Informed decision making: an annotated bibliography and systematic review

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Content: Health Technology Assessment 1999; Vol. 3: No. 1 Review
Informed decision making: an annotated bibliography and systematic review
H Bekker JG Thornton CM Airey JB Connelly J Hewison MB Robinson
J Lilleyman M MacIntosh AJ Maule S Michie AD Pearman
Health Technology Assessment NHS R&D HTA Programme
HTA
Standing Group on Health Technology
Current members Chair: Professor Sir Miles Irving, Professor of Surgery, University of Manchester, Hope Hospital, Salford Professor Martin Buxton, Professor of Economics, Brunel University Professor Francis Creed, School of Psychiatry & Behaviour Sciences, University of Manchester Professor Charles Florey, Department of Epidemiology & Public Health, Ninewells Hospital & Medical School, University of Dundee
Professor John Gabbay, Director, Wessex Institute for Health Research & Development Professor Sir John Grimley Evans, Department of Geriatric Medicine, Radcliffe Infirmary, Oxford Dr Tony Hope, The Medical School, University of Oxford Professor Richard Lilford, Regional Director, R&D, West Midlands Dr Jeremy Metters, Deputy Chief Medical Officer, Department of Health
Professor Maggie Pearson, Regional Director of R&D, NHS Executive North West Mr Hugh Ross, Chief Executive, The United Bristol Healthcare NHS Trust Professor Trevor Sheldon, Director, NHS Centre for Reviews & Dissemination, University of York Professor Mike Smith, Director, The Research School of Medicine, University of Leeds Dr John Tripp, Department of Child Health, Royal Devon & Exeter Healthcare NHS Trust
Professor Tom Walley, Department of Pharmacological Therapeutics, University of Liverpool Dr Julie Woodin, Chief Executive, Nottingham Health Authority Professor Kent Woods (Chair Designate), Regional Director of R&D, NHS Executive Trent
Past members Dr Sheila Adam, Department of Health Professor Angela Coulter, Director, King's Fund, London Professor Anthony Culyer, Deputy Vice-Chancellor, University of York Dr Peter Doyle, Executive Director, Zeneca Ltd, ACOST Committee on Medical Research & Health Professor John Farndon, Professor of Surgery, University of Bristol
Professor Howard Glennester, Professor of Social Science & Administration, London School of Economics & Political Science Mr John H James, Chief Executive, Kensington, Chelsea & Westminster Health Authority Professor Michael Maisey, Professor of Radiological Sciences, Guy's, King's & St Thomas's School of Medicine & Dentistry, London
Mrs Gloria Oates, Chief Executive, Oldham NHS Trust Dr George Poste, Chief Science & Technology Officer, SmithKline Beecham Professor Michael Rawlins, Wolfson Unit of Clinical Pharmacology, University of Newcastleupon-Tyne Professor Martin Roland, Professor of General Practice, University of Manchester
Professor Ian Russell, Department of Health Sciences & Clinical Evaluation, University of York Dr Charles Swan, Consultant Gastroenterologist, North Staffordshire Royal Infirmary
Details of the membership of the HTA panels, the NCCHTA Advisory Group and the HTA Commissioning Board are given at the end of this report.
HTA
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Informed decision making: an annotated bibliography and systematic review
H Bekker1 JG Thornton2 CM Airey3 JB Connelly3 J Hewison1 MB Robinson3
J Lilleyman2 M MacIntosh2 AJ Maule4 S Michie5 AD Pearman4
1 School of Psychology, University of Leeds, UK 2 Centre for Reproduction Growth and Development, University of Leeds, UK 3 Nuffield Institute, University of Leeds, UK 4 Business School, University of Leeds, UK 5 Psychology and Genetics Research Group, UMDS, London, UK
Published February 1999 This report should be referenced as follows: Bekker H,Thornton JG,Airey CM, Connelly JB, Hewison J, Robinson MB, et al. Informed decision making: an annotated bibliography and systematic review. Health Technol Assess 1999;3(1). Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA web site (see overleaf).
NHS R&D HTA Programme
T he overall aim of the NHS R&D Health Technology Assessment (HTA) programme is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and work in the NHS. Research is undertaken in those areas where the evidence will lead to the greatest benefits to patients, either through improved patient outcomes or the most efficient use of NHS resources. The Standing Group on Health Technology advises on national priorities for health technology assessment. Six advisory panels assist the Standing Group in identifying and prioritising projects. These priorities are then considered by the HTA Commissioning Board supported by the National Coordinating Centre for HTA (NCCHTA). This report is one of a series covering acute care, diagnostics and imaging, methodology, pharmaceuticals, population screening, and primary and community care. It was identified as a priority by the Screening Panel and funded as project number 94/27/03. The views expressed in this publication are those of the authors and not necessarily those of the Standing Group, the Commissioning Board, the Panel members or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for the recommendations for policy contained herein. In particular, policy options in the area of screening will be considered by the National Screening Committee. This Committee, chaired by the Chief Medical Officer, will take into account the views expressed here, further available evidence and other relevant considerations. Reviews in Health Technology Assessment are termed `systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others.
Series Editors:
Andrew Stevens, Ruairidh Milne and Ken Stein
Editorial Assistant: Melanie Corris
The editors have tried to ensure the accuracy of this report but cannot accept responsibility for any errors or omissions. They would like to thank the referees for their constructive comments on the draft document.
ISSN 1366-5278 © Crown copyright 1999 Enquiries relating to copyright should be addressed to the NCCHTA (see address given below). Published by Core Research, Alton, on behalf of the NCCHTA. Printed on acid-free paper in the UK by The Basingstoke Press, Basingstoke. Copies of this report can be obtained from: The National Coordinating Centre for Health Technology Assessment, Mailpoint 728, Boldrewood, University of Southampton, Southampton, SO16 7PX, UK. Fax: +44 (0) 1703 595 639 Email: [email protected] http://www.soton.ac.uk/~hta
Health Technology Assessment 1999; Vol. 3: No. 1
Contents
List of abbreviations .................................... i Executive summary .................................... iii 1 Introduction .................................................. 1 Factors associated with informed decision making .............................................. 1 Measures of informed decision making ........ 2 Decision-making theory ................................. 2 Aims of review ................................................. 3 2 Methods ......................................................... 5 Search strategy ................................................ 5 Inclusion criteria ............................................ 5 Data extraction ............................................... 6 Data synthesis ................................................. 8 3 Results ............................................................ 11 Summaries of extracted information by study ............................................................ 11 Summary by frequency tables ........................ 11 Summary by study number listings ............... 14 Synthesising findings ..................................... 14 4 Discussion ...................................................... 29 Evaluating the methods ................................. 29 Overview of results ......................................... 29 Suggested applications of the review ............ 31 Recommendations for research .................... 32
References .................................................... 33 Appendix 1 References used to develop the search strategy ......................................... 35 Appendix 2 The principle of the search strategy ................................................ 37 Appendix 3 MEDLINE search strategy ....... 39 Appendix 4 Data extraction coding forms .. 41 Appendix 5 Bibliography: studies by study number ................................................. 43 Appendix 6 Bibliography: studies by author ......................................................... 67 Appendix 7 Decision details by study design (grouped by health area) .................. 81 Appendix 8 Intervention details by study design (grouped by health area in same order as appendix 7) ............................ 125 Health Technology Assessment reports published to date .......................................... 151 Health Technology Assessment panel membership ....................................... 153
Health Technology Assessment 1999; Vol. 3: No. 1
List of abbreviations
AA ACS A&E BPH BSE CF CPR CVD FOB GP HBM HCP HIV HRT RCT SLT STD TB TRA VI WI
Alcoholics Anonymous* American Cancer Society* accident and emergency benign prostatic hypertrophy breast self examination* cystic fibrosis* cardiopulmonary resuscitation* cardiovascular disease* faecal occult blood* general practitioner* Health Belief Model* healthcare professional human immunodeficiency virus hormone replacement therapy* randomised controlled trial (In this study a, b and c are used to denote RCTs with a low risk of bias, an unknown risk of bias, and a high risk of bias, respectively.) social learning theory sexually transmitted disease tuberculosis theory of reasoned action verbal information written information
* Used only in appendices
i
Health Technology Assessment 1999; Vol. 3: No. 1
Executive summary
Background
professionals making decisions about another individual's care, and articles not published in
Everyone makes decisions about their health, and
English were excluded.
many healthcare interventions aim to encourage
this. An informed decision is one where a reasoned Data extraction
choice is made by a reasonable individual using
This was performed using coding forms by a
relevant information about the advantages and
member of the project group and checked by a
disadvantages of all the possible courses of action, team member, with disagreements resolved by
in accord with the individual's beliefs.
discussion. Abstracts were assessed and the articles
retrieved if the review criteria were met. Final
inclusion decisions were made by the first author
Objectives
of this report and verified by another member of the project group.
· To provide an unbiased bibliography of
controlled studies evaluating interventions that
Articles were classified by study quality according to
may affect informed patient decision making.
the hierarchy of evidence, underlying theory, the
· To classify studies by research design, decision-
domain of health care, and the health decision.
making theory, type of intervention and
The comparison groups, other factors associated
health setting.
with the decision-making process, reported
· To describe the measures of informed patient
measures, and a summary of the findings were
decision making and other outcomes reported.
recorded.
· To identify under-reported areas and direct
future research.
Data synthesis
Descriptive summaries and qualitative analysis were
performed. The health domains and decisions were
Methods
too diverse for meaningful quantitative metaanalysis.
Data sources
The electronic databases MEDLINE, BIDS (social
science), and PsycLIT were searched for 1991­96. The journals Medical Decision Making, Patient
Results
Education and Counseling, and Preventive Medicine
Following handsearching and abstract evaluation
were handsearched for 1986­96.
825 articles were distributed to the project group
members and 547 were subsequently included
Inclusion criteria
within the bibliography.
Studies were included if they reported the results
of a controlled study of any intervention using real Study quality
patients making a health decision. Specifically, ran- There were 336 RCTs, 114 non-randomised
domised controlled trials (RCTs), non-randomised concurrent studies, 34 historical, and 63 `before
concurrent studies, historical studies, and same
and after' same-sample studies. Only 51 of the
subject `before and after' studies were included.
RCTs were classified as having a low risk of bias.
Health decisions were defined to include any re-
A total of 267 studies claimed to have approached
ported health behaviour change as well as explicit a representative sample of participants, but only
decisions. Interventions were defined broadly to
243 reported the number invited to take part.
include any that could reasonably be expected to
Few studies provided adequate descriptions of
affect informed decision making, such as changes
the intervention materials.
in information provision, cost, or service provision.
Patients were defined as any individual making a
Theoretical context
decision about health care. Experimental studies
A total of 206 studies referred to an underlying
on healthy student volunteers, studies of health
theory. Of these, 101 referred to theories explain-
iii
Executive summary
ing decision making such as expected utility theory, prospect theory or social cognition models. Health domain and the decision A total of 251 studies were in general medicine, 114 cancer, 108 genitourinary medicine, 61 primary care, 31 paediatrics; 15 mental health, 10 dentistry, 11 surgery, seven genetics, and 31 obstetrics and gynaecology, and midwifery. The decision was classified as a life-style change in 357 studies, a screening decision in 114, a treatment decision in 107, a decision to participate in the consultation in 51, and as another type of decision in 26 studies. Interventions A total of 301 interventions were of information provision itself, 273 varied the delivery of information, 208 provided patient feedback, 94 manipulated information in some other way, 55 prompted active patient participation, and 89 of another intervention altogether. Decision-making factors A total of 512 studies assessed actual rather than hypothetical decisions, 476 involved decisions affecting the participant rather than a third party and in 525 studies the decision was made without time pressure. Only 26 studies explicitly made patients aware of their involvement in the decision-making process. Measures assessed Demographic details were recorded in 515 studies, knowledge in 181, decision-making measures in 169, measures of affect in 69, satisfaction in 60, self-efficacy in 75, personality trait in 20 and other variables in 111 studies. Summary result Only five studies were theory driven, assessed measures associated with informed decision making, and used a low risk of bias design. Although of disparate design these five studies suggest that information and education are relatively ineffective ways of facilitating informed decision making, compared with the context and social influences. Studies reporting manipulation of information, and provision of feedback, were the most likely to report an effect.
Conclusions There is a paucity of well-designed, theoretically driven and adequately operationalised research assessing informed patient decision making. Given the small number of high-quality studies and the relatively slow increase in research in this area there is no need for the NHS to revisit this topic as a review for 5 years. Resources should be concentrated on better primary research. Recommendations for research Future primary research should work under an explicit theory of decision making, record process measures to permit evaluation of whether the decision was informed, and if evaluating experimental interventions use randomised trials with a low risk of bias. A booklet describing the main decision-making theories, and an inventory of suitable outcome measures could be developed to help clinical researchers design appropriate studies. Complementary systematic reviews would be valuable. · The effect of interventions on patient preferences. (At least 50 trials were excluded from the present bibliography because no behaviour change was recorded.) · Observational studies of real patient decision making. Studies using tape-recorded consultations, verbal thinking aloud protocols, and other written or computer-based processtracing methods will predominate. · Assessing the effect of additional information, manipulation of information, provision of feedback, and group delivery of information on informed patient decision making. Primary research is a priority in areas such as genetics, prenatal diagnosis and where decisions are often made by proxy, such as paediatrics and mental health. Primary research is required to evaluate the following types of interventions: · decision aids, such as graphical and computerbased devices · information manipulation, such as decision analysis, prompts, and feedback.
iv
Health Technology Assessment 1999; Vol. 3: No. 1
Chapter 1 Introduction
E veryone makes decisions about their health care, such as whether to brush their teeth,
Decision context The following features of the health decision
smoke, or take headache pills, and some have to
suggest that different psychological evaluations are
make difficult decisions, such as whether to under- required, which may alter the extent to which an
go a prenatal diagnosis test, or choosing between
individual makes an informed decision.
chemotherapy or surgery for cancer. Generally
people want to make these decisions for themselves · Type of health decision, for example, smoking
and to be given the information required to make
or drinking alcohol; attending a physician
them wisely. Many healthcare interventions aim to
appointment; adhering to medication; having
encourage this.
a Diagnostic Test; participating in choice
of treatment.
However, there is no agreed definition of an
· Seriousness of the outcome, for example,
informed decision because it depends on the
choosing to take a headache pill, deciding
theoretical predisposition of the researcher. For
whether to donate an organ or not.
some an informed decision is one where the final
· Familiarity with the decision, for example,
choice accords with an underlying theory, such as
deciding whether or not to exercise is more
expected utility theory. For others it is the process
commonly experienced by people than deciding
that matters, and whether this follows a particular
whether or not to have a genetic test.
theory, that defines an informed decision. The two · Level of certainty, for example, declining
approaches cannot easily be reconciled, and the
insulin always makes diabetic people ill, whereas
following is a compromise definition: an informed
declining prenatal screening only carries a risk
decision is one where a reasoned choice is made by
of giving birth to a Down's syndrome child.
a reasonable individual, using relevant information · Health domain, for example, making choices
about the advantages and disadvantages of all the
in medicine, in surgery or in primary care.
possible courses of action, in accord with the
· Recipient, for example, deciding for yourself
individual's beliefs. In practice individuals rarely
or for your child.
make decisions this way. They have a limited processing capacity and overcome these by using
Decision maker
modes of thinking and reasoning that simplify the People vary in their preferred degree of involve-
issues. These heuristic modes of thinking deter-
ment in health decisions.1 Some want all possible
mine which aspects are attended to and how they
information whereas others are happy to rely on a
are interpreted.
physician's recommendation or a more intuitive,
`gut reaction'. Personality traits, need for control,
Several models and theories have been developed
beliefs about the doctor­patient role, current state
to explain how individuals make decisions and
of health or illness, and the degree of anxiety or
how decision making may be facilitated. Some
depression and an individual's ability to understand
of the factors that affect an individual's ability
health information vary widely.2 It is likely that
to make an informed decision and theories
these individual differences will affect the degree
of decision making are discussed in more
to which informed decisions are made.
detail below.
Other influences
Individuals are often unable to deal systematically
Factors associated with informed decision making
with large amounts of information, and employ heuristics to reduce the processing required. These often result in decisions being made from the
The factors associated with an individual's ability to context rather than the content of the information.
make an informed health decision can be grouped Decisions may change when the same factual
into those pertaining to a) the decision context, b) information is presented in slightly different ways,
the decision maker, and c) other influences. Only
for example, by framing the information either
the last are directly alterable.
positively or negatively, expressing figures as
1
Introduction
percentages, risk, inverse risk, or verbally.3,4 The
For example, moderately raised anxiety is
context also affects whether a reasoned decision is
associated with a more systematic evaluation
made. For example, individuals under time pres-
of the information but great anxiety is associ-
sure or experiencing extreme affect (e.g. frighten-
ated with the application of heuristics.5 Equally
ed or angry), are more likely to use an heuristic,
an individual is as likely to be satisfied with
whereas those who perceive a need to justify the
health care if the decision was made following
decision outcome or who are only moderately
a health professional's recommendation or
anxious are more likely to use all the information.
after an in-depth evaluation of all the
available information.
Decision aids such as memory prompts, repeating
information, reducing the quantity or improving
Most of these measures focus on the outcomes
the clarity of information, and presenting inform-
following the making of the health decision. It is
ation in different mediums may also affect decision likely that the effects of memory and the need to
making. It is likely that extra relevant prompt
continue with the same healthcare team will affect
information will reduce the cognitive load and
their validity. Equally, few of these measures evalu-
promote informed decision making. However, too ate the decision-making process, that is, the type
much information may make people rely on an
and way information was used by the individual
established heuristic and lead to worse decisions.
when making the decision. It is also necessary to
ensure that the final decision was based on an
Finally, extraneous factors such as charging for
unbiased evaluation of all the available information
a service, the availability of transport, the shape
including the risks and alternatives. A number of
of an inhaler or the presence of a no-smoking
process-tracing techniques are available. These
policy will alter an individual's evaluation of the
include: verbal protocols; analysis of tape-recorded
available information.
consultations following the application of a
technique like content analysis to the transcripts;
and the use of information boards or computer
Measures of informed
programmes to track the information used.
decision making
Perhaps because of these issues of measurement,
The most frequently used measures of informed
little is known about the impact of encouraging
decision making and their limitations are
informed decision making on the individual. There
discussed below.
is some evidence to suggest that too much
evaluation of the available information leads to
· Noting the health behaviour indicates a decision reduced post-decision satisfaction.6 However, the
was made but no more than this.
application of heuristics is more likely to lead to
· Knowledge assesses the individual's ability to
poorer outcomes than adequately surveying all the
recall information. Although, better-informed
alternatives.7 Such conflicts can be resolved only in
decision makers probably recall more, this does the light of an underlying theory.
not mean the information was used.
· Utilities measure individual's values or attitudes
towards the choices available rather than the decision outcome. Proponents of expected
Decision-making theory
utility theory argue that a good decision is
There are three broad types of decision-making
one consistent with the choice derived from an
theory.8 The first, normative theory describes
equation that integrates an individual's values
what people ought to do if they wish to be rational
for each outcome with the likelihood of the
decision makers. These axiomatic theories are
outcome occurring. As an informed decision
based on mathematical and statistical proofs.9
should accord with a patient's attitudes, it is
The most important, classical decision theory,
likely that an informed decision will be consist-
assumes that people are perfectly informed, and
ent with a decision derived from expected
are familiar with all the alternatives that are
utility theory. However, deciding in accord
available to them, as well as their beliefs and
with personal utilities is not sufficient for a
preferences associated with these alternatives.
decision to be classified as informed.
The rational or best course of action is the one
· Affect measures anxiety, satisfaction and regret, that maximises expected utility.7
which are often reported. Although reduced
affect may be desirable it is not necessarily
2
associated with informed decision making.
Descriptive theories, in contrast, describe how people actually make decisions.10 At least since
Health Technology Assessment 1999; Vol. 3: No. 1
the early 1950s it has been clear that people
accuracy/quality of the decision.13 Many factors,
rarely do this in accord with normative theories.11
such as fatigue, time pressure, stress and other
Simon suggested that because of their limited
emotional states, and lack of engagement with the
processing capacity, or bounded rationality,
problem, induce the use of simpler sub-optimal
individuals adopted more simplistic modes of
strategies.5,20,21 Similarly the school of naturalistic
thinking that are generally good, but can lead
decision making has shown that people make
to poor decision making.12,13
decisions in very different ways when they have
expertise and experience to draw on.23
The third type of decision-making theory,
prescriptive theory, recognises that human beings Not surprisingly such theories have given rise to
can be poor decision makers and is concerned with many different ways to improve decision making.
the development of decision aids to help them.14
One approach has involved specifying a structured
Early approaches were based on a modified norm- sequence of activities similar to those specified by
ative theory, taking into consideration evidence
normative theories, for example, decision analysis
from how people actually make decisions unaided. and the use of decision trees for risky decisions, or
For example, social cognition models15 and
Analytical Hierarchy Process for riskless ones.14,24
prospect theory4 maintain that an individual's
A second approach, scenario planning25 has
behaviour is logically related to their values and
been developed for strategic decisions involving
beliefs. However, by describing the underlying
outcomes that occur only in the medium-to-long
cognitive processes such as attitudes, biases or
term, and which cannot be ascribed probabilities.
schemas, they permit the development of more
This involves developing positive and negative
effective decision aids.
scenarios that describe how the future could
unfold, and choosing the action that is best,
An understanding of informed decision making in regardless of which does occur. A third approach
patients depends, in part, on knowing how patients involves training people to reason more effectively
currently make decisions (descriptive theory) and
such that they follow rules based on formal
how they can be assisted to make better decisions
models from statistics, logic and probability
(prescriptive theory). There are many descriptive
theory.26 All such approaches recognise that
theories relevant to this issue. One concerns the
different types of decision require different
simplistic modes of thinking (heuristics) used when types of prescriptive solution.27
judging risk and uncertainty,7,12,16 which can lead to
misperceptions of risk and poor decisions. Similarly Taken together, this body of theory provides a rich
framing, the way a problem is presented, for
source of information for judging patient decision
example, emphasising gains rather than losses,
making, and the development of evidence-based
affects risk-taking propensity (preference for a safe medicine has provided the impetus for a critical
over an equivalent risky option).4,17 Another sub-
evaluation of decision aids. Interventions aimed at
optimal way in which people tend to gather and
supporting patient decision making should be
interpret information is illustrated by the confirm- developed in the context of these bodies of theory,
ation bias, involving the selective processing of
and a primary function of this review is to assess
information that confirms initial expectations.7
the extent to which the published literature on
Both professionals and the lay-population are
informed decision making in patients achieves
subject to these simplistic modes of thinking.18,19
this. In addition, this body of knowledge provides
a base for evaluating the existing research on
People's commitments to different courses of
informed decision making, and to determine
action are affected by the procedure used to
whether the implicit and explicit models of
establish their preferences. They often judge one
decision making underlying this research are
alternative as more attractive but select another
coherent and appropriate.
when asked to choose between them.16 This
suggests that preferences are not necessarily a
good guide to final choices, and challenges the view that people have stable preferences for
Aims of review
decision outcomes.
The aim is to provide a comprehensive, annotated
bibliography of controlled studies of interventions
People adopt a range of different underlying
that might plausibly inform patient healthcare
information processing strategies for different
decision making. Studies have been classified by
problems, with each strategy differentiated in
the hierarchy of evidence and by theoretical con-
terms of the mental effort required and the
text. Information about the type of intervention,
3
Introduction
health setting, measures reported and main research findings are recorded. The bibliography provides a summary of the evidence describing patient decision making, factors associated with decision making, evaluated interventions and theory-driven research. Such a review will enable identification of under-reported areas and aim to provide answers to the following questions.
· Can decision making be facilitated? · Do people who have more information make better decisions? · Does the way in which we present information change the effectiveness of the decision? · Does the context affect decision making? · Does the effectiveness of information on decision making vary by medical setting?
4
Health Technology Assessment 1999; Vol. 3: No. 1
Chapter 2 Methods
Search strategy Studies considered for inclusion within the systematic review were first identified from abstracts generated from one of two sources: electronic databases and handsearches of complete sets of journals. Articles were retrieved if the review criteria were met or the abstract contained insufficient information to assess the review criteria.
Handsearching Three journals were selected for handsearching because of their relevance to the healthcare users decision making area: Medical Decision Making, Patient Education and Counseling, and Preventive Medicine. In the handsearch, every abstract within every volume was read and considered for inclusion. All volumes were handsearched for the years 1986­96 inclusive.
Electronic databases Over 6 months a search strategy was developed for
Inclusion criteria
the electronic databases MEDLINE, PsycLIT, and
The review inclusion criteria were developed
BIDS (social science). A pilot strategy had been
over 4 months, during which over 300 abstracts
developed for inclusion within the initial protocol downloaded from the pilot MEDLINE and PsycLIT
from a set of keywords chosen by the project group. search strategies were circulated to all project
Additional keywords were included within the
group members. At monthly meetings, each group
strategy derived from: 17 articles considered
member fed back the inclusion or exclusion status
relevant to the field of informed patient decision
of each abstract. When members disagreed a
making (appendix 1); and 100 articles considered discussion took place until a set of working rules
for inclusion within the review following appli-
was developed. At the end of this development
cation of the pilot strategy to MEDLINE and hand- phase, agreement between group members on
searching of the journal Medical Decision Making.
the inclusion and exclusion criteria was reached.
The keywords of the final strategy were modified
Nevertheless, in this area there are no pre-defined
and expanded within each of the electronic
or obvious boundaries to be used for selection
databases by the research officer experienced
criteria, and some of the cut-off categories may
in electronic searches and systematic reviews
appear arbitrary. For inclusion, each study published
(appendix 2). The final strategy included terms
within an article had to fulfil the following criteria.
from three categories: decision making field or
healthcare users and comparative study designs
· Study participants must be patients. A patient
(appendix 3).
was defined as any individual making a health
decision. Studies using university student
The sensitivity of the search strategy was
participants were excluded. Studies assessing
evaluated by comparing the number of articles
health professional decision making about
identified by handsearching a second journal,
another individual's care were excluded.
Patient Education and Counseling. The pilot strategy
identified 7% of articles considered for inclusion
· A study must report a behavioural measure
while the final strategy identified 62%. This
of the health decision made. This measure
sensitivity figure was considered satisfactory as
of reported or observed behaviour assesses
electronic searches identify between 17­82%
decision making, a more inclusive category than
of relevant articles.28 However, these efforts to
informed decisions. This broad health behaviour
increase sensitivity resulted in significantly
outcome measure incorporates many decisions
reducing the specificity of the final strategy,
including: smoking; adherence to medication;
as 17,860 abstracts were generated for the
attendance for screening; and choices between
years 1991­96 alone. Consequently, the appli-
treatments like chemotherapy or surgery. The
cation of the strategy was limited to articles
issue of whether to include such lifestyle
published between these years to ensure
decisions was debated extensively by the group.
completion of a review considering the
Some members considered these to be often
resources available.
affected more by other factors than the inform-
5
Methods
ation and decision process itself; others argued that this is only a qualitative difference from
Data extraction
other health decisions and an arbitrary line
To ensure consistent information was extracted from
would have to be drawn if they were to be ex-
each study of each article, a data extraction sheet or
cluded. We decided to include such studies. The coding form was developed over a 6-month period
health behaviour included real, in the sense that (appendix 4). The categories within the coding
an event happened, intended or hypothetical
form were informed with reference to the decision
outcomes. Studies were excluded if the health
making and integration of research literature, and
behaviour measure assessed the effectiveness of a the expertise of members of the project group. Each
pharmacological treatment such as one compar- draft coding frame was piloted on articles derived
ing the effects of placebo gum with nicotine gum from the search strategies and modifications agreed
on smoking cessation. Additionally, studies that within the group monthly meetings. Following
did not assess actual or reported behaviour were piloting, several categories were simplified or omit-
excluded, such as those that only reported bio-
ted because it proved impossible to achieve consist-
physiological measures, knowledge, satisfaction, ency between articles, as the information published
preferences or utilities, and changes in affect.
was not described or presented in a format
compatible with the review's research question.
· A study must assess an experimental
intervention. The definition of an experimental There follows a brief explanation of the inform-
study was interpreted broadly to include any
ation extracted from each article.
design that evaluated an experimental group
with a comparison group. Studies with one of six Study identification number
designs were included: randomised controlled
Each study was allocated a unique number. If more
trial (RCT) with a low risk of bias (RCTa); RCT
than one study was reported in one article, each
with an unknown risk of bias (RCTb); RCT with study was given a separate identification number
a high risk of bias (RCTc); non-randomised
and coding form. If a study was published more
concurrent; historical studies or `before and
than once in different articles, this too was treated
after' intervention with different samples; and,
as a separate study.
`before and after' intervention with the same
sample. Studies assessing predictors of a behavi- Location of research
our such as factors associated with breast screen- This meant the country where the study
ing attendance, were excluded. The definition
was undertaken.
of an intervention was broad to incorporate the
many factors that may alter decision making:
Domain of health care
offering additional information; framing figures The area of health in which the decision was made
in different ways; patient use of a decision aid;
was recorded. Responses within this free-text box
comparison of information mediums; offers of
were later categorised into 11 medical domains:
free transportation; introduction of fluoride
dentistry; cancer; general medicine and infectious
to water supplies; and so on.
diseases; HIV and sexually transmitted diseases
(STDs); mental health; paediatrics; genetics;
· The study must be published in English.
obstetrics and gynaecology, and midwifery; surgery
and accident and emergency (A&E); primary care;
All abstracts generated from the search strategies
other (alternative medicine, marital counselling).
were assessed for inclusion by the first author of
this report. Articles were retrieved if the review
Participants
criteria were met or the abstract contained
The person making the health decision whom may
insufficient information. Batches of ten articles
or may not receive the health care was recorded.
were sent in rotation to each member of the project
group. The inclusion criteria were again assessed by Age groups
that member of the project group and, if included, Participants were classified as child, adult, or
a data extraction coding form was completed for
elderly by the reviewer.
each study of each article. Completed forms were
returned to the first author of this report and
Health status
checked. Classification disagreements were
Participants were classified by the reviewer as well,
resolved by discussion. All review details and
physically impaired, or mentally impaired by the
extracted information were entered into the
reviewer. For example, participants attending for:
6
project electronic database.
health promotion programmes were classified as
Health Technology Assessment 1999; Vol. 3: No. 1
`well'; athletes foot, cancer follow-up, and surgery were classified as `physically impaired'; depression, anxiety, and schizophrenia were classified as `mentally impaired'. If the decision maker was a spouse or relative, the health status recorded was that of the person making the decision not the recipient of the decision. So, the decision maker carer of a person with Alzheimer's disease was classified as `well'. Decision associated factor 1 Decisions were classified as real, hypothetical or intended. Real decisions were those health actions carried out by the participant such as attending for mammography or using an inhaler. Hypothetical and intended decisions were later combined and included decisions made based on an option becoming available in the future, a vignette based on imaginary decisions and intentions about future behaviours. For example, a non-pregnant woman making a decision to have a test for Down's syndrome in a future pregnancy, or an individual intending to use a condom during the next sexual encounter.
· to use a health service · to make a lifestyle change · to attend for testing (screening and diagnostic) · to adhere to treatment regimens · to actively participate within the consultation (e.g. question asking and research) · other (e.g. organ donation and willingness to pay). Theoretical context This noted the authors' references to a theoretical framework that informed the study design or intervention. Any type of theory alluded to was noted in the free-text box and subsequently classified into one of the following four categories: · no theory · explanation decision-making theory (social cognition models, prospect theory and expected utility theory) · health-promotion theories (social learning theory and skill acquisition theories) · other psychological models (illness representation, attribution theory and stress coping models).
Decision associated factor 2
The project group did not assess the adequacy of
Decisions were classified as implicit or explicit
the operationalisation of theories nor infer whether
according to whether the researchers and decision the research was theory driven if the authors did
makers were aware that they were making a
not explicitly mention a theory.
health decision.
Measures described
Decision associated factor 3
This table was used to record any measure
Studies were classified into those where the
described within the published paper other than
decision maker was the recipient of the decision
the health behaviour outcome measure. As noted
outcome or those where the recipient was a third
in the introduction, several measures have been
party. For example, a decision to be immunised
used to assess informed patient decision making,
compared with having a child immunised. Some
and others are associated with the process of
decisions were more difficult to classify and minor decision making. A free-text box was used to list all
rules were established: decisions made by pregnant the measures the authors described. Before
women were classified as participant even though
piloting, the project group aimed to note the type
decisions about amniocentesis and termination
of analysis associated with each measure. However,
would impact on a foetus; and use of condoms was little consistency was achieved across papers in the
said to affect both the participant and other.
type of measures used and the reporting of results.
Subsequently, only the description of the type of
Decision associated factor 4
measures referred to was classified and grouped
Studies were classified into those where the
as follows:
decision was time restrained, made at the same
time as the intervention, and those that were not
· demographic variables: age, sex, level of
time restrained, made some while after the
education, social class, marital status, religion
intervention. The important difference being
· personal history: sexual orientation, medical
whether the participant was given the opportunity
history, law infringements, health insurance,
to reflect on, and change, the decision.
reproductive history, physiological assessment
· decision-making process measures: attitudes,
Health decision
utilities, reasons, preferences, variables
A free-text box was provided to write the type of
of operationalised models, perception of
health decision made. These decision types were
risk, perception of severity, autonomy,
then classified into one of six decision categories:
intention, motivation
7
Methods
· efficacy: efficacy and self-efficacy
· `before and after' studies with same sample
· knowledge measures
(e.g. assessed cessation smoking before and
· satisfaction: usefulness of information,
after a workplace intervention).
satisfaction with information
· affect: anxiety, depression, regret, worry
Quality of the study 2
· personality factors: need for cognition, need
This assessed the level of intervention. Studies
for cognitive closure, locus of control
were classified into those where the unit of inter-
· other variables: perception of well being,
vention was the individual patient, and those
perception of disability, social support,
where some other unit of allocation such as
alienation, memory, willingness to pay.
hospitals, communities, or patients allocated
by health professional.
Intervention groups
This table provided a description of the main
Quality of the study 3
components of each group assessed within the
Where possible, details of the sample approached
experimental intervention. It was assumed that a
were recorded in order to collect details on the
routine health encounter would include the
representativeness of the sample. First, whether
provision of verbal information by a health
the sample invited to participate included: all avail-
professional to a patient. Any variation from this
able participants; a systematic sample; a volunteer
norm was noted in the free-text box. For example, or convenience sample; or, not adequately
comparison group: routine care; Group 1: routine described. Second, the actual number of partic-
care plus leaflet; Group 2: routine care plus leaflet ipants was recorded: those who were invited to
plus free test. The main components were subse-
participate, those who participated, and those who
quently categorised within the following groups:
were included within the final analysis. The latter
was often difficult to extract from the published
· additional information (leaflet, video,
information.
computer, posters)
· group-delivery information (media, classroom
Quality of the study 4
based, group counselling)
A free-text box was provided for reviewers to
· information manipulation (framing,
highlight additional causes for concern, such
directiveness, more/less information)
as inappropriate use of statistics, confounds
· patient-prompted information (decision
between group allocation, and so on. However,
aid, memory prompt, pre-consultation
as there was so much diversity between the types
rehearsal questions)
of study designs and application of analyses, the
· service change (additional contact by health
comments within this box became meaningless,
professional, free service)
and it was subsequently omitted from the
· environmental change (introduction of
final bibliography.
no-smoking policy, shops altering food displays)
· other (incentives, alternative treatment offered). Quality of the study 5
Within the area of informed patient decision
Quality of the study 1
making, the issue of the readability and accessibility
Study designs were classified according to the
of intervention materials is of particular import-
hierarchy of evidence (Cochrane handbook)
ance when aiming to explain variations in
as follows:
understanding. In an attempt to describe the
quality of intervention materials a category was
· RCTa (e.g. randomisation from serially
created to document whether or not the inter-
numbered, opaque sealed envelopes, third party vention materials had been piloted or evaluated
or computer; low risk of bias)
for readability. Unfortunately the information
· RCTb (e.g. unclear how randomised; unknown
pertaining to this extraction was inconsistently
risk of bias)
reported, if mentioned at all, and was omitted
· RCTc (e.g. tossed coins or approached patients
from the final coding of articles.
on alternate days; high risk of bias)
· non-randomised concurrent (e.g. intervention
community compared with comparative community)
Data synthesis
· non-randomised historic (e.g. assessed uptake
Four new variables were calculated to encourage
of cervical screening before and after
integration of the research findings with the
8
remuneration of doctors)
review objectives.
Health Technology Assessment 1999; Vol. 3: No. 1
· The theoretical context variable combined information on reference to a theory-driven study with reference to a decision-making measure. Four classifications were created: theory and decision-making measure; theory only; decision-making measure only; neither theory nor decision-making measure. · The summary of reported effects variable was a crude record of whether the authors reported an effect size between the intervention and health behaviour outcome measure: effect reported; no effect reported; mixed effects reported (e.g. different interventions did not show differential effects but an effect over time or some behaviour changes showed an effect and others did not). · The single variable for health domain was created to maximise the efficiency of subsequent chi-square analysis. A few studies classified as being associated with more than one area of health were modified to force this information into one mutually exclusive category. · The single variable for health decision was created to maximise the efficiency of subsequent chi-square analysis. A few studies classified as being associated with more than one type of decision were modified to force this information into one mutually exclusive category. First, the results were presented as descriptive summaries and listings of articles by study number,
grouped by health domain, decision and theoretical context. Second, the review identified five studies that were described as `good' studies because they fulfilled the following criteria: design reported as RCTa; referred to a theory when designing the study or intervention; and assessed at least one decision-making measure. The findings of these studies are discussed in detail with reference to the reviews objectives. However, no meaningful quantitative meta-analysis have been applied as the reported information was too diverse. Third, non-parametric analyses were used in an attempt to answer the five questions outlined within the aims. The associations between the reported effect of the intervention on the health behaviour and health domain, health decision, and type of intervention were assessed. The trajectory of knowledge The number of studies using different types of methodology, using a decision-making theory, and recording an informed decision outcome were analysed by publication year. Results were plotted for the 5 years 1991, 1992, 1993, 1994 and 1995, for which both a full-year computer-based search and handsearch had been done.
9
Health Technology Assessment 1999; Vol. 3: No. 1
Chapter 3 Results
A total of 547 reports fulfilled the inclusion criteria and formed the bibliography. They are listed by study number in appendix 5 and alphabetically by author in appendix 6. As the amount of extracted information is large, there are several ways to synthesise and present the results. The remaining format of this section summarises the information in accordance with the research aim of this review. The bibliography is available in electronic format from JG Thornton, Centre for Reproduction, Growth and Development, 34 Hyde Terrace, Leeds, LS2 9LN. Summaries of extracted information by study Appendices 7 and 8 summarise all the information extracted following application of the coding form. Appendix 7 includes information on: health decisions; domain of health care; health status and age of participants; reported theoretical context; intervention groups; and, reported measures. Appendix 8 includes: level of intervention; sample size; representativeness of sample; and summary of reported results. Both tables follow the order of: study design (RCTa, RCTb, RCTc, non-randomised concurrent, non-randomised historical, and `before and after' same sample); theory (did or did not report a theory); and health domain. Summary by frequency tables The following tables describe the number of studies within each of the following coding frame categories: study design; type of intervention; health decision; health area; theory; decision associated factors; reported measures; theoretical context; and,
reported effects. Two tables are reported for each category. The first table shows the number of studies within each level of the category. As this review has referred to the hierarchy of evidence as a means of quality assessment, the second table reports the number of studies within each level of category by study design. Study design Table 1 describes the number of studies by one of six study designs. Type of intervention Tables 2 and 3 describe the number of studies using a particular type of intervention such as written leaflet or the provision of free transport. Note that these categories are not mutually exclusive. For example, one study may have assessed a number of written leaflets framed in different ways, or a media intervention compared with leaflet distribution in clinics. For example, 67% of RCTa studies compared the effects of additional information with the health decision whereas only 10% evaluated the impact of patient prompt. Health decision Tables 4 and 5 describe the number of studies looking at a particular health decision or health behaviour. Note that these categories are not mutually exclusive and a study may be classified more than once. For example, a healthy diet programme may have two stages involving cholesterol screening and change in food choice resulting in both the lifestyle and testing health-promotion categories being recorded. Seventy-one per cent of concurrent studies looked at lifestyle change decisions. The frequencies for the modified, mutually exclusive health decision variable were: lifestyle change, 275 (50%); attendance testing, 103 (19%); adherence treatment, 92 (17%); utilisation of services, 51 (9%); and, other, 26 (5%).
TABLE 1 Frequency of study design (n = 547)
RCTa
RCTb
RCTc
Concurrent Historical Before/after
low-risk bias unknown bias high-risk bias
same sample
Number of studies
51
208
77
114
34
63
11
Results
TABLE 2 Frequency of intervention type
Type of intervention
Examples
n
Used additional information
Written leaflet, audio-tape, video-tape, computer
301
Manipulated information
Illustrations, framing, graphics
94
Changed delivery of information
Letter, telephone, physicians versus nurse
273
Provided feedback
Demonstrate learnt skills, results of screening test
208
Used patient prompt
Decision aid, memory
55
Used group-delivery information
Media, classroom, community programmes
273
Manipulated environment
No-smoking policy, design inhaler, free service
109
Other
Patient incentives, health professional prompt
89
TABLE 3 Frequency of studies by type of interventions and design RCTa RCTb RCTc
Used additional information
34
105
52
Manipulated information
15
50
17
Changed delivery of information
27
111
47
Provided feedback
14
81
33
Used patient prompt
5
19
15
Used group-delivery information
11
48
21
Manipulated environment
12
29
11
Other
4
38
9
Concurrent Historical Before/after same sample
58
16
36
11
0
1
50
10
28
47
5
28
9
2
5
63
14
31
30
13
14
20
7
11
TABLE 4 Frequency of studies by type of health decision
Type of decision
Examples
n
Utilisation of services
Attendance at appointment, use call-out service
51
Health promotion ­ changes lifestyle Smoking, drinking, exercise, substance use, safe sex
357
Health promotion ­ attendance testing Breast, colorectal, cervical screening
114
Adherence to treatment
Medication, surgery, behavioural therapy
107
Active participation
Question asking within consultation, taking part in research
20
Other
Organ donation, willingness to pay
6
TABLE 5 Frequency of studies by health decision and study design
RCTa RCTb RCTc
Concurrent Historical Before/after same sample
Utilisation of services
8
20
9
7
4
3
Health promotion ­ changes lifestyle 28
128
47
81
21
52
Health promotion ­ attendance testing 14
39
18
22
10
11
Adherence to treatment
12
46
14
18
6
11
Active participation
3
11
3
0
1
2
12
Other
0
3
1
2
0
0
Health Technology Assessment 1999; Vol. 3: No. 1
Health domain Tables 6 and 7 describe the number of studies within a particular health domain. Note that these categories are not mutually exclusive and a study may be classified more than once. For example, a study looking at postnatal depression may be classified as both midwifery and mental health, or a smoking study may come under both general medicine and cancer. Eighteen per cent of `before and after' same-sample studies assessed an intervention associated with cancer care or prevention. The frequencies for the modified, mutually exclusive health domain variable were: general medicine, 189 (35%); cancer, 109 (20%); the
human immunodeficiency virus (HIV) and STDs, 103 (19%); primary care, 55 (10%); obstetrics, 29 (5%); and, other, 62 (11%). Theory Tables 8 and 9 describe the number of studies that referred to a theory to drive the research. These show that 85% of historical studies were not theory driven. Decision associated factors As there was little variation between studies on these four variables, the frequencies are reported within the text, and no `by design' frequencies are given.
TABLE 6 Frequencies of studies by health domain
Health domain
Examples
n
Cancer
Breast, testicular, colorectal, cervical
114
Dentistry
Oral hygiene
10
Genetics
Huntington's chorea, cystic fibrosis (CF), sickle cell
7
General medicine
Cardiovascular disease (CVD) risk (smoking, exercise,
251
alcohol), chronic illness (asthma, diabetes)
HIV and STD
Condom use, needle exchange
108
Mental health
Depression, scizophrenia, anxiety
15
Obstetrics, gynaecology and midwifery Prenatal care, breast feeding, infertility
31
Paediatrics
Sudden infant death syndrome
6
Primary care
Coughs, colds, immunisations
61
Surgery and A&E
Urology, ophthalmology
11
Other
Alternative medicine, marital difficulties
13
TABLE 7 Frequency of studies by health domain and design
RCTa
RCTb
RCTc Concurrent Historical Before/after same sample
Cancer
13
44
16
22
8
11
Dentistry
0
5
0
2
3
0
Genetics
1
1
2
2
1
0
General medicine
22
104
36
54
8
27
HIV and STD
6
32
12
28
8
22
Mental health
3
8
1
2
0
1
Obsetrics, gynaecology and midwifery 6
8
6
4
3
4
Paediatrics
0
3
0
1
2
0
Primary care
5
30
9
8
3
6
Surgery and A&E
2
3
2
3
1
0
Other
0
2
5
3
2
1
13
Results
TABLE 8 Frequency of studies by theory reported
Type of theory
Examples
n
No theory reported
341
Decision-making theory
Prospect theory, framing bias, health belief model (HBM), stages
101
change, theory planned behaviour
Health promotion theory
Social learning theory (SLT), skill-based theory
63
Other theories
Attribution, stress-coping model, illness representation
42
TABLE 9 Frequency studies by theory reported and study design
No theory reported Decision-making theory Health promotion theory Other theories
RCTa 36 7 2 6
RCTb 116 48 26 18
RCTc 41 20 7 9
Concurrent Historical Before/after same sample
67
29
52
19
2
5
23
1
4
5
2
2
· Number of studies that referred to real of
reported by the study authors and no independent
hypothetical decision: real decisions, 512 (94%). verification of the quality of the study has
· Number of studies that encouraged patients to
been incorporated.
play an active part or increase awareness of the
decision-making process: explicit decision-
making process encouraged, 26 (5%). · Number of studies where the recipient of the
Summary by study number listings
decision outcome was the participant or a
To facilitate identification of studies, the study
third party: recipient same as decision
numbers of articles are listed by various categories in
maker, 476 (87%).
Tables 16­20. The study number suffixes (indicating
· Number of studies wither with or without time
the number of studies within an article) have been
restraint: no time restraint, 525 (96%).
omitted for this summary unless required to avoid
ambiguity. Study numbers in Tables 16­19 are
Reported measures
grouped into the following categories:
Tables 10 and 11 describe all the measures reported
by the study authors within the text. Note that these · type of intervention
categories are not mutually exclusive. One study
· health decision
may have reported demographic variation, assessed · health area
anxiety and described reasons for choosing the
· theoretical context.
final behaviour.
Study numbers in Table 20 are all RCT studies classi-
Theoretical context
fied as most likely to assess informed patient deci-
This derived variable describes the number of
sion making. That is to say, studies that have referred
studies that reported a theoretical framework and
to a decision-making theory and assessed a decision-
a decision-making process and outcome measures
making process measure. the studies in Table 20 are
(Tables 12 and 13). It attempts to provide an inform- grouped according to type of intervention.
ed decision-making variable classification. Only five
(10%) of RCTa studies referred to a theory and
measured some aspect of `informed' decision making such as attitudes or reasons.
Synthesising findings
Two techniques were used in an attempt to
Reported effects
synthesise the review findings. First, the integration
Tables 14 and 15 describe the number of studies
of research findings from the five good studies that
that reported as association, or not, between the
fulfilled the specific criteria. Second, the appli-
intervention and the health decision outcome.
cation of chi-square analysis to the crude measure
14
This is a crude measure based on the results
of reported effect with the following variables:
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 10 Frequency of studies by measures reported
Measures Demographics Personal history Decision making Self-efficacy Knowledge Satisfaction Affect Trait Other
Examples
n
Sex, age, level of education, marital status, religion
515
Medical and family history, physiological assessment
386
Attitudes, reasons, preferences, perception of risk, social norms 169
Perception of efficacy and self-efficacy
75
Knowledge
181
Perceived satisfaction and usefulness
60
Depression, anxiety, worry, relief
69
Type A, locus control, cognitive closure
20
Social support, coping, health professional measures
111
TABLE 11 Frequencies of studies by measures reported and study design
Demographics Personal history Decision making Self-efficacy Knowledge Satisfaction Affect Trait Other
RCTa 51 43 11 6 12 9 7 2 9
RCTb 198 159 63 32 57 24 39 7 45
RCTc 76 52 27 11 27 12 10 3 16
Concurrent Historical Before/after same sample
106
28
56
78
17
37
35
9
24
19
0
7
49
9
27
5
18
4
5
0
6
6
0
2
29
5
7
TABLE 12 Frequency of studies by theoretical context
n
Theory and decision-making measures
96
Theory only
110
Decision-making measures only
73
No theory or decision-making measure
268
TABLE 13 Frequency of studies by theoretical context and study design
RCTa
RCTb
RCTc Concurrent Historical Before/after same sample
Theory and decision-making measures 5
47
16
21
1
6
Theory only
10
45
20
26
4
5
Decision-making measures only
6
16
11
14
8
18
No theory or decision-making measures 30
100
30
53
21
34
15
Results
TABLE 14 Frequency of studies reporting finding an effect or not
n
Effect reported
294
No effect reported
173
Mixed effects reported
80
TABLE 15 Frequency of studies by reported finding an effect or not and design
Effect reported No effect reported Mixed effects reported
RCTa 29 15 7
RCTb 100 79 29
RCTc 38 31 8
Concurrent Historical Before/after same sample
61
20
46
33
7
8
20
7
9
design; intervention; health domain; health
Nevertheless, it appears that information and
decision; and, theoretical context.
education are not the most effective ways of facili-
tating informed decision making. One study found
Five good studies
that changing the amount of information about risks
The following five studies used an RCT with low risk and side-effects of a drug did not affect patients'
of bias, reported `informed' decision-making
adherence to the treatment (Quaid et al). In another,
variables and referred to a theory.
varying the quantitative information used to intro-
duce a new medication made no difference to the
· 197 - 1 Plaskon PP, Fadden MJ. Cancer screening decision to participate in a research trial in 55% of
utilisation: is there a role for social work in
out-patients (Simel and Feussner), though it did
cancer prevention? Social Work in Health Care
influence the choice of the 45% who cited this
1995;21(4):59­70.
information in their decision. Although an education
· 310 - 1 Quaid K, Faden R, Vining E, Freeman J.
intervention was found to increase exercise amongst
Informed consent for a prescription drug:
patients at risk of heart disease over a 12-week period,
impact of disclosed information on patient
this included behavioural planning (Schultz). When
understanding and medical outcomes. Patient
other behavioural strategies of goal setting, self-
Education and Counseling 1990;15:249­59.
monitoring, positive reinforcement and telephone
· 325 - 1 Schultz S. Educational and behavioural
follow-up were added, frequency of exercise was sig-
strategies related to knowledge of and partic-
nificantly increased after 6 weeks. The importance of
ipation in an exercise program after cardiac
situational factors was demonstrated in the decision
positron emission tomography. Patient Education of general practice patients to use a kit for colorectal
and Counseling 1993;22:47­57.
cancer screening. All patients were given educational
· 542 - 1 Simel DL, Feussner JR. A randomised
information, but screening increased from 0% to
controlled trial comparing quantitative informed 51% when patients were given a free kit rather than
consent formats. Journal of Clinical Epidemiology
told to go to the general practice office or to one of
1991;44(8):771­7.
three pharmacies to buy a kit (Plaskon and Fadden).
· 799 - 1 DiClemente RJ, Wingwood GM.
The role of cognitive and social, as well as behavi-
A randomised controlled trial of an HIV
oural, factors in influencing decision making is evi-
sexual risk-reduction intervention for
dent in an intervention aimed at reducing HIV sexual
young African-American women. JAMA
risk amongst African­American women (DiClemente
1995;274(16):1271­6.
and Wingwood). Although an educational inter-
vention did not bring about change, a social skills
A formal integrative review of these five studies
intervention, based on social Cognitive theory and
would not be useful as each study evaluates a
theory of gender and power, increased condom use.
different decision, refers to a different theory
and considers different interventions. Some
Although these studies are of disparate populations
participants were well and others physically ill,
making disparate decisions, they show the import-
and some samples were selected systematically
ance of the context and social influences on
16
and others by convenience (Table 21).
individual's decision making.
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 16 Study numbers (without suffix unless necessary) by type of intervention
Type of intervention and study design
No. of Study numbers studies
Additional information ­ written 258
RTCa
30 39, 50, 64, 67, 85, 101, 118, 120, 122, 196, 197, 200, 216, 275, 299, 301, 316, 325, 333, 350, 387, 393, 483, 509, 542, 648, 724, 741, 778, 793
RCTb
87 19, 22, 28, 48, 63, 104, 110, 114, 135, 140, 143, 150, 157, 158, 158, 167, 176, 183, 207, 210, 211, 213, 216, 232, 233, 234, 241, 259, 265, 268, 269, 277, 279, 285, 288, 295, 302, 327, 332, 337, 357, 372, 376, 414, 420, 434, 454, 465, 469, 482, 490, 491, 506, 511, 520, 525, 530, 533, 541, 572, 587, 600, 616, 632, 632, 635, 639, 644, 652, 667, 668, 671, 675, 679, 683, 690, 693, 700, 705, 706, 728, 732, 747, 757, 783, 794, 796
RCTc
46 58, 72, 83, 98, 115, 154, 169, 170, 181, 242, 248, 254, 287, 296, 303, 320, 324, 329, 343, 349, 354, 360, 363, 375, 381, 407, 442, 459, 471, 472, 473, 484, 507, 508, 528, 601, 640, 646, 649, 712, 717, 743, 752, 754, 790, 792
Concurrent
53 3, 44, 125, 136, 146, 171, 177, 180, 203, 205, 205, 206, 215, 237, 243, 245, 246, 251, 253, 261, 273, 280, 283, 312, 315, 367, 370, 373, 386, 391, 394, 404, 418, 440, 446, 448, 453, 463, 464, 504, 515, 516, 579, 628, 631, 663, 665, 709, 726, 740, 780, 791, 813
Before/after different samples
16 26, 97, 149, 192, 193, 294, 340, 383, 462, 495, 514, 575, 619, 658, 670, 765
Before/after same sample
26 35, 42, 111, 126, 133, 162, 163, 218, 244, 262, 266, 270, 348, 384, 449, 450, 467, 480, 522, 526, 544, 573, 676, 770, 809, 815
Additional information ­ audiotape 10
RCTa
2
117, 581
RCTb
4
264, 371, 465, 488
RCTc
3
154, 472, 754
Concurrent
1
663
Additional information ­ video-tape 74
RCTa
3
23, 585, 741
RCTb
27 28, 55.1, 55.2, 155, 207, 241, 289, 341, 376, 424, 438, 454, 458, 491, 502, 533, 616, 635, 639, 644, 705, 728, 742, 758, 776, 789, 794
RCTc
15 37, 181, 254, 287, 293, 310, 329, 354, 484, 528, 640, 646, 696, 720, 762
Concurrent
13 184, 205, 205, 240, 246, 261, 311, 313, 464, 579, 628, 631, 791
Before/after different samples 3
26, 294, 658
Before/after same sample
13 35, 49, 79, 123, 364, 450, 467, 526, 594, 610, 651, 655, 746
Additional information ­
computer based
7
RCTb
5
327, 396, 488, 493, 667
Concurrent
1
40
Before/after same sample
1
795
Manipulated information ­
illustration or graphic
14
RCTa
2
50, 117
RCTb
5
19, 150, 305, 357, 371
RCTc
4
324, 459, 473, 649
Concurrent
2
177, 448
Before/after same sample
1
723
Manipulated information ­
framing or quantity
84
RCTa
14 39, 67, 101, 117, 118, 275, 301, 393, 542, 724, 755, 778, 793, 799
RCTb
47 19, 55, 86, 105, 137, 158, 167, 176, 183, 211, 226, 288, 295, 305, 321, 327, 332, 341, 420, 426, 434, 438, 482, 490, 491, 494, 533, 587, 600, 634, 636, 644, 653, 667, 668, 671, 683, 685, 690, 693, 727, 742, 747, 757, 772, 783, 789
RCTc
14 115, 310, 377, 380, 381, 471, 473, 481, 507, 512, 684, 691, 752, 788
Concurrent
9
136, 257, 280, 386, 453, 586, 748, 760, 822
continued
17
Results
TABLE 16 contd Study numbers (without suffix unless necessary) by type of intervention
Type of intervention and study design
No. of Study numbers studies
Change in delivery of information
­ community or hospital
10
RCTa
1
39
RCTb
3
47, 234, 564
RCTc
3
485, 752, 790
Concurrent
3
586, 748, 775
Change in delivery of information
­ alter contact with health
professional
183
RCTa
18 52, 64, 117, 196, 200, 202, 325, 333, 350, 585, 606, 638, 648, 678, 724, 778, 781, 799
RCTb
70 1, 4, 10, 22, 63, 102, 135, 139, 140, 147, 157, 165, 174, 207, 211, 212, 241, 249, 259, 263, 268, 269, 276, 277, 285, 289, 291, 304, 328, 336, 341, 353, 365, 369, 403, 439, 447, 458, 465, 479, 491, 494, 503, 511, 525, 527, 530, 533, 553, 554, 576, 616, 622, 629, 632, 632, 635, 636, 639, 659, 693, 702, 707, 728, 742, 766, 776, 783, 807, 814
RCTc
23 58, 80, 98, 169, 170, 181, 320, 329, 354, 375, 407, 411, 442, 470, 472, 528, 601.2, 640, 695, 720, 754, 763, 792
Concurrent
36 71, 82, 89, 95, 136, 171, 177, 194, 205.1, 205.2, 206, 237, 246, 251, 253, 256, 260, 273, 284, 312, 313, 367.2, 373, 416, 453, 456, 464, 504, 529, 555, 570, 579, 628, 726, 740, 791
Before/after different samples 8
26, 239, 340, 462, 575, 619, 623, 674
Before/after same sample
28 35, 38, 49, 84, 111, 123, 162, 218, 244, 262, 270, 367, 449, 480, 521, 544, 621, 650, 651, 654, 723, 729, 746, 770, 798, 809, 815, 821
Change in delivery of information
­ letter
83
RCTa
10 39, 41, 52, 101, 216, 275, 299, 316, 378, 648
RCTb
39 110, 143, 158.1, 158.2, 167, 213, 216, 259, 265, 269, 285, 352.1, 352.2, 352.3, 372, 395, 414, 420, 426, 439, 447, 469, 543, 566, 572, 589, 620, 630, 634, 652, 653, 668, 683, 727, 728, 747, 757, 783, 784
RCTc
19 56, 115, 154, 172, 248, 296, 320, 349, 363, 381, 412, 484, 507, 512, 640, 712, 717, 752, 790
Concurrent
14 61, 146, 237, 253, 257, 394, 404, 446, 516, 546, 631, 740, 760, 813
Before/after different samples 1
100
Change in delivery of information
­ telephone
47
RCTa
7
52, 196, 202, 299, 325, 638, 714
RCTb
23 63, 139, 143, 168, 233, 265, 288, 304, 352.2, 353, 369, 403, 408, 414, 420, 482, 572, 576, 600, 622, 668, 702, 783
RCTc
9
287, 380, 475, 481, 512, 640, 711, 754, 788
Concurrent
3 257, 394, 446
Before/after different samples 4 26, 239, 514, 619
Before/after same sample
1 218
18
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 16 contd Study numbers (without suffix unless necessary) by type of intervention
Type of intervention and study design
No. of Study numbers studies
Provision of feedback or skills
acquisition
208
RCTa
14 64, 107, 120, 275, 316, 325, 387, 393, 585, 648, 714, 755, 781, 799
RCTb
81 4, 10, 20, 22, 104, 110, 114, 135, 140, 145, 147, 157, 165, 174, 207, 210, 212, 216, 217, 220, 223, 226, 233, 241, 247, 263, 264, 268, 269, 277, 291, 295, 307, 327, 328, 341, 371, 396, 414, 424, 439, 454, 458, 478, 479, 491, 492, 502, 503, 511, 525, 527, 530, 533, 541, 553, 562, 576, 616, 630, 632, 632, 635, 636, 644, 660, 667, 668, 679, 685, 690, 700, 705, 707, 742, 758, 766, 772, 776, 783, 814
RCTc
33 72, 80, 98, 115, 154, 287, 293, 320, 329, 354, 360, 375, 377, 381, 405, 407, 442, 472, 475, 481, 601, 640, 646, 649, 684, 696, 708, 720, 749, 754, 788, 792, 817
Concurrent
47 3, 17, 18, 89, 125, 136, 177, 184, 222, 240, 246, 251, 253, 273, 283, 284, 311, 313, 315, 335, 345, 367, 370, 373, 385, 386, 394, 404, 416, 440, 448, 453, 486, 504, 515, 555, 628, 631, 663, 726, 731, 740, 759, 760, 791, 813, 823
Before/after different samples 5
26, 149, 619, 623, 765
Before/after same sample
28 35, 42, 46, 49, 84, 99, 123, 132, 133, 159, 162, 270, 355, 361, 364, 384, 449, 450, 480, 521, 522, 526, 594, 621, 654, 676, 688, 729
Patient prompt ­ use of decision aid 5
RCTb
2
396, 493
RCTc
1
472
Before/after same sample
2
42, 594
Patient prompt ­ use of memory
or information aid
45
RCTa
4
85, 333, 378, 387
RCTb
13 157, 269, 372, 420, 447, 469, 482, 506, 576, 700, 707, 783, 794
RCTc
14 115, 154, 172, 254, 303, 343, 360, 381, 481, 601, 640, 691, 712, 763
Concurrent
9
44, 243, 246, 253, 315, 394, 448, 631, 760
Before/after different samples 2
340, 421
Before/after same sample
3
162, 449, 544
Patient prompt ­ shared health professional/patient decision making 5
RCTa
1
678
RCTb
4
27, 279, 337, 564
Group delivery of information
163
RCTa
11 50, 107, 117, 120, 200, 483, 585, 648, 724, 778, 799
RCTb
46 1, 4, 22, 96, 143, 145, 147, 174, 207, 211, 212, 223, 241, 255.2, 263, 264, 269, 277, 285, 328, 341, 414, 424, 438, 478, 479, 489, 491, 492, 494, 530, 533, 553, 564, 616, 632, 632, 635, 636, 659, 660, 705, 736, 766, 807, 814
RCTc
21 58, 72, 80, 98, 254, 303, 320, 354, 375, 405, 407, 442, 485, 640, 649, 684, 696, 720, 743, 749, 792
Concurrent
46 3, 18, 44, 45, 95, 125, 136, 146, 180, 184, 203, 222, 238, 240, 253, 258, 261, 273, 280, 283, 284, 335, 370, 373, 385, 416, 440, 448, 453, 456, 463, 515, 555, 570, 579, 608, 628, 665, 686, 709, 731, 740, 759, 760, 780, 825
Before/after different samples 11 97, 149, 192, 340, 383, 461, 514, 662, 670, 680, 765
Before/after same sample
28 38, 42, 49, 79, 99, 123, 132, 133, 159, 262, 270, 348, 355, 361, 364, 467, 521, 522, 526, 573, 621, 650, 651, 654, 657, 723, 746, 809
continued
19
Results
TABLE 16 contd Study numbers (without suffix unless necessary) by type of intervention
Type of intervention and study design
No. of Study numbers studies
Change in health service provision 83
RCTa
9
39, 41, 52, 64, 197, 425, 509, 714, 741
RCTb
21 47, 48, 135, 143, 213, 234, 269, 285, 289, 352.3, 372, 376, 439, 454, 554, 566, 683, 732, 736, 768, 769
RCTc
10 56, 254, 287, 293, 296, 412, 470, 484, 646, 752
Concurrent
22 3, 75, 136, 146, 177, 180, 203, 237, 243, 256, 312, 397, 448, 452, 455, 464, 516, 529, 618, 686, 726, 822
Before/after different samples 8
340, 383, 421, 462, 575, 737, 765, 767.1
Before/after same sample
13 38, 163, 218, 244, 342, 355, 537, 655, 729, 770, 795, 798, 809
Manipulation of the environment
23
RCTa
2
216, 229
RCTb
1
220
RCTc
2
56, 442
Concurrent
10 18, 75, 180, 206, 215, 235, 251, 284, 390, 464
Before/after different samples 6
142, 149, 423, 462, 550, 563
Before/after same sample
2
270, 537
Group delivery ­ use of media
70
RCTb
6
22, 135, 143, 217, 285, 705
RCTc
2
58, 792
Concurrent
38 3, 18, 44, 45, 146, 171, 180, 184, 203, 205.1, 205.2, 206, 215, 222, 237, 238, 243, 246, 251, 258, 280, 311, 312, 323, 335, 367.2, 391, 448, 463, 464, 608, 631, 665, 686, 709, 726, 740, 780
Before/after different samples 14 97, 149, 192, 340, 383, 461, 462, 514, 619, 658, 662, 670, 680, 765
Before/after same sample
10 38, 42, 49, 162, 218, 367, 522, 657, 746, 809
Other ­ health professional
prompts for action
14
RCTa
1
724
RCTb
1
395
Concurrent
5
205, 404, 455, 791, 822
Before/after different samples 4
34, 192, 401, 413
Before/after same sample
3
466, 522, 809
Other ­ patient incentives
32
RCTa
2
64, 200
RCTb
12 22, 102, 135, 156, 165, 216, 269, 352, 424, 644, 652, 814
RCTc
2
106, 115
Concurrent
7
18, 44, 184, 280, 283, 367, 515
Before/after different samples 3
149, 462, 765
Before/after same sample
6
162, 179, 262, 367, 450, 688
20
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 17 Study numbers (without suffix unless necessary) by health decision
Health decision and study design
No. of Study numbers studies
Decision to use a service
e.g. attend an appointment,
use a call-out service
51
RCTa
8
196, 202, 333, 425, 606, 638, 678, 714
RCTb
20 10, 20, 27, 28, 167, 302, 337, 369, 372, 376, 426, 439, 494, 511, 520, 554, 706, 733, 769, 796
RCTc
9
83, 106, 172, 248, 320, 470, 481, 717, 788
Concurrent
7
75, 82, 323, 331, 394, 504, 748
Before/after different samples 4
97, 294, 563, 737
Before/after same sample
3
42, 537, 676
Decision to make a lifestyle
change (health promotion)
e.g. stop smoking, exercise
357
RCTa
28 23, 50, 64, 85, 101, 107, 118, 120, 196, 200, 216, 229, 299, 316, 325, 333, 350, 378, 393, 581, 585, 648, 724, 741, 755, 781, 793, 799
RCTb
128 1, 4, 22, 24, 27, 32, 47, 55, 55, 63, 86, 102, 104, 110, 135, 139, 140, 143, 145, 147, 156, 157, 158, 158, 165, 174, 183, 207, 210, 211, 212, 213, 216, 217, 220, 223, 226, 233, 234, 241, 247, 249, 255, 259, 263, 264, 265, 268, 269, 276, 277, 279, 288, 289, 291, 295, 305, 307, 308, 321, 327, 328, 336, 341, 356, 365, 371, 372, 376, 395, 396, 398, 402, 403, 408, 414, 424, 426, 454, 457, 458, 465, 478, 489, 490, 491, 492, 503, 511, 525, 533, 541, 553, 562, 564, 572, 574, 576, 600. 616, 620, 632, 632, 633, 635, 636, 639, 644, 659, 660, 668, 679, 685, 690, 705, 707, 732, 733, 736, 742, 758, 766, 768, 772, 776, 783, 807, 814
RCTc
47 72, 80, 98, 115, 154, 170, 181, 242, 254, 287, 293, 296, 310, 320, 324, 329, 360, 363, 375, 405, 407, 442, 459, 471, 472, 473, 475, 484, 485, 512, 528, 601, 601, 640, 646, 649, 684, 696, 708, 720, 749, 752, 754, 762, 777, 792, 817
Concurrent
81 3, 17, 18, 40, 71, 89, 95, 125, 136, 146, 161, 171, 177, 180, 184, 194, 206, 209, 215, 222, 235, 237, 238, 240, 245, 246, 251, 253, 255, 256, 257, 258, 260, 261, 273, 280, 283, 284, 311, 312, 313, 345, 367, 370, 373, 385, 386, 390, 391, 392, 409, 416, 440, 453, 455, 456, 463, 464, 515, 529, 555, 570, 579, 618, 628, 631, 663, 665, 709, 726, 731, 740, 759, 773, 775, 779, 780, 791, 813, 822, 823
Before/after different samples 21
26, 97, 100, 142, 149, 239, 340, 421, 423, 461, 462, 514, 550, 619, 623, 647, 658, 662, 680, 765, 767
Before/after same sample
52 35, 38, 49, 79, 84, 91, 123, 126, 132, 133, 159, 162, 163, 179, 198, 218, 244, 262, 266, 270, 342, 348, 355, 364, 367, 384, 450, 466, 467, 480, 521, 522, 526, 544, 545, 573, 610, 621, 650, 651, 654, 655, 657, 676, 688, 723, 729, 746, 770, 798, 815, 821
continued 21
Results
TABLE 17 contd Study numbers (without suffix unless necessary) by health decision
Health decision and study design
No. of Study numbers studies
Decision to attend for testing (health promotion) e.g. breast/colorectal screening 114
RCTa
14 39, 41, 52, 85, 101, 108, 117, 122, 197, 275, 316, 333, 509, 778
RCTb
39 48, 86, 114, 232, 285, 288, 289, 305, 307, 352, 352, 352, 353, 372, 395, 420, 438, 439, 482, 491, 543, 566, 587, 589, 620, 630, 634, 652, 653, 675, 683, 690, 713, 727, 728, 747, 757, 784, 789
RCTc
18 37, 56, 154, 248, 296, 354, 377, 380, 381, 412, 484, 507, 508, 695, 712, 743, 752, 790
Concurrent
22 44, 45, 61, 171, 203, 205, 205, 243, 246, 257, 394, 397, 404, 418, 446, 448, 516, 546, 608, 686, 760, 813
Before/after different samples 10 34, 192, 193, 294, 383, 401, 421, 575, 670, 737
Before/after same sample
11 46, 99, 126, 133, 348, 384, 466, 746, 795, 809, 815
Decision to adhere to treatment
regimen e.g. drugs, surgery,
behaviour therapy
107
RCTa
12 53, 202, 216.2, 229, 299, 301, 333, 378, 427, 483, 714, 781
RCTb
46 6.1, 6.2, 6.3, 51, 57, 63, 88, 96, 104, 105, 137, 139, 150, 167, 168, 176, 234, 291, 304, 327, 328, 332, 357, 369, 395, 402, 414, 434, 447, 469, 479, 488, 502, 527, 530, 564, 572, 612, 622, 633, 671, 693, 698, 702, 768, 794
RCTc
14 98, 169, 170, 181, 303, 349, 363, 380, 411, 471, 512, 691, 711, 763
Concurrent
18 18, 71, 82, 95, 124, 146, 313, 315, 323, 331, 335, 452, 455, 486, 586, 618, 775, 825
Before/after different samples 6
193, 239, 413, 563, 674, 767
Before/after same sample
11 42, 74, 342, 361, 449, 466, 522, 544, 594, 655, 676
Decision to take an active part
in consultation or participate
in research
20
RCTa
3
67, 387, 542
RCTb
11 155, 216, 434, 488, 493, 506, 600, 629, 667, 700, 816
RCTc
3
343, 472, 601
Before/after different samples 1
495
Before/after same sample
2
111, 594
Other decisions e.g. donate an
organ, pay for treatment
6
RCTb
3
19, 176, 408
RCTc
1
58
Concurrent 22
2
190, 430
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 18 Study numbers (without suffix unless necessary) by health domain
Health domain and study design
No. of Study numbers studies
Cancer
114
RCTa RCTb
13 23, 39, 41, 52, 85, 101, 108, 117, 122, 197, 275, 316, 509 44 48, 86, 114, 140, 207, 232, 263, 269, 285, 288, 307, 352.1, 352.2, 352.3, 353, 395, 420, 434, 438, 458, 482, 488, 491, 527, 533, 541, 543, 566, 587, 630, 653, 667, 675, 683, 690, 700, 705, 713, 727, 728, 757, 784, 789, 816
RCTc
16
Concurrent
22
Before/after different samples 8
37, 154, 248, 296, 310, 354, 377, 380, 412, 484, 507, 508, 691, 695, 712, 752 44, 61, 136, 171, 180, 203, 205.1, 205.2, 237, 243, 246, 385, 386, 397, 404, 418, 446, 448, 546, 608, 686, 760 34, 100, 192, 383, 401, 421, 575, 765
Before/after same sample
11 46, 99, 126, 133, 198, 266, 466, 746, 795, 809, 815
Dentistry
10
RCTb
5
371, 457, 562, 576, 758
Concurrent non-randomised 2
529, 618
Before/after different samples 3
97, 563, 737
Genetics RCTa
7
1
778
RCTb RCTc
1
20
2
743, 790
Concurrent
2
Before/after different samples 1
430, 516 294
General medicine RCTa
251 22 50, 53, 64, 67, 118, 120, 196, 200, 216.2, 229, 301, 325, 350, 483, 542, 581, 648, 714, 724, 755, 781, 793
RCTb
104 1, 10, 20, 27, 28, 32, 47, 55.1, 55.2, 57, 63, 88, 102, 104, 105, 110, 137, 139, 140, 143, 145, 147, 155, 157, 158.1, 158.2, 168, 174, 183, 207, 210, 211, 213, 216, 217, 220, 223, 226, 233, 241, 247, 249, 255.2, 259, 263, 264, 265, 268, 269, 276, 277, 279, 291, 295, 304, 305, 308, 321, 327, 328, 332, 336, 341, 356, 365, 372, 376, 395, 396, 398, 402, 414, 426, 439, 447, 469, 489, 490, 502, 503, 527, 530, 541, 564, 574, 600, 612, 620, 622, 629, 644, 652, 659, 668, 671, 679, 693, 702, 707, 769, 772, 783, 807, 814
RCTc
36 56, 72, 80, 115, 169, 170, 242, 254, 287, 303, 310, 320, 329, 343, 360, 375, 381, 405, 411, 442, 459, 471, 472, 473, 475, 481, 485, 601.1, 601.2, 640, 708, 711, 752, 754, 763, 792
Concurrent
54
Before/after different samples 8
45, 82, 89, 184, 194, 206, 209, 215, 222, 235, 237, 238, 245, 251, 253, 255, 256, 257, 258, 260, 261, 273, 280, 283, 284, 311, 312, 313, 315, 323, 345, 367, 370, 390, 394, 409, 416, 418, 440, 452, 453, 456, 464, 504, 586, 631, 709, 726, 731, 740, 759, 779, 813, 823 340, 423, 461, 462, 495, 514, 550, 658
Before/after same sample
27 42, 74, 79, 84, 111, 133, 162, 179, 218, 244, 262, 270, 348, 355, 367, 384, 449, 466, 521, 522, 544, 594, 621, 657, 676, 798, 821
continued
23
Results
TABLE 18 contd Study numbers (without suffix unless necessary) by health domain
Health domain and study design
No. of Study numbers studies
HIV and STD
108
RCTa
6
107, 202, 393, 585, 741, 799
RCTb
32 4, 22, 24, 156, 165, 212, 223, 226, 247, 277, 289, 341, 424, 454, 465, 478, 492, 525, 600, 632, 632, 635, 636, 639, 660, 685, 732, 733, 736, 742, 766, 776
RCTc
12 181, 360, 407, 528, 646, 649, 684, 696, 720, 749, 762, 817
Concurrent
28 17, 18, 71, 125, 161, 177, 240, 251, 311, 373, 391, 392, 453, 455, 463, 486, 515, 555, 579, 628, 663, 665, 748, 759, 780, 791, 822, 823
Before/after different samples 8
142, 423, 550, 619, 647, 662, 670, 680
Before/after same sample
22 35, 38, 49, 91, 123, 159, 364, 450, 467, 480, 526, 537, 545, 610, 650, 651, 654, 655, 688, 723, 729, 770
Mental health
15
RCTa
3
67, 427, 606
RCTb
8
28, 96, 479, 493, 494, 511, 554, 794
RCTc
1
717
Concurrent
2
124, 825
Before/after same sample
1
361
Obstetrics and gynaecology,
and midwifery
31
RCTa
6
196, 200, 425, 678, 724, 778
RCTb
8
135, 137, 403, 616, 634, 698, 733, 768
RCTc
6
83, 106, 115, 293, 329, 788
Concurrent
4
3, 71, 190, 486
Before/after different samples 3
26, 514, 623
Before/after same sample
4
132, 163, 621, 650
Paediatrics
6
RCTb
3
167, 520, 706
Concurrent
1
335
Before/after different samples 2
193, 239
Primary care
61
RCTa
5
299, 333, 378, 387, 638
RCTb
30 6.1, 6.2, 6.3, 19, 27, 32, 47, 51, 167, 174, 234, 302, 337, 357, 369, 395, 408, 414, 426, 506, 520, 553, 572, 589, 620, 633, 706, 747, 769, 796
RCTc
9
98, 172, 363, 470, 512, 601, 601, 752, 777
Concurrent
8
95, 146, 190, 257, 331, 418, 775, 813
Before/after different samples 3
193, 413, 767
Before/after same sample
6
62, 342, 348, 466, 537, 573
continued 24
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 18 contd Study numbers (without suffix unless necessary) by health domain
Health domain and study design
No. of studies
Surgery/A&E
11
RCTa
2
RCTb
3
RCTc
2
Concurrent
3
Before/after different samples 1
Other area of health care
13
RCTb
2
RCTc
5
Concurrent
3
Before/after different samples 2
Before/after same sample
1
Study numbers 581, 714 150, 490, 622 80, 777 40, 75, 394 674 176, 288 58, 170, 293, 324, 349 194, 570, 773 149, 461 84
TABLE 19 Study numbers (without suffix unless necessary) by reported theory and measure of informed decision making
Theory, measures and study design
No. of Study numbers studies
Theory and measure reported
96
RCTa
5
197, 301, 325, 542, 799
RCTb
47 24, 86, 114, 140, 145, 176, 210, 211, 217, 220, 232, 255.2, 276, 277, 288, 321, 371, 376, 420, 424, 426, 434, 438, 454, 458, 478, 492, 502, 525, 616, 620, 622, 632.1, 632.2, 635, 659, 660, 667, 668, 690, 700, 742, 758, 766, 768, 776, 784
RCTc
16 72, 115, 242, 354, 360, 380, 472, 507, 640, 691, 696, 717, 749, 762, 792, 817
Concurrent
21 89, 180, 238, 240, 253, 255, 313, 345, 370, 373, 391, 416, 453, 515, 516, 608, 663, 709, 759, 760, 822
Before/after different samples 1
26
Before/after same samples
6
46, 126, 198, 364, 526, 594
Theory only
110
RCTa
10 101, 107, 117, 120, 275, 333, 387, 427, 483, 585
RCTb
45 1, 4, 19, 20, 27, 104, 157, 158.1, 158.2, 165, 167, 207, 223, 226, 233, 241, 247, 264, 269, 291, 295, 305, 307, 332, 357, 403, 457, 469, 490, 493, 503, 506, 541, 576, 600, 633, 636, 644, 685, 707, 757, 789, 794, 814, 816
RCTc
20 56, 58, 80, 98, 169, 181, 248, 254, 287, 324, 329, 375, 405, 442, 484, 508, 528, 601.1, 601.2, 646
Concurrent
26 17, 18, 95, 136, 184, 190, 209, 237, 251, 261, 311, 367, 386, 404, 440, 446, 456, 463, 464, 486, 618, 628, 631, 726, 780, 823
Before/after different samples 4
462, 647, 658, 765
Before/after same sample
5
179, 262, 367, 450, 654
Measure only
73
RCTa
6
39, 316, 350, 509, 581, 678
RCTb
16 102, 105, 135, 147, 183, 212, 249, 302, 336, 341, 489, 494, 520, 562, 698, 783
RCTc
11 154, 310, 343, 381, 459, 473, 649, 684, 712, 720, 743
Concurrent
14 3, 44, 45, 177, 243, 256, 385, 430, 504, 570, 665, 686, 773, 825
Before/after different samples 8
193, 239, 383, 413, 423, 514, 619, 662
Before/after same sample
18 35, 49, 79, 111, 132, 159, 163, 218, 244, 342, 467, 480, 573, 610, 621, 650, 655, 688
25
Results
TABLE 20 Study numbers (without suffix unless necessary) by intervention from informed decision-making RCTs
Intervention and study design
No. of Study numbers studies
Additional information
45 72, 114, 115, 140, 176, 197, 210, 211, 232, 242, 277, 288, 301, 325, 354, 360, 371, 376, 420, 424, 434, 438, 454, 458, 472, 502, 507, 525, 542, 616, 632.1, 632.2, 635, 640, 667, 668, 690, 696, 700, 717, 742, 758, 762, 776, 792
Additional written information
35 72, 114, 115, 140, 176, 197, 210, 211, 232, 242, 277, 288, 301, 325, 354, 360, 376, 420, 434, 454, 472, 507, 525, 542, 616, 632.1, 632.2, 635, 640, 667, 668, 690, 700, 717, 792,
Manipulation of information
20 86, 115, 176, 211, 288, 301, 321, 380, 420, 426, 434, 438, 507, 542, 667, 668, 690, 691, 742, 799
Provision of feedback/ skills acquisition
40 72, 114, 115, 140, 145, 210, 217, 220, 277, 325, 354, 360, 371, 424, 454, 458, 472, 478, 492, 502, 525, 616, 632.1, 632.2, 635, 640, 660, 667, 668, 690, 696, 700, 742, 749, 758, 766, 776, 792, 799, 817
Use of patient prompts
7
115, 360, 420, 472, 640, 691, 700
Group delivery of information
22 72, 145, 211, 255.2, 277, 354, 424, 438, 478, 492, 616, 632.1, 632.2, 635, 640, 659, 660, 696, 749, 766, 792, 799
Manipulation of the environment 1
220
Incentives
2
115, 424
TABLE 21 Results information for five RCTa studies assessing informed decision making
Health decision and intervention
Impact of intervention Process measures
on health decision
(other measures)
Impact intervention on process and other measures
197 Utilisation screening kit: 1 ­ verbal information (VI) 2 ­ VI + free kit provided
0% uptake VI only 51% uptake VI + kit
Perception of risk of having colorectal cancer (none)
Not used in analysis
301 Adherence to medication: 1 ­ routine written information (WI) 2 ­ enhanced risk (WI)
No group differences to adherence drug
Perceived seriousness risks and side-effects (anxiety, knowledge) enhanced WI)
Enhanced WI associated greater perceived seriousness risks (no effect anxiety, greater knowledge
325 Uptake exercise: 1 ­ VI + screening results 2 ­ VI + screening results + encouraged to selfmonitor by writing down goals, diary of exercise
No group differences on exercise uptake and maintenance. Both groups increased over time
Perception of health (knowledge)
Not used in analysis (no group differential effect knowledge, increase over time)
542 Consent to participate in research: 1 ­ WI framed as a drug working `twice as fast' 2 ­ WI framed as a drug working `half as fast'
Participation greater in `twice as fast' group
Type of information used `Twice as fast' used more
for decision, reasons `quantitative' information,
participation (none)
not analysed by group
799 Changes risky sex:
Social skills group only Perception of partner Social skills group associated
1 ­ delayed intervention
associated greater safer norms (knowledge,
changes in perception of partner
2 ­ VI about HIV prevention sex practices
perceived self-efficacy) norms
(culturally) framed
(no group differences knowledge,
(one session)
Note: differential
social skills greater perceived
3 ­ VI + social skills
attrition rates
self-efficacy)
(five sessions) 26
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 22 Eight chi-square analyses for type of intervention by reported health behaviour effect
Effect (n = 294)
Additional information
157
Manipulation of information
42
Change in delivery of information 161
Provision of feedback
99
Use of patient prompts
33
Use of group-delivery information 92
Manipulation of environment
11
Other
52
d.f. = degrees of freedom
No effect Mixed effect Chi-square value
(n = 173) (n = 80)
(d.f. = 2)
93
51
2.89
31
11
1.30
75
37
6.17
70
39
6.70
17
5
1.74
61
35
4.42
5
7
5.00
23
14
1.65
Significance p = 0.236 p = 0.524 p = 0.046 p = 0.035 p = 0.420 p = 0.110 p = 0.082 p = 0.439
TABLE 23 Chi-square analysis for health domain by reported health behaviour effect
Effect
No effect
Mixed effect
General medicine Cancer HIV Primary care Obstetrics Other
87
68
34
70
31
8
55
27
21
28
19
8
15
9
5
19
19
4
Chi-square value (d.f. = 10) 18.7
Significance p = 0.044
TABLE 24 Chi-square analysis for type of health decision by reported health behaviour effect
Lifestyle change Attendance testing Adherence to treatment Utilisation of service Other
Effect 129 66 58 23 18
No effect 93 28 27 17 8
Mixed effect 53 9 7 11 0
Chi-square value (d.f. = 8) 24.1
Significance p = 0.002
Non-parametric analyses Non parametric chi-square analyses were carried out between the crude reported effect variable and intervention used, health domain, and health decision. Intervention Because many studies involved more than one manipulation within the intervention, such as written information and delivery of information, individual analyses were carried out for each intervention. All eight chi-square analyses assessing the association between the type of intervention employed and the likelihood of reporting an effect size for the health behaviour described are reported in Table 22. As several analyses were carried
out, the results ought to be interpreted with caution.
Health domain Table 23 describes the chi-square analysis for health domain by reported health behaviour effect. It assesses the association between the health domain of the decision and the likelihood of reporting an effect for the health behaviour described.
Type of health decision
Table 24 describes the chi-square analysis for
the type of health decision by reported health
behaviour effect. It assesses the association
between the type of decision context with the
likelihood of reporting an effect for the health
behaviour described.
27
Results
The trajectory of knowledge The number of included studies by year of publication is shown in Figures 1­4. The total is shown in Figure 1, trials broken down by quality of
randomisation in Figure 2, non-randomised studies in Figure 3 and studies using a decision theory or recording an informed decision measure are shown in Figure 4.
No. of studies 120 110 100 90 80 70 60
1991
1992 1993 1994 Year of publication
1995
FIGURE 1 Number of studies by year of publication
No. of studies 50
40
30
20
10
0 1991
1992 1993 1994 Year of publication
1995
FIGURE 2 Number of studies by quality of randomisation (s, RCTa; q, RCTb; v, RCTc)
No. of studies 25
20
15
10
5
0 1991
1992 1993 1994 Year of publication
1995
No. of studies 25
20
15
10
5
0 1991
1992 1993 1994 Year of publication
1995
FIGURE 3 Number of studies using a decision theory or recording an informed decision measure (s, decision theory only; q, informed decision measure only; v, theory and informed decision measure)
FIGURE 4 Number of observation studies by year (s, concurrent; q, before/after same sample; v, before/after different samples)
28
Health Technology Assessment 1999; Vol. 3: No. 1
Chapter 4 Discussion
T his bibliography summarises 547 controlled studies evaluating the effect of a range of
attend for screening, were omitted because there is no evaluation of an intervention. Reviews in all three
interventions on real patient decision making. The of these areas would probably increase understand-
strengths are the systematic method of compilation, ing of how individuals make decisions, and which
the quality classifications using the hierarchy of
measures best assess informed decision making but
evidence and by theory, the categorisation of all
would not evaluate intervention to facilitate
measures recorded, and the classification by
informed patient decision making.
health domain and by type of intervention. We
have identified under-researched areas for future
Although, this review systematically applied the
empirical work and well-studied areas to which
pre-defined criteria to a large number of studies
quantitative systematic reviews can be applied.
(n = 17,860), not all the available evidence was
The following discussion is divided into four parts: evaluated. Resource constraints resulted in
an evaluation of our methods; an overview of the
three electronic databases being searched for
findings; suggested uses of the review; and
publications from only 5 years, and three journals
recommendations for further research.
handsearched for papers from a 10-year period.
The complete electronic databases and reference
sections from included articles or `grey literature'
Evaluating the methods
were not searched. This deficit will have reduced the number of studies in the review. However, it
Systematic identification
was clear from the handsearching that patient
The advantage of integrating research by the
rather than expert or professional decision
systematic application of set criteria to all eligible
making is a more recent area of interest.
articles is reduced bias. Other types of review tend
to be guided by specific research agendas and may
preferentially include studies supporting this. Recommendations drawn from this type of
Overview of results
systematic review will be based on a fairer
Describing the area researched
representation of the literature. The main
Although the search strategy effectively generated
disadvantage of a rigid methodology is the
a high proportion of studies with an RCT design
systematic exclusion of information from studies
(Table 1), less than 10% of studies were classified
that do not fulfil the inclusion criteria.
as having a low risk of bias. Although some studies
in which the randomisation procedures were not
Three areas of related research were excluded for
adequately explained may also have had a low risk
this reason: studies of patient's preferences for
of bias, this is disappointing. The number of such
health care; studies assessing changes in knowledge studies is rising only slowly and as a proportion of
without recording behaviour; and comparative
all studies, rising not at all (Figure 2).
studies describing predictors of behaviour. Studies
measuring preferences were excluded because these The majority of interventions involved providing
are only weakly associated with the final treatment
patients with more information (55%) and/or
choice or health decision. Nevertheless, as the
changing the delivery of information (50%). Few
patient is not committed to the final choice, they
evaluated the manipulation of information (17%)
provide an excellent opportunity to evaluate more
or the effectiveness of patient prompts or decision
theoretically driven interventions.29­31 Many such
aids (10%). This is disappointing as it is manip-
studies exist and their integration should be a
ulation of information and the application of
priority for a future systematic review. Likewise,
decision aids rather than additional information
studies describing only knowledge change were
that are more likely to be associated with changes
excluded because knowledge alone is not a direct
in informed patient decision making.32
measure of informed patient decision making. Com-
parative studies describing predictors of behaviour
The majority of decisions were concerned with
such as the reasons why individual's attend or do not health promotion. For example, decisions
29
Discussion
regarding healthy eating or attendance for
design with a low risk of bias. This suggests that
screening. There were few comparative studies
future NHS research effort in this area should
evaluating decision making within the area of
concentrate on better quality primary research
adherence to treatment, genetics, or active
rather than on secondary reviews of existing
participation within the consultation. The least-
evidence. As the rate of production of such good
researched areas of health appear to be genetics,
quality studies is low (Figures 2 and 3), the Health
obstetrics, surgery, dentistry and mental health.
Technology Assessment programme need not
This is surprising as both prenatal and genetic
repeat this systematic review for at least 5 years.
testing particularly emphasise the importance of
autonomy and informed patient decision making
Synthesising the review data
within their aims. Although there is an established Can decision making be facilitated?
literature evaluating the impact and uptake of such The ideal evidence to answer this question could be
testing33 few studies have used experimental
provided by the five studies that assessed informed
designs to evaluate facilitation of informed patient patient decision making using an RCT design with
decision making. The lack of studies in mental
low risk of bias (Table 21). However, of these only
health is also particularly striking and should
three assessed the association between the inter-
be remedied.
vention and decision making process measures.
Although research exists evaluating the application
Over 90% of studies recorded some demographic
of decision-making techniques to professionals'
details of participants. By identifying consistent
decision making and explaining patient decision
variations within populations, interventions can be making, it is clear that interventions aimed at
appropriately targeted. However, unless researchers facilitating patient informed decision making
investigate why these variations occur it is unlikely are under-researched.
that interventions will be sufficiently informed.
The results of Table 10 suggest that few studies are
Do people who have more information make
able to explain any between-participant variations. better decisions?
Less than a third assess decision-making process
It is impossible to give a single answer to this
measures or knowledge and less than an eighth
apparently simple question because it implies
assess affect so that few conclusions can be drawn
that some decisions may be better than others
about either the impact or interaction between
and suggests that there is an external way of vali-
emotion and decision making. Finally, only 4%
dating whether the decision made was correct.
assess any trait variations that may account for
The criteria by which a decision is evaluated
individual differences for preferences for amount
depends on the underlying theory. In the absence
of information or styles in utilising the information. of theory it is not obvious for example whether
an intervention that increases knowledge, alters
Only 18% of studies referred to both a theory to
behaviour, but also causes anxiety, is resulting
inform their study and assessed measures associated in a more informed decision.
with the decision-making process. This figure is, if
anything, over-generous. Any theory referred to
In this review, we assess whether additional
within the study was recorded whether or not it was information was associated with the health
adequately operationalised. Additionally, less than behaviour, but note that few studies operationalised
15% of studies were concerned with other factors
a theory or aimed to manipulate factors associated
that have been associated with the decision-making with the decision process and outcome. Note also
process such as time pressure and proxy decision
that because there was little consistency in the
making. As so few studies actually employed a
presentation of findings between studies, only a
theory that may explain variations in patient
crude measure of intervention effect was created for
decision-making behaviour, it is not unreasonable
this latter analysis. This indicated whether the study
to conclude that few experimental studies have
reported a change (effect), no change (no effect) or
actually evaluated informed patient decision
a mixture of change and no change (mixed effect)
making. The absolute rate of studies using a theory in the health behaviours. Consequently, the findings
and recording a measure of informed decision
from this analysis are tentative.
making is rising only slowly in proportion to the
overall rise in studies generally (Figure 3).
Interventions, then, usually included two or more
factors that may be associated with decision-making
Only five studies were identified that were theory
measures. Subsequent analysis could not compare
driven, assessed measures associated with informed the effectiveness of different interventions with
30
decision-making, and used a randomised trial
health decision, as this classification did not have
Health Technology Assessment 1999; Vol. 3: No. 1
mutually exclusive categories. Independent chi-square analysis had to be carried out for each intervention and the likelihood of reporting an effect (Table 22). The reporting of an effect did not mean that the decision was any more or less informed. The results of the analysis for interventions using additional information are located on row 1 (Table 22).
ventions within the cancer domain are more refined so impacting on the behaviour or that there is something about cancer that interacts with the decision. It is probably not justified to extrapolate findings from studies in cancer to other health areas, and researchers need to be aware that the setting may affect the informed decision making process.
Half of the 301 studies evaluating additional
Does the context of the decision affect
information reported an effect of information on
decision making?
the decision behaviour. However, studies were no
The analysis suggests an association between the
more likely to report an effect than report no or
type of health decision and the likelihood of
mixed effects. So, additional information may or
studies reporting an effect (Table 24). There is an
may not be associated with decision behaviour. A
effect from the type of health decision (Table 23)
more detailed breakdown of the additional inform- with studies concerned with lifestyle and utilisation
ation studies would be needed before conclusions of services being less likely to report a treatment
could be drawn. For example, what information
effect than others. Similarly studies that showed
medium was used? Was the intervention comparing little or no effect of interventions on lifestyle or
information with no information or information
service utilisation decisions should not be extra-
with another type of intervention? What was the
polated to other types of decisions where more
quality of the information? All the study numbers
effects may be seen.
of informed decision making studies using RCT
designs (good quality) are listed (Table 20) to
provide the basis for any reader attempting a quantitative review in these areas. For example, 45 studies were recorded under the additional
Suggested applications of the review
information intervention. Of these 21 (47%)
Identification of under-researched areas
reported an effect on the decision behaviour,
Certain health areas and types of decisions have
17 (38%) no effect, and 7 (16%) mixed effects.
been more extensively researched than others and
the studies in Table 20 provide the basis for a num-
Does the way in which we present information
ber of systematic reviews. Bekker has embarked
change the effectiveness of the decision?
on two: a review of the effect of manipulation of
There were a number of interventions that may
information, and a review of the effect of the effect
be referred to when answering this question: addi-
of provision of feedback and skills acquisition.
tional intervention; manipulation information;
Clinical genetics and prenatal diagnosis are other
delivery information; group delivery information;
obvious under-researched areas. Work in these
and, patient prompts. Those studies that altered the areas should be a priority, not only because patient
delivery of information were more likely to report an decision making is widely recognised to be import-
effect. Twenty good quality trials manipulated the
ant here, but also because the strong scientific
delivery of the information (Table 20), 11 (55%)
base provides an excellent test bed for improving
reported an effect on decision behaviour. Studies
our understanding of real patient decision
that provided feedback and social skills training
making generally.
were more likely to report mixed effects on
behaviour. If the 40 good-quality trials using
Design of the ideal study
feedback (Table 20) were more closely categorised,
All studies in this area would benefit from reference
some reliable differences between effective and
to one of the decision-making theories, which were
ineffective feedback interventions may be illustrated. described in the chapter 1, at the design stage. A
study evaluating how people make decisions ought
Does the effectiveness of information on
to include a measure of the individual's decision-
decision making vary by medical setting?
making process such as a description of the
The analysis suggests there is an association
information used to make the decision. Knowledge
between the health domain in which the research is measures alone are not sufficient. Explanatory
carried out and the likelihood of reporting of an
studies will find a cross-sectional design the most
effect (Table 23). Studies evaluating cancer related
useful, and a process tracing technique applied to
decisions were more likely to report an effect on
the transcript of a consultation will usually provide
behaviour. Such a finding may mean that inter-
the best understanding of how decisions were made.
31
Discussion
Studies evaluating decision facilitation may use observational methods to formulate the research
Recommendations for research
question, but must eventually use the best-quality
· Future primary research should not simply
experimental design, the RCT. Typically, the com-
rely on behavioural or psychometric outcomes
parison should be against routine care, as there are
but should work under a theory of decision
no well-evaluated and clearly effective interventions
making, and record decision process measures
in this area. The following is a description of an
that permit evaluation of whether the decision
unpublished study carried out by Bekker. It is an
was informed. If evaluating experimental inter-
example of an ideal study to evaluate the facilitation
ventions, they must use RCT methods with a
of informed decision making.
low risk of bias.
· A booklet describing the main decision-
Question: Does decision analysis increase informed
making theories, and an inventory of suitable
decision making by women ­ choosing to
questionnaires and interview-based outcome
have a diagnostic test in pregnancy after
measures could be developed to help
a screen positive?
clinical health researchers design
Theory: Decision analysis is a decision aid derived
appropriate studies.
from expected utility theory. Expected
· Complementary systematic reviews of the
utility theory, the theory of planned
following topics would be valuable:
behaviour, and reasoned-based models
­ trials evaluating the effect of interventions
of decision making informed the
on patient preferences. At least 50 such
evaluation measures.
studies were excluded from the present
Design: RCT with a low risk of bias ­ numbered,
bibliography because no behaviour change
sealed, opaque envelopes were opened
was recorded.
for allocation to either a routine
­ observational studies furthering the
information consultation or a decision-
understanding of real patient decision
analysis consultation.
making. Three process-tracing methodo-
Measures: The consultation was audio-tape
logies will predominate: tape-recorded
recorded, transcribed and coded. A
consultations; verbal protocols of thinking
questionnaire was completed after the
aloud techniques; and information
decision was made and 4 weeks later.
boards or computer programmes to
The following variables were assessed:
document the information referred
­ informed decision making: study speci-
to by patients.
fic coding frame and computer pro-
­ assessing the effect of additional information,
gramme applied to transcripts assessing
manipulation of information, provision of
thinking words and information utilised
feedback, and group delivery of information
­ reasoning: questionnaire included
on subsequent informed patient
measures of beliefs, attitudes,
decision making.
perception of risk, and knowledge
· Primary research is required in the following
­ affect: anxiety and decisional conflict
health areas:
assessed by questionnaires, use of
­ genetics and prenatal diagnosis. This area
emotion-laden words assessed by
is a good place to begin because the nature
the computer programme analysis
of the information base, with relatively
of transcripts
simple clearly-defined options with known
­ clinical: consultation length recorded
risks corresponds closely to the terms that
and perceived usefulness of information
decision theories use.
­ behaviour: decision to be or not
­ areas where decisions are often made
be tested
by proxy such as paediatrics and
­ other: demographic variations,
mental health.
reproductive history and individual
· Primary research is required to evaluate the
differences in information processing
following types of interventions:
assessed by questionnaires.
­ Decision aids, such as graphical,
pictorial, computer and Internet-
In summary the ideal study should randomise
based devices.
using a method with a low risk of bias, be designed
­ Information manipulation, such as decision
with reference to decision-making theory, and
analysis, patient prompts and provision of
include measures of the decision-making process
feedback, and scenario-based approaches to
32
and outcome.
informing choice of treatments.
Health Technology Assessment 1999; Vol. 3: No. 1
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16. Bazerman MH, Tenbrusel AE, Wade-Benzani K. Negotiating with yourself and losing: making decisions with competing internal preferences. Academy of Management Review 1998;23:225­41.
2. Ley P. Communicating with patients: improving communication, satisfaction and compliance. UK: Croom Helm, 1988. 3. Tversky A, Kahneman D. Judgement under uncertainty: heuristics and biases. Science 1974;185:1124­31. 4. Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science 1981;211:453­8. 5. Janis I, Mann L. Decision making: a psychological analysis of conflict, choice, and commitment. USA: Free Press, 1977. 6. Wilson TD, Schooler JW. Thinking too much: introspection can reduce the quality of preferences and decisions. J Pers Soc Psychol 1991;60:181­92. 7. Baron J. Thinking and deciding. 2nd edition. New York: Cambridge University Press, 1994. 8. Kleindorfer PR, Kunreuther HC, Schoemaker PJH. Decision Sciences: an integrative perspective. New York: Cambridge University Press, 1993. 9. Savage LJ. The foundations of statistics. New York: Wiley. 10. Goldstein WM, Hogarth RM. Judgment and decision research: some historical context. In: Goldstein WM, Hogarth RM, editors. Research on judgment and decision making: currents, connections and controversies. New York: Cambridge University Press, 1997. 11. Simon HA. A behavioral model of rational choice. Q J Econ 1955;69:99­118.
