Abstract
Objective
To systematically investigate the extent and type of theory use in physical activity and dietary interventions, as well as associations between extent and type of theory use with intervention effectiveness.Methods
An in-depth analysis of studies included in two systematic reviews of physical activity and healthy eating interventions (k = 190). Extent and type of theory use was assessed using the Theory Coding Scheme (TCS) and intervention effectiveness was calculated using Hedges's g. Metaregressions assessed the relationships between these measures.Results
Fifty-six percent of interventions reported a theory base. Of these, 90% did not report links between all of their behavior change techniques (BCTs) with specific theoretical constructs and 91% did not report links between all the specified constructs with BCTs. The associations between a composite score or specific items on the TCS and intervention effectiveness were inconsistent. Interventions based on Social Cognitive Theory or the Transtheoretical Model were similarly effective and no more effective than interventions not reporting a theory base.Conclusions
The coding of theory in these studies suggested that theory was not often used extensively in the development of interventions. Moreover, the relationships between type of theory used and the extent of theory use with effectiveness were generally weak. The findings suggest that attempts to apply the two theories commonly used in this review more extensively are unlikely to increase intervention effectiveness.Full text links
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Funding
Funders who supported this work.
British Heart Foundation
Cancer Research UK
Economic and Social Research Council (1)
Grant ID: ES/G007470/1
Fuse, the Centre for Translational Research in Public Health
Medical Research Council (3)
Grant ID: UD99999924
Fuse, the Centre for Translational Reseach in Public Health (renewal)
Professor Ashley Adamson, Newcastle University
Grant ID: MR/K02325X/1
Methods for strengthening evaluation and implementation: specifying components of behaviour change interventions
Professor Susan Michie, University College London
Grant ID: G0901474