How best to reduce unhealthy risk-taking behaviours? A meta-review of evidence syntheses of interventions using self-regulation principles

ABSTRACT

Self-regulation is a key antecedent of health and behaviour-change interventions have utilised self-regulation approaches to promote health. The present study used a novel methodology, a nested meta-review, to: (a) integrate and summarise information from evidence syntheses of diverse self-regulation interventions to reduce risk-taking, in the behavioural domains of smoking, alcohol and drug use, unhealthy eating, externalising problem behaviours, and sexual risk-taking; (b) identify intervention features implicated in risk-taking prevention or reduction; and (c) provide recommendations for future research and practice. Searches of eight databases yielded 21 eligible evidence syntheses, 15 taking a primarily social-cognitive strategy (k = 1,103 total studies), and 6 taking a primary trait/developmental strategy (k = 119); total N > 650,000. Intervention features most frequently associated with reduced risk-taking included: delivery of multiple components through (either, or a mix of) group, individual, computer, and one-one-one delivery; screening and pharmacotherapy, where relevant; targeting only one behavioural outcome; provision of counselling, stress-management, skills-training, self-monitoring, self-control and impulsivity training, and personalised feedback; identification of barriers and ‘resolution’ of barriers; tailoring to age and ethnicity; and, also, incorporating social support by peers. Some of these patterns were more visible in meta-analyses with higher methodological quality. Recommendations for research and practice are offered.

KEYWORDS:

• Self-regulation
• risk-taking
• health
• behaviour change interventions
• meta-review

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Prominence is the frequency with which a given feature is associated with reduced risk-taking in the studies.

Additional information

Funding

This work was supported by the National Institutes of Health (NIH) Science of Behavior Change Common Fund Program through an award administered by the National Institute on Aging (U.S. PHS grant 5U24AG052175). The views presented here are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.