Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews

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ORIGINAL ARTICLE

Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews David P French, PhD 1 & Elaine Cameron, PhD 1 & Jack S Benton, MSc 1 & Christi Deaton, PhD 2 & Michelle Harvie, PhD 3

# The Author(s) 2017. This article is published with open access at Springerlink.com

Abstract Background The assessment and communication of disease risk that is personalised to the individual is widespread in healthcare contexts. Despite several systematic reviews of RCTs, it is unclear under what circumstances that personalised risk estimates promotes change in four key health-related behaviours: smoking, physical activity, diet and alcohol consumption. Purpose The present research aims to systematically identify, evaluate and synthesise the findings of existing systematic reviews.

Electronic supplementary material The online version of this article (doi:10.1007/s12160-017-9895-z) contains supplementary material, which is available to authorized users. * David P French [email protected] Elaine Cameron [email protected] Jack S Benton [email protected] Christi Deaton [email protected] Michelle Harvie [email protected] 1

Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Coupland 1 Building, Manchester M13 9PL, England

2

School of Clinical Medicine, Forvie Site, University of Cambridge, Cambridge CB2 0SR, England

3

Nightingale Centre, University Hospital South Manchester, Manchester M23 9LT, England

Methods This systematic review of systematic reviews followed published guidance. A search of four databases and two-stage screening procedure with good reliability identified nine eligible systematic reviews. Results The nine reviews each included between three and 15 primary studies, containing 36 unique studies. Methods of personalising risk feedback included imaging/visual feedback, genetic testing, and numerical estimation from risk algorithms. The reviews were generally high quality. For a broad range of methods of estimating and communicating risk, the reviews found no evidence that risk information had strong or consistent effects on health-related behaviours. The most promising effects came from interventions using visual or imaging techniques and with smoking cessation and dietary behaviour as outcomes, but with inconsistent results. Few interventions explicitly used theory, few targeted self-efficacy or response efficacy, and a limited range of Behaviour Change Techniques were used. Conclusions Presenting risk information on its own, even when highly personalised, does not produce strong effects on health-related behaviours or changes which are sustained. Future research in this area should build on the existing knowledge base about increasing the effects of risk communication on behaviour. Keywords Systematic review . Risk communication . Behaviour change . Behaviour The global burden of disease is increasingly due to noncommunicable diseases such as cardiova