Changing habits to improve health: New study indicates behavior changes work

November 10, 2015

CORVALLIS, Ore. - Improving your heart health may be as simple as making small behavioral changes - a new study of behavioral health interventions suggests that they are effective at helping people alter their lifestyles and lead to physical changes that could improve overall health.

The findings also indicate a shift is needed in the way such interventions are evaluated by researchers and used by health care providers, said Veronica Irvin of Oregon State University, a co-author of the study just published in the Annals of Behavioral Medicine.

Behavioral treatments such as individual counseling or group training to improve nutrition or physical activity, reduce or stop smoking, or adhere to a drug treatment plan, often are overlooked because medical care providers tend to believe it is too difficult for people the make changes to their established lifestyles, said Irvin, an assistant professor in the College of Public Health and Human Sciences at OSU.

But large clinical drug trials for potential new medications often fail to show that those treatments make patients better, and drugs sometimes are associated with undesirable side effects, she said. Modification of health behavior is another option for health providers and their patients, Irvin explained, but is underutilized in clinical medical practice as well as in public health policy because many providers remain unconvinced that people can change their behavior to improve their health.

She and her co-author, Robert M. Kaplan of the Agency for Healthcare Research and Quality, conducted a comprehensive and systematic review of large-budget studies funded by the National Institutes of Health that involved behavioral interventions such as individual counseling or group training to improve nutrition or physical activity, reduce or stop smoking, or adhere to a drug treatment plan.

More than 80 percent of the randomized clinical trials that included a behavioral intervention reported a significant improvement for the targeted behavior and a significant physiological impact such a reduction in weight or blood pressure. Greater improvements were observed when the intervention simultaneously targeted two behaviors, such as nutrition and physical activity, which are considered lifestyle behaviors.

"This research suggests that behavioral interventions should be taken more seriously," Irvin said. "It indicates that people are able to achieve realistic behavioral changes and improve their cardiovascular health."

But the researchers also noted that few of the studies documented morbidity and mortality outcomes that are often required for drug trials. Previous research by Irvin and Kaplan found that most drug trials fail to reduce mortality. Behavioral interventions should be studied in a similar fashion, Irvin said.

"There are more positive outcomes with these trials, but they don't often measure mortality," Irvin said. "The next step for behavioral trials should be to measure results using clinical outcomes, such as the number of heart attacks and hospitalizations, experienced by participants."

Most behavior interventions reviewed for the study showed benefits using surrogate markers for these kinds of clinical events. For example, treatments for high cholesterol have the goal of reducing heart attacks and extending life. Measures of cholesterol are surrogate markers because they are believed to be related to the clinical goal of reducing deaths.

But the surrogate markers are not always predictive of clinical outcomes, which is a potential concern for medical researchers. Future behavioral trials should investigate these clinical events as they would be in a traditional drug trial, Irvin said.

In this study, 17 trials reported a morbidity outcome, with seven showing a significant effect on reducing morbidity outcomes such as hospitalization or cardiovascular events.

Irvin and Kaplan began work on the study while the two worked together in the National Institutes of Health's Office of Behavior and Social Science Research. They reviewed all large-budget clinical trials evaluating behavioral interventions for the treatment or prevention of cardiovascular disease that had received funding from the National Heart, Lung and Blood Institute or the National Institute of Diabetes & Digestive and Kidney Diseases between 1980 and 2012.

In all, 38 studies were included in the research. They were did not include 20 large-budget trials from the period in this study because no results from those trials have been published.

This underscores the need for more publication of research even if the outcomes were not as expected, Irvin said. Publishing these null outcomes prevents the unnecessary replication of studies and also may inform doctors and patients about which treatments are not likely to be helpful.
-end-


Oregon State University

Related Physical Activity Articles from Brightsurf:

Physical activity in the morning could be most beneficial against cancer
The time of day when we exercise could affect the risk of cancer due to circadian disruption, according to a new study with about 3,000 Spanish people  

Physical activity and sleep in adults with arthritis
A new study published in Arthritis Care & Research has examined patterns of 24-hour physical activity and sleep among patients with rheumatoid arthritis, lupus, and knee osteoarthritis.

Regular physical activity seems to enhance cognition in children who need it most
Researchers at the Universities of Tsukuba and Kobe re-analyzed data from three experiments that tested whether physical activity interventions lead to improved cognitive skills in children.

The benefits of physical activity for older adults
New findings published in the Scandinavian Journal of Medicine & Science in Sports reveal how physically active older adults benefit from reduced risks of early death, breast and prostate cancer, fractures, recurrent falls, functional limitations, cognitive decline, dementia, Alzheimer's disease, and depression.

Physical activity may protect against new episodes of depression
Increased levels of physical activity can significantly reduce the odds of depression, even among people who are genetically predisposed to the condition.

Is physical activity always good for the heart?
Physical activity is thought to be our greatest ally in the fight against cardiovascular disease.

Physical activity in lessons improves students' attainment
Students who take part in physical exercises like star jumps or running on the spot during school lessons do better in tests than peers who stick to sedentary learning, according to a UCL-led study.

Physical activity may attenuate menopause-associated atherogenic changes
Leisure-time physical activity is associated with a healthier blood lipid profile in menopausal women, but it doesn't seem to entirely offset the unfavorable lipid profile changes associated with the menopausal transition.

Are US adults meeting physical activity guidelines?
The proportion of US adults adhering to the 'Physical Activity Guidelines for Americans' from the US Department of Health and Human Services didn't significantly improve between 2007 and 2016 but time spent sitting increased.

Children from disadvantaged backgrounds do less vigorous physical activity
Children from disadvantaged backgrounds and certain ethnic minority backgrounds, including from Pakistani and Bangladeshi backgrounds, have lower levels of vigorous physical activity, according to researchers at the University of Cambridge.

Read More: Physical Activity News and Physical Activity Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.