventions. Twenty of 27 comparisons found evidence for initiation of behavior change (14 of 17 comparisons for physical activity; two of two for diet; four of eight for combined interventions). Ten of 25 studies evaluated post-intervention maintenance of change, with three reporting that maintenance was achieved for at least 50% of outcomes. Dissemination studies were rare (n=3), as were dose–response (n=2) and cost-effectiveness analyses (n=2).

Conclusions

Given the strength of evidence for telephone-delivered physical activity and dietary change interventions, greater emphasis on dissemination studies is warranted.

Section snippets

Context

The importance of regular physical activity and a healthy diet is widely recognized in the prevention and management of many prevalent chronic conditions, including hypertension, type 2 diabetes, cardiovascular disease, and some cancers.1 In the context of an aging population, and concerns about increasing rates of overweight and obesity and lifestyle-related chronic diseases, effective and broad-reaching physical activity and dietary-change interventions are required. The evidence base for

Search Strategy and Data Sources

To identify studies published since the last review a structured search of PubMed, MEDLINE, and PsycINFO was conducted from January 2006 to April 2010. The following search terms were used: (telephone interventions OR phone interventions OR telephone programs OR phone programs OR telephone trials OR phone trials OR telephone intervention trials OR phone intervention trials OR automated telephone OR automated phone) AND (diet OR nutrition OR dietary intake OR physical activity OR exercise).

Study Selection

The search yielded a total of 375 publications across the three databases. Of these publications, 349 were excluded (Figure 1). An additional dissemination study published prior to 2006 was identified and included. Thus, the total number of studies included in the review was 25 (reported in 27 publications). Two studies evaluated two telephone intervention conditions, thus the total number of comparisons was 27. The total number of participants across all studies was 11,174.

Intervention targets, frequency, and duration

Of the 25 studies,

Discussion

This systematic review updates an earlier review5 of telephone-delivered physical activity and dietary intervention studies published in 2007. Of particular note is the increasing rate of publications, with this update identifying almost as many studies published within a 4-year period as the previous review, which included studies conducted over 4 decades. This update found continued strong evidence for telephone-delivered physical activity and dietary behavior interventions for producing

Conclusion and Recommendations

Findings from this updated review provide continuing strong evidence supporting the efficacy of telephone-delivered interventions to promote physical activity and dietary change. In fact, the evidence is so strong that it supports the contention by Kessler and Glasgow, put forward recently in this journal,12 that RCT designs (at least those comparing a telephone-delivered intervention to a no-treatment control) are no longer needed. What is needed is a concerted focus on research that may

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