Elsevier

Preventive Medicine

Volume 46, Issue 3, March 2008, Pages 181-188
Preventive Medicine

Review
Multiple health behavior change research: An introduction and overview

https://doi.org/10.1016/j.ypmed.2008.02.001Get rights and content

Abstract

In 2002, the Society of Behavioral Medicine's special interest group on Multiple Health Behavior Change was formed. The group focuses on the interrelationships among health behaviors and interventions designed to promote change in more than one health behavior at a time. Growing evidence suggests the potential for multiple-behavior interventions to have a greater impact on public health than single-behavior interventions. However, there exists surprisingly little understanding of some very basic principles concerning multiple health behavior change (MHBC) research. This paper presents the rationale and need for MHBC research and interventions, briefly reviews the research base, and identifies core conceptual and methodological issues unique to this growing area. The prospects of MHBC for the health of individuals and populations are considerable.

Section snippets

Overview

In 2002, the Society of Behavioral Medicine formed a special interest group (SIG) to contribute to the development of a science of multiple health behavior change (MHBC) for health promotion and disease management. This multidisciplinary group of researchers and practitioners focuses on the interrelationships among health behaviors and interventions designed to promote change in more than one health behavior at a time. Recognizing that intervention on multiple behaviors presents a unique set of

Studies of MHBC interventions in populations

The idea of intervening on multiple risk behaviors concurrently became a focus of attention in the early 1970s as a means of preventing cardiovascular disease (CVD) (Labarthe, 1998). One early proposal was a factorial design to evaluate the independent and joint contributions of intervention on diet, physical activity, and smoking habits in a single trial named “Jumbo.” The proposal was deemed too costly, however, and the trial was never conducted. Large-scale multifactoral CVD risk factor

Methodological issues

Methodological challenges with multibehavioral interventions include design considerations, participant burden, and lack of agreement on how best to conceptualize and analyze multiple risk behavior change.

Conclusions

MHBC research is steadily increasing in sophistication, relevance, and impact. The editorial by J. O. Prochaska (2008) identifies future research needs and provides a vision of the developing MHBC field research. The prospects for the health of the individuals and populations we serve are considerable.

Acknowledgments

This work was supported by the National Institute on Drug Abuse (#K23 DA018691), the State of California Tobacco-Related Disease Research Program (#13KT-0152), the National Cancer Institute (#R01 CA109941), and the Hawaii Medical Service Association, an Independent Licensee of the Blue Cross and Blue Shield Association. The authors have no financial interests related to the material in the manuscript. We thank Andrea Kozak, PhD, James Prochaska, PhD, Wayne Velicer, PhD, and Ken Wallston, PhD

References (75)

  • HallK.L. et al.

    Meta-analytic examination of the strong and weak principles across 48 health behaviors

    Prev. Med.

    (2008)
  • HserY.I. et al.

    Tobacco use as a distal predictor of mortality among long-term narcotics addicts

    Prev. Med.

    (1994)
  • JohnsonS.S. et al.

    Transtheoretical Model-based multiple behavior intervention for weight management: Effectiveness on a population basis

    Prev. Med.

    (2008)
  • KellerS. et al.

    Multiple health risk behaviors in German first-year university students

    Prev. Med.

    (2008)
  • KlesgesR.C. et al.

    Smoking status: effects on the dietary intake, physical activity, and body fat of adult men

    Am. J. Clin. Nutr.

    (1990)
  • NoarS.M. et al.

    Applying health behavior theory to multiple behavior change: Considerations and approaches

    Prev. Med.

    (2008)
  • ProchaskaJ.O.

    Multiple health behavior research represents the future of preventive medicine

    Prev. Med.

    (2008)
  • ProchaskaJ.O. et al.

    Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms

    Prev. Med.

    (2005)
  • ProchaskaJ.J. et al.

    Methods of quantifying change in multiple risk factor interventions

    Prev. Med.

    (2008)
  • ProchaskaJ.O. et al.

    Initial efficacy of MI, TTM tailoring and HRI's with multiple behaviors for employee health promotion

    Prev. Med.

    (2008)
  • PronkN.P. et al.

    Meeting recommendations for multiple healthy lifestyle factors. Prevalence, clustering, and predictors among adolescent, adult, and senior health plan members

    Am. J. Prev. Med.

    (2004)
  • SanchezA. et al.

    Patterns and correlates of multiple risk behaviors in overweight women

    Prev. Med.

    (2008)
  • UngerJ.B.

    Stages of change of smoking cessation: relationships with other health behaviors

    Am. J. Prev. Med.

    (1996)
  • VandelanotteC. et al.

    A randomized trial of sequential and simultaneous multiple behavior change interventions for physical activity and fat intake

    Prev. Med.

    (2008)
  • YusufS. et al.

    Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study

    Lancet

    (2004)
  • BabyakM. et al.

    Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months

    Psychosom. Med.

    (2000)
  • BlumenthalJ.A. et al.

    Effects of exercise training on older patients with major depression

    Arch. Intern. Med.

    (1999)
  • Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin

    N. Engl. J. Med.

    (2002)
  • DuRantR.H. et al.

    The relationship between early age of onset of initial substance use and engaging in multiple health risk behaviors among young adolescents

    Arch. Pediatr. Adolesc. Med.

    (1999)
  • EbrahimS. et al.

    Multiple risk factor interventions for primary prevention of coronary heart disease

    Cochrane Database Syst. Rev.

    (2006)
  • EdingtonD.W. et al.

    The financial impact of changes in personal health practices

    J. Occup. Environ. Med.

    (1997)
  • EdingtonD.W.

    Emerging research: a view from one research center

    Am. J. Health Promot.

    (2001)
  • EmmonsK.M. et al.

    Project PREVENT: a randomized trial to reduce multiple behavioral risk factors for colon cancer

    Cancer Epidemiol. Biomark. Prev.

    (2005)
  • FarquharJ.W. et al.

    Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project

    JAMA

    (1990)
  • FioreM.C.

    A clinical practice guideline for treating tobacco use and dependence: A US public health service report

    JAMA

    (2000)
  • GortmakerS.L. et al.

    Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health

    Arch. Pediatr. Adolesc. Med.

    (1999)
  • HallS.M. et al.

    Weight gain prevention and smoking cessation: cautionary findings

    Am. J. Public Health

    (1992)
  • Cited by (437)

    View all citing articles on Scopus
    1

    A founding chair of the Society of Behavioral Medicine's (SBM) Special Interest Group on Multiple Health Behavior Change (MHBC).

    2

    A former co-chair of the SBM Special Interest Group on MHBC and current SBM President.

    3

    Is co-chair of the SBM Special Interest Group on MHBC.

    View full text