17. Kuhberger A. Theoretical conceptions of framing effects in risky decisions. In: Ranyard R, Crozier WR, Svenson O, editors. Decision making: cognitive models and explanations. London: Routledge, 1997. 18. McNeil BJ, Pauker SG, Sox HC, Tversky A. On the elicitation of preferences for alternative therapies. New Engl J Med 1982;306:1259­62. 19. Christensen-Szalanski JJJ, Bushyhead JB. Physicians' use of probabilistic information in real clinical settings. J Exp Psychol [Hum Percept] 1981;7:928­35. 20. Mann L. Stress, affect and decision making. In: Yates FJ, editor. Risk-taking behavior. New York: Wiley, 1991. 21. Mano H. Risk taking, framing effects and affect. Organizational Behavior and Human Decision Processes 1994;57:35­58. 22. Svenson O, Maule AJ, editors. Time pressure and stress in human judgment and decision making. New York: Plenum, 1993. 23. Klein GA, Orasnu J, Calderwood R, Zsambok CE, editors. Decision making in action: models and methods. USA: Ablex Publishing Corporation, 1993. 24. Olson DL. Decision aids for selection problems. New York: Springer, 1996. 25. Van der Heijden K. Scenarios: the art of strategic conversation. London: Wiley, 1996
12. Kahneman D, Slovic P, Tversky A, editors. Judgment under uncertainty: heuristics and biases. Cambridge: Cambridge University Press, 1982. 13. Payne JW, Bettman JR, Johnson EJ. The adaptive decision maker. Cambridge: Cambridge University Press, 1993.
26. Russo J, Shoemaker PJH. Confident decision making. Piatkus, 1989. 27. Klein GA. An overview of naturalistic decision making applications. In: Zsambok CE, Klein G, editors. Naturalistic decision making. New Jersey: Erlbaum, 1997.
14. Goodwin P, Wright G. Decision analysis for management judgement. 2nd edition. New York: Wiley, 1997.
28. Dickeson. In: Cooper HM, editor. Integrating research: a guide for literature review. 2nd edition. London: Sage, 1989.
15. Conner M, Norman P, editors. Predicting health
29. Siegert EA, Clipp EC, Mulhausen P, Kochersberger.
behaviour: research and practice with social
Impact of advance directive videotape on patient
cognition models. Milton Keynes: Open University Press, 1996.
comprehension and treatment preferences. Arch Fam Med 1996;5:207­12.
33
References
30. Mazur DJ, Hickam. Patients and physicians' interpretations of graphic data displays. Med Decis Making 1993;13:59­63. 31. Mazur DJ, Merz JF. Older patients' willingness to trade off urologic adverse outcomes for a better chance at five-year survival in the clinical setting of prostate cancer. J Am Geriatr Soc 1995;43:979­84.
32. O'Connor AM, Llewellyn-Thomas HA, Drake ER. An annotated bibliography of research on shared decision making. National Cancer Institute of Canada 1995. Available from URL: http://hiru.mcmaster.ca/cpep/sdm/ 33. Marteau TM, Richards M, editors. The troubled helix. 1997
34
Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 1
References used to develop the search strategy
Bekker H, Modell M, Dennis G, Silver A, Matthew C, Bobrow M, et al. Uptake of cystic fibrosis testing in primary care; supply push or demand pull. BMJ 1993;306:1584­6. Clayton EW, Hannig VL, Pfotenhauer JP, et al. Teaching about cystic fibrosis carrier screening by using written and video information. Am J Hum Genet;57:171­81. Field T, Sandberg D, Quetel TA, Garcia R, Rosario M. Effects of ultrasound feedback on pregnancy anxiety, fetal activity, and neonatal outcome. Obstet Gynecol 1985;66:525­8. Freda MC, Andersen HF, Damus K, Merkatz IR. Are there differences in information given to private and public prenatal patients? Am J Obstet Gynecol 1993;169:155­60. Heckerling PS, Verp MS. Amniocentesis or chorionic villus sampling for prenatal genetic testing: a decision analysis. J Clin Epidemiol 1991;44(7):657­70. Lichtenstein S, Newman JR. Empirical scaling of common verbal phrases associated with numerical probabilities. Psychol Sci 1987;9(10):563­4. Livingstone J, Axton RA, Mennie M, Gilfillan A, Brock. A preliminary trial of couple screening for cystic fibrosis; designing an appropriate information leaflet. Clin Genet 1993;43:57­62. Llewellyn-Thomas HA, Thiel EC, Sem FW, Woermke DE. Presenting clinical trial information: a comparison of methods. Patient Education and Counseling 1995;25:97­107. Marteau TM, Kidd J, Michie S, Cook R, Johnston M, Shaw RW. Anxiety knowledge and satisfaction in women receiving false positive results on routine prenatal screening: a randomised controlled trial. J Psychosom Obstet Gynaecol 1993;14:185­96.
Mazur DJ, Merz JF. Older patients' willingness to trade off urologic adverse outcomes for a better chance at five-year survival in the clinical setting of prostate cancer. J Am Geriatr Soc 1995;43:979­84. Miedzybrodzka ZH, Hall MH, Mollison J, Templeton A, Russell IT, Dean JC, et al. Antenatal screening for carriers of cystic fibrosis: randomised trial of stepwise v couple screening. BMJ 1995;310:353­7. Pauker SP, Pauker SG. The amniocentesis decision: ten years of decision analytic experience. Birth defects; original article series 23(2):151­69. March of Dimes Birth Defects Foundation, 1987. Savage R, Armstrong D. Effects of a general practitioners consulting style on patient satisfaction: a controlled study. BMJ 1990;301:968­70. Simes RJ, Tattersall MH, Coates AS, Raghaven D, Solomon HG, Smartt H. Randomised comparison of procedures for obtaining informed consent in clinical trials of treatment for cancer. BMJ 1986;293:1065­8. Schapiro MC, Najman A, Change J, Keeping D, Morrison J, Western JS. Information control and the exercise of power in the obstetrical encounter. Soc Sci Med 1983;17:139­46. Thornton JG, Hewison J, Lilford RJ, Vail A. A randomised trial of three methods of giving information about prenatal testing. BMJ 1995;311:1127­30. Wilkinson C, Jones JM, McBride J. Anxiety caused by abnormal result of cervical smear test: a controlled trial. BMJ 1990;300:440.
35
Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 2 The principle of the search strategy
Decision-making terms Career choice Decision making Communication Cybernetics Advertising Decision support techniques Thinking Creativeness
OR
Patient terms Psychological models Psychological theory Probability Risk Patient acceptance health care Patient participation Knowledge, attitudes, practice Truth disclosure Treatment refusal Fees, charges, willingness to pay Consumer satisfaction Consumer participation Health education Professional­patient relations Public opinion Sick role Counselling Genetic counselling Applied psychology
PLUS Comparative-study terms Comparative study Cross-sectional study Data collection Statistics Evaluation studies Feasibility studies Cohort studies Random allocation Clinical trials Control trials Research study design Pilot projects intervention studies Measures 37
Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 3 MEDLINE search strategy
career choice/ exp decision making/ 2 not 1 exp communication/ exp cybernetics/ exp advertising/ exp animal communication/ 5 or 6 or 7 4 not 8 exp decision support techniques/ "neural networks (computer)"/ 10 not 11 informed consent/ exp thinking/ exp autism/ creativeness/ exp esthetics/ 15 or 16 or 17 14 not 18 models, psychological/ exp probability/ exp risk/ risk-taking/ exp psychological theory/ exp patient acceptance of health care/ exp patient participation/ exp knowledge, attitudes, practice/ exp truth disclosure/ exp treatment refusal/ (patient adj3 decision).ti,ab. fee$ charg$.ti,ab. willing$ to pay.ti,ab. or/3,9,12-13,19-32
exp consumer participation/ exp consumer satisfaction/ exp health education/ health status/ exp professional-patient relations/ exp patient acceptance of health care/ exp public opinion/ sick role/ genetic counseling/ exp counseling/ psychology, applied/ (referral and consultation).ti,ab,sh. exp attitude to health/ (patient adj3 decision).ti,ab. or/34-47 comparative study/ cross-sectional studies/ exp data collection/ exp statistics/ exp evaluation studies/ exp feasibility studies/ exp cohort studies/ exp random allocation/ exp clinical trials/ exp research/ exp "study design (non mesh)"/ exp pilot projects/ exp intervention studies/ (clinical adj2 trial).ti,ab. (control$ adj2 trial$).ti,ab. measure$.ti,ab. or/49-64 33 and 48 and 65
39
Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 4
Data extraction coding forms
Page 1, Table 1 -- Article identification details
Field Article review number number studies project number number of duplicate Authors Title Journal details Included/excluded (reasons exclude) Database Date downloaded Date sent to reviewer Date returned reviewer Initials reviewer
Details
................... ................... ................... ...................
.........................................................................................................................................................
.........................................................................................................................................................
.........................................................................................................................................................
included
excluded
.........................................................................................................................................................
MEDLINE
PsycLIT
BIDS
handsearch
______ /______
______ /______
______ /______
MA HB JC JH JM MM SM AP MR JT
Page 2, Table 1 ­ Describing health decision and quality study Summary health decision (free text)
Location research: unknown UK North America S. Africa Australia/NZ other (write .................................... ..........................................................)
Participants: unknown adult well pregnant physically impaired elderly (> 65) mentally impaired child (< 17) non-English speaking
The nature of the decision is: A) real intended hypothetical B) implicit explicit C) affects ­ participant other D) made at ­ time intervention later
Domain of health care: Write type of illness or health domain research located (e.g. cervical/breast cancer, asthma, health promotion, cardiovascular risk factors, HIV/condom use, smoking cessation, drug use, tuberculoses, malaria, etc.) ..................................................................... .....................................................................
Defining type of health decision: Write type of health decision (e.g. screening, diagnostic testing, medication/ drug therapy, surgical treatment, behavioural therapy, willingness to pay, research, cessation, etc.) ..................................................................... .....................................................................
Authors awareness theory: Decision making theory: 0 = no theory referred to Write in the name of theory referred to in the introduction or methods section ... ........................................................................ ........................................................................
Quality of study: Design of study: randomised (RCT) a b c non-randomised concurrent before/after different sample before/after same sample Other (e.g. matched case-controlled) .....................................................................
Quality of study continued... Level of intervention: patient level other level not rec. Sample invited to participate: total `population' available stratified/systematic sample volunteer/non-systematic sample not adequately described
Quality of study continued... Sample size: total number available _____ not rec. total number invited _____ not rec. number participated _____ not rec. number excluded _____ not rec. number in final analysis _____ not rec.
Quality of study continued...
Quality of study continued...
Reference to be accessed ...
Causes for concern:
Development intervention materials:
no/not obvious causes for concern
piloted intervention: no yes in part
yes (please write any concerns)
piloted measures: no yes in part
..................................................................... readability score: no yes in part
..................................................................... 41
Appendix 4
Page 3, Table 1 ­ Description of intervention groups
Nature of intervention: explicit information
change in service
other
Comparative group Group 1 Group 2 Group 3 Group 4 Group 5
Description of intervention (write ...)
Code
...................................................................... [ ] [ ] ...................................................................... [ ] [ ]
...................................................................... [ ] [ ] ...................................................................... [ ] [ ]
...................................................................... [ ] [ ] ...................................................................... [ ] [ ]
...................................................................... [ ] [ ] ...................................................................... [ ] [ ]
...................................................................... [ ] [ ] ...................................................................... [ ] [ ]
Number in group (n)
Page 3, Table 2 ­ Variables described within article
Variable
Code
Write variables described within the study (e.g. age, gender, attitudes, social support)
Alongside each variable, tick whether the analysis of the variable was descriptive, main effect or interaction.
Descriptives
Main effect analysis Interaction analysis
Page 4, Table 1 ­ Description health decision outcome
Description (write...)
Continuous/categorical
Validated, piloted, study specific val pil study val pil study
Description validated measure (write):
Page 4, Table 2 ­ Results evaluating the association of the intervention and decision outcome
Variable
Categorical level/group e.g. adhere 1 not adhere 2
Group 1 not available or `n' or mean (sd) n
Group 2 not available or `n' or mean (sd) n
Group 3 not available or `n' or mean (sd) n
Group 4 not available or `n' or mean (sd) n
Group 5 not available or `n' or mean (sd) n
sd = standard deviation Page 4, Table 3 ­Text box summarising the results of the intervention Write summary results of intervention on decision outcome and author's main outcome measures.
42
Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 5 Bibliography: studies by study number
1 - 1 Lindholm LH, Ekbom T, Dash C, Isacsson A, Schersten B. Changes in cardiovascular risk factors by combined pharmacological and nonpharmacological strategies: the main results of the CELL Study. Journal of Internal Medicine 1996;240(1):13­22. 3 - 1 Davies-Adetugbo AA. Promotion of breast feeding in the community: impact of health education programme in rural communities in Nigeria. Journal of Diarrhoeal Diseases Research 1996;14(1):5­11. 4 - 1 Hoffman JA, Caudill BD, Koman JJ 3rd, Luckey JW, Flynn PM, Mayo DW. Psychosocial treatments for cocaine abuse. 12-month treatment outcomes. Journal of Substance Abuse Treatment 1996;13(1):3­11. 6 - 1 El-Chaar GM, Mardy G, Wehlou K, Rubin LG. Randomized, double blind comparison of brand and generic antibiotic suspensions: II. A study of taste and compliance in children. Pediatric Infectious Disease Journal 1996;15(1):18­22. 6 - 2 El-Chaar GM, Mardy G, Wehlou K, Rubin LG. Randomized, double blind comparison of brand and generic antibiotic suspensions: II. A study of taste and compliance in children. Pediatric Infectious Disease Journal 1996;15(1):18­22.
19 - 1
Mazur DJ, Hickam DH. Five-year survival curves: how much data are enough for patient­physician decision making in general surgery? European Journal of Surgery 1996;162(2):101­4.
20 - 1
Gil KM, Wilson JJ, Edens JL, Webster DA, Abrams MA, Orringer E, Grant M, Clark WC, Janal MN. Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease. Health Psychology 1996;15(1):3­10.
22 - 1
Pauw J, Ferrie J, Rivera Villegas R, Medrano Martinez J, Gorter A, Egger M. A controlled HIV/AIDS-related health education programme in Managua, Nicaragua. AIDS 1996;10(5):537­44.
23 - 1
Hagopian GA. The effects of informational audiotapes on knowledge and self-care behaviors of patients undergoing radiation therapy. Oncology Nursing Forum 1996;23(4):697­700.
24 - 1
Gordon CM, Carey MP. Alcohol's effects on requisites for sexual risk reduction in men: an initial experimental investigation. Health Psychology 1996;15(1):56­60.
26 - 1
Hartley BM, O'Connor ME. Evaluation of the `Best Start' breast-feeding education program. Archives of Pediatrics and Adolescent Medicine 1996;150(8):868­71.
6 - 3 El-Chaar GM, Mardy G, Wehlou K, Rubin LG. Randomized, double blind comparison of brand and generic antibiotic suspensions: II. A study of taste and compliance in children. Pediatric Infectious Disease Journal 1996;15(1):18­22.
27 - 1
Maisiak R, Austin J, Heck L. Health outcomes of two telephone interventions for patients with rheumatoid arthritis or osteoarthritis. Arthritis and Rheumatism 1996;39(8):1391­9.
10 - 1
Toseland RW, O'Donnell JC, Engelhardt JB, Hendler SA, Richie JT, Jue D. Outpatient geriatric evaluation and management. Results of a randomized trial. Medical Care
28 - 1
Mercer BS. A randomized study of the efficacy of the PROPATH Program for patients with Parkinson disease. Archives of Neurology 1996;53(9):881­4.
1996;34(6):624­40.
32 - 1 Agras WS, Berkowitz RI, Arnow BA, Telch CF,
17 - 1
Smith MU, Katner HP. Quasi-experimental evaluation of three AIDS prevention activities for maintaining knowledge, improving attitudes, and changing risk behaviors of high school
Marnell M, Henderson J, Morris Y, Wilfley DE. Maintenance following a very-low-calorie diet. Journal of Consulting and Clinical Psychology 1996;64(3):610­3.
seniors. AIDS Education and Prevention
34 - 1 Foley EC, D'Amico F, Merenstein JH. Five-year
1995;7(5):391­402.
follow-up of a nurse-initiated intervention to
18 - 1 Goldberg L, Elliot DL, Clarke GN, MacKinnon DP, Zoref L, Moe E, Green C, Wolf SL. The Adolescents Training and Learning to Avoid
improve mammography recommendation. Journal of the American Board of Family Practice 1995;8(6):452­6.
Steroids (ATLAS) prevention program.
35 - 1 O'Hara P, Messick BJ, Fichtner RR, Parris D. A
Background and results of a model intervention.
peer-led AIDS prevention program for students
Archives of Pediatrics and Adolescent Medicine 1996;150(7):713­21.
in an alternative school. Journal of School Health 1996;66(5):176­82.
43
Appendix 5
37 - 1
Yancey AK, Tanjasiri SP, Klein M, Tunder J. Increased cancer screening behavior in women of color by culturally sensitive video exposure. Preventive Medicine 1995;24(2):142­8.
38 - 1
Bearss N, Santelli JS, Papa P. A pilot program of contraceptive continuation in six schoolbased clinics. Journal of Adolescent Health 1995;17(3):178­83.
39 - 1
Bowman J, Sanson-Fisher R, Boyle C, Pope S, Redman S. A randomised controlled trial of strategies to prompt attendance for a Pap smear. Journal of Medical Screening 1995;2(4):211­8.
40 - 1 Rabin JM, McNett J, Badlani GH. `Compu-Void II': the computerized voiding diary. Journal of Medical Systems 1996;20(1):19­34.
41 - 1
Turner KM, Wilson BJ, Gilbert FJ. Improving breast screening uptake: persuading initial nonattenders to attend. Journal of Medical Screening 1994;1(3):199­202.
42 - 1
Gillies J, Barry D, Crane J, Jones D, MacLennan L, Pearce N, Reid J, Toop L. A community trial of a written self management plan for children with asthma. Asthma Foundation of NZ Children's Action. New Zealand Medical Journal 1996;109(1015):30­3.
44 - 1
Gardiner JC, Mullan PB, Rosenman KD, Zhu Z, Swanson GM. Mammography usage and knowledge about breast cancer in a Michigan farm population before and after an educational intervention. Journal of Cancer Education 1995;10(3):155­62.
50 - 1
Reid C, McNeil JJ, Williams F, Powles J, Cardiovascular risk reduction: a randomized trial of two health promotion strategies for lowering risk in a community with low socioeconomic status. Journal of Cardiovascular Risk 1995;2(2):155­63.
51 - 1
Ellerbeck E, Khallaf N, el Ansary KS, Moursi S, Black R. Caretaker compliance with different antibiotic formulations for treatment of childhood pneumonia. Journal of Tropical Pediatrics 1995;41(2):103­8.
52 - 1
Mohler PJ. Enhancing compliance with screening mammography recommendations: a clinical trial in a primary care office. Family Medicine 1995;27(2):117­21.
53 - 1
Friedman RH, Kazis LE, Jette A, Smith MB, Stollerman J, Torgerson J, Carey K. A telecommunications system for monitoring and counseling patients with hypertension. Impact on medication adherence and blood pressure control. American Journal of Hypertension 1996;9(4 Pt 1):285­92.
55 - 1
Sussman S, Parker VC, Lopes C, Crippens DL, Elder P, Scholl D. Empirical development of brief smoking prevention videotapes which target African-American adolescents. International Journal of the Addictions 1995;30(9):1141­64.
55 - 2
Sussman S, Parker VC, Lopes C, Crippens DL, Elder P, Scholl D. Empirical development of brief smoking prevention videotapes which target African-American adolescents. International Journal of the Addictions 1995;30(9):1141­64.
45 - 1
Heath GW, Fuchs R, Croft JB, Temple SP, Wheeler FC. Changes in blood cholesterol awareness: final results from the South Carolina Cardiovascular Disease Prevention Project. American Journal of Preventive Medicine 1995;11(3):190­6.
46 - 1
Kash KM, Holland JC, Osborne MP, Miller DG. Psychological counseling strategies for women at risk of breast cancer. Monographs ­ National Cancer Institute 1995;(17):73­9.
56 - 1 Christensen B. Payment and attendance at general practice preventive health examinations. Family Medicine 1995;27(8):531­4.
57 - 1
Detry JM, Block P, De Backer G, Degaute JP. Patient compliance and therapeutic coverage: comparison of amlodipine and slow release nifedipine in the treatment of hypertension. The Belgian Collaborative Study Group. European Journal of Clinical Pharmacology 1995;47(6):477­81.
47 - 1
Lave JR, Ives DG, Traven ND, Kuller LH. Participation in health promotion programs by the rural elderly. American Journal of Preventive Medicine 1995;11(1):46­53.
48 - 1
Straton JA, Sutherland GJ, Hyndman JC. Cervical cancer screening for hospital inpatients: report of an intervention study. Australian Journal of Public Health 1995;19(3):288­93.
58 - 1 Sanner MA, Hedman H, Tufveson G. Evaluation of an organ-donor-card campaign in Sweden. Clinical Transplantation 1995;9(4):326­33.
61 - 1
Bjorge T, Gunbjorud AB, Haugen OA, Skare GB, Trope C, Thoresen SO. Mass screening for cervical cancer in Norway: evaluation of the pilot project. Cancer Causes and Control 1995;6(6):477­84.
49 - 1 Sunwood J, Brenman A, Escobedo J, Philpott T,
63 - 1 Cherkin DC, Deyo RA, Street JH, Hunt M, Barlow
Allman K, Mueller J, Jaeger J, Brown LK, Cole FS.
W. Pitfalls of patient education. Limited success
44
School-based AIDS education for adolescents. Journal of Adolescent Health 1995;16(4):309­15.
of a program for back pain in primary care. Spine 1996;21(3):345­55.
Health Technology Assessment 1999; Vol. 3: No. 1
64 - 1
Burton LC, Paglia MJ, German PS, Shapiro S, Damiano AM. The effect among older persons of a general preventive visit on three health behaviors: smoking, excessive alcohol drinking, and sedentary lifestyle. The Medicare Preventive Services Research Team. Preventive Medicine 1995;24(5):492­7.
67 - 1
Griffith CH 3rd, Wilson JF, Emmett KR, Ramsbottom-Lucier M, Rich EC. Knowledge and experience with Alzheimer's disease. Relationship to resuscitation preference. Archives of Family Medicine 1995;4(9):780­4.
71 - 1
Elk R, Schmitz J, Manfredi L, Rhoades H, Andres R, Grabowski J. Cessation of cocaine use during pregnancy: a preliminary comparison. Addictive Behaviors 1994;19(6):697­702.
72 - 1
Berman BA, Gritz ER, Braxton-Owens H, Nisenbaum R. Targeting adult smokers through a multi-ethnic public school system. Journal of Cancer Education 1995;10(2):91­101.
74 - 1
Conget I, Jansa M, Vidal M, Vidal J, Manzanares JM, Gomis R. Effects of an individual intensive educational control program for insulindependent diabetic subjects with poor metabolic control. Diabetes Research and Clinical Practice 1995;27(3):189­92.
75 - 1
Della Valle CJ, Levitz CL, Bora FW Jr. Health care utilization and attitudes toward health insurance. A comparison of privately insured and medical assistance or uninsured patients. American Journal of Orthopedics 1995;24(6):483­7.
79 - 1
Fardy PS, White RE, Clark LT, Amodio G, Hurster MH, McDermott KJ, Magel JR. Health promotion in minority adolescents: a Healthy People 2000 pilot study. Journal of Cardiopulmonary Rehabilitation 1995;15(1):65­72.
80 - 1
Oldenburg B, Martin A, Greenwood J, Bernstein L, Allan R. A controlled trial of a behavioral and educational intervention following coronary artery bypass surgery. Journal of Cardiopulmonary Rehabilitation 1995;15(1):39­46.
82 - 1
Boulet LP, Boutin H, Cote J, Leblanc P, Laviolette M. Evaluation of an asthma self-management education program. Journal of Asthma 1995;32(3):199­206.
83 - 1
Binstock MA, Wolde-Tsadik G. Alternative prenatal care. Impact of reduced visit frequency, focused visits and continuity of care. Journal of Reproductive Medicine 1995;40(7):507­12.
85 - 1
Ferris DG, Golden NH, Petry LJ, Litaker MS, Nackenson M, Woodward LD. Effectiveness of breast self-examination prompts on oral contraceptive packaging. Journal of Family Practice 1996;42(1):43­8.
86 - 1
Navarro AM, Senn KL, Kaplan RM, McNicholas L, Campo MC, Roppe B. Por La Vida intervention model for cancer prevention in Latinas. Monographs ­ National Cancer Institute 1995;(18):137­45.
88 - 1
Williford SL, Johnson DF. Impact of pharmacist counseling on medication knowledge and compliance. Military Medicine 1995;160(11):561­4.
89 - 1
Boudreau F, Godin G, Pineau R, Bradet R. Health risk appraisal in an occupational setting and its impact on exercise behavior. Journal of Occupational and Environmental Medicine 1995;37(9):1145­50.
91 - 1
DiScenza S, Nies M, Jordan C. Effectiveness of counseling in the health promotion of HIVpositive clients in the community. Public Health Nursing 1996;13(3):209­16.
95 - 1
Simeoni E, Bauman A, Stenmark J, O'Brien J. Evaluation of a community arthritis program in Australia: dissemination of a developed program. Arthritis Care and Research 1995;8(2):102­7.
96 - 1
McFarlane WR, Lukens E, Link B, Dushay R, Deakins SA, Newmark M, Dunne EJ, Horen B, Toran J. Multiple-family groups and psychoeducation in the treatment of schizophrenia. Archives of General Psychiatry 1995;52(8):679­87.
97 - 1
Bian JY, Zhang BX, Rong WS. Evaluating the social impact and effectiveness of four-year `Love Teeth Day' campaign in China. Advances in Dental Research 1995;9(2):130­3.
98 - 1
Taal E, Riemsma RP, Brus HL, Seydel ER, Rasker JJ, Wiegman O. Group education for patients with rheumatoid arthritis. Patient Education and Counseling 1993;20(2­3):177­87.
99 - 1
Forsyth MC, Fulton DL, Lane DS, Burg MA, Krishna M. Changes in knowledge, attitudes and behavior of women participating in a community outreach education program on breast cancer screening. Patient Education and Counseling 1992;19(3):241­50.
100 - 1 Maurer WJ. Breast cancer screening complacency and compliance. Wisconsin Medical Journal 1995;94(6):305­6.
84 - 1
Kuthy S, Grap MJ, Penn L, Henderson V. After the party's over: evaluation of a drinking and driving prevention program. Journal of Neuroscience Nursing 1995;27(5):273­7.
101 - 1 Kendall C, Hailey BJ. The relative effectiveness
of three reminder letters on making and keeping
mammogram appointments. Behavioral Medicine 1993;19(1):29­34.
45
Appendix 5
102 - 1 Glasgow RE, Hollis JF, Ary DV, Boles SM. Results of a year-long incentives-based worksite smokingcessation program. Addictive Behaviors 1993;18(4):455­64. 104 - 1 Boehm S, Schlenk EA, Raleigh E, Ronis D. Behavioral analysis and behavioral strategies to improve self-management of type II diabetes. Clinical Nursing Research 1993;2(3):327­44. 105 - 1 Murray MD, Birt JA, Manatunga AK, Darnell JC. Medication compliance in elderly outpatients using twice-daily dosing and unit-of-use packaging. Annals of Pharmacotherapy 1993;27(5):616­21. 106 - 1 Stevens-Simon C, O'Connor P, Bassford K. Incentives enhance postpartum compliance among adolescent prenatal patients. Journal of Adolescent Health 1994;15(5):396­9. 107 - 1 Caceres CF, Rosasco AM, Mandel JS, Hearst N. Evaluating a school-based intervention for STD/AIDS prevention in Peru. Journal of Adolescent Health 1994;15(7):582­91.
122 - 1 Verne J, Kettner J, Mant D, Farmer A, Mortenson N, Northover J. Self-administered faecal occult blood tests do not increase compliance with screening for colorectal cancer: results of a randomized controlled trial. European Journal of Cancer Prevention 1993;2(4):301­5. 123 - 1 Remafedi G. Cognitive and behavioral adaptations to HIV/AIDS among gay and bisexual adolescents. Journal of Adolescent Health 1994;15(2):142­8. 124 - 1 Weiden P, Rapkin B, Zygmunt A, Mott T, Goldman D, Frances A. Postdischarge medication compliance of inpatients converted from an oral to a depot neuroleptic regimen. Psychiatric Services 1995;46(10):1049­54. 125 - 1 Magura S, Kang SY, Shapiro JL. Outcomes of intensive AIDS education for male adolescent drug users in jail. Journal of Adolescent Health 1994;15(6):457­63.
108 - 1 Park SI, Saxe JC, Weesner RE. Does use of the Coloscreen Self-Test improve patient compliance with fecal occult blood screening? American Journal of Gastroenterology 1993;88(9):1391­4.
126 - 1 Kurtz ME, Kurtz JC, Given B, Given CC. Promotion of breast cancer screening in a work site population. Health Care for Women International 1994;15(1):31­42.
110 - 1 Fries JF, Bloch DA, Harrington H, Richardson N, Beck R. Two-year results of a randomized controlled trial of a health promotion program in a retiree population: the Bank of America Study. American Journal of Medicine 1993;94(5):455­62. 111 - 1 Holley JL, Nespor S, Rault R. The effects of providing chronic hemodialysis patients written material on advance directives. American Journal of Kidney Diseases 1993;22(3):413­8.
132 - 1 Kasemsarn P, Ngarmpiyasakul C, Phongpanich S, Pulkasisri N. Baby-friendly hospital: how to sustain? Journal of the Medical Association of Thailand 1995;78(7):362­8. 133 - 1 Sobczyk W, Hazel N, Reed CD, Ciarroccki B, Cohen S, Varga D. Health Promotion Schools of Excellence: a model program for Kentucky and the nation. Journal of the Kentucky Medical Association 1995;93(4):142­7.
114 - 1 Champion V, Huster G. Effect of interventions on stage of mammography adoption. Journal of Behavioral Medicine 1995;18(2):169­87. 115 - 1 Anderson AS, Campbell DM, Shepherd R. The influence of dietary advice on nutrient intake during pregnancy. British Journal of Nutrition 1995;73(2):163­77. 117 - 1 Weinrich SP, Weinrich MC, Stromborg MF, Boyd MD, Weiss HL. Using elderly educators to increase colorectal cancer screening. Gerontologist 1993;33(4):491­6. 118 - 1 McIntosh NA, Clark NM, Howatt WF. Reducing tobacco smoke in the environment of the child with asthma: a cotinine-assisted, minimal-contact intervention. Journal of Asthma 1994;31(6):453­62.
135 - 1 Sciacca JP, Dube DA, Phipps BL, Ratliff MI. A breast feeding education and promotion program: effects on knowledge, attitudes, and support for breast feeding. Journal of Community Health 1995;20(6):473­90. 136 - 1 Girgis A, Sanson-Fisher RW, Tripodi DA, Golding T. Evaluation of interventions to improve solar protection in primary schools. Health Education Quarterly 1993;20(2):275­87. 137 - 1 Taddio A, Ito S, Einarson TR, Leeder JS, Koren G. Effect of counseling on maternal reporting of adverse effects in nursing infants exposed to antibiotics through breast milk. Reproductive Toxicology 1995;9(2):153­7.
120 - 1 Shope JT, Kloska DD, Dielman TE, Maharg R.
139 - 1 Kirkman MS, Weinberger M, Landsman PB,
Longitudinal evaluation of an enhanced alcohol
Samsa GP, Shortliffe EA, Simel DL, Feussner JR.
misuse prevention study (AMPS) curriculum for
A telephone-delivered intervention for patients
46
grades six-eight. Journal of School Health 1994;64(4):160­6.
with NIDDM. Effect on coronary risk factors. Diabetes Care 1994;17(8):840­6.
Health Technology Assessment 1999; Vol. 3: No. 1
140 - 1 Gritz ER, Carr CR, Rapkin D, Abemayor E, Chang LJ, Wong WK, Belin TR, Calcaterra T, Robbins KT, Chonkich G, Beumer J, Ward PH. Predictors of long-term smoking cessation in head and neck cancer patients. Cancer Epidemiology, Biomarkers and Prevention 1993;2(3):261­70.
157 - 1 Greenberg RA, Strecher VJ, Bauman KE, Boat BW, Fowler MG, Keyes LL, Denny FW, Chapman RS, Stedman HC, LaVange LM, Glover LH, Haley NJ, Loda FA. Evaluation of a home-based intervention program to reduce infant passive smoking and lower respiratory illness. Journal of Behavioral Medicine 1994;17(3):273­90.
142 - 1 Ingold FR, Toussirt M. Transmission of HIV among drug addicts in three French cities: implications for prevention. Bulletin on Narcotics 1993;45(1):117­34. 143 - 1 McFall SL, Michener A, Rubin D, Flay BR, Mermelstein RJ, Burton D, Jelen P, Warnecke RB. The effects and use of maintenance newsletters in a smoking cessation intervention. Addictive Behaviors 1993;18(2):151­8. 145 - 1 Santi SM, Cargo M, Brown KS, Best JA, Cameron R. Dispositional risk factors for smoking-stage transitions: a social influences program as an effect modifier. Addictive Behaviors 1994;19(3):269­85. 146 - 1 Ohmit SE, Furumoto-Dawson A, Monto AS, Fasano N. Influenza vaccine use among an elderly population in a community intervention. American Journal of Preventive Medicine 1995;11(4):271­6.
158 - 1 Strecher VJ, Kreuter M, Den Boer DJ, Kobrin S, Hospers HJ, Skinner CS. The effects of computer-tailored smoking cessation messages in family practice settings. Journal of Family Practice 1994;39(3):262­70. 158 - 2 Strecher VJ, Kreuter M, Den Boer DJ, Kobrin S, Hospers HJ, Skinner CS. The effects of computer-tailored smoking cessation messages in family practice settings. Journal of Family Practice 1994;39(3):262­70. 159 - 1 Miller RL. Assisting gay men to maintain safer sex: an evaluation of an AIDS service organization's safer sex maintenance program. AIDS Education and Prevention 1995;7(5 Suppl): 48­63. 161 - 1 Muller O, Sarangbin S, Ruxrungtham K, Sittitrai W, Phanuphak P. Sexual risk behaviour reduction associated with voluntary HIV counselling and testing in HIV infected patients in Thailand. AIDS Care 1995;7(5):567­72.
147 - 1 Lloyd HM, Paisley CM, Mela DJ. Barriers to the adoption of reduced-fat diets in a UK population. Journal of the American Dietetic Association 1995;95(3):316­22.
162 - 1 Stock LZ, Milan MA. Improving dietary practices of elderly individuals: the power of prompting feedback, and social reinforcement