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Corneel Vandelanotte, Are Simultaneously Delivered Health Behavior Change Interventions the Way of the Future?: a Comment on King et al., Annals of Behavioral Medicine, Volume 46, Issue 2, October 2013, Pages 133–134, https://doi.org/10.1007/s12160-013-9511-9
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Non-communicable chronic diseases are associated with a small number of modifiable health risk behaviors, such as diet, tobacco use, physical activity, and alcohol consumption [1]. Unfortunately, the prevalence of these health risk behaviors is high and they tend to occur in clusters [2]. As such, the evaluation of population-based interventions that can influence multiple health behaviors to reduce the burden of chronic disease and health care costs seem to make good (economic) sense [3]. The scarcity of studies evaluating such interventions is therefore surprising, and many questions on how such interventions are best delivered remain unanswered. For example, it is unknown how many health behaviors can be targeted effectively in a single intervention without “overloading” participants [4]. Similarly, it is unclear whether such interventions are best to be implemented sequentially (one behavior after another) or simultaneously (all at once) [5].
In this respect, King et al. [6] have conducted a timely and interesting study. The study focused on two health behaviors (diet and physical activity) with four intervention groups: a sequential exercise-first group, a sequential diet-first group, a simultaneous group, and a control group. The time interval between sequential interventions was 4 months. At the end of the 12-month intervention, the results showed that the behaviors targeted first in the sequential interventions had changed more than the behaviors targeted secondly. However, in the simultaneous intervention both behaviors had changed equally with a magnitude close to that of the first behavior in the sequential interventions. The authors conclude that delivering physical activity interventions simultaneously may result in the most positive sustained outcomes across two health behaviors.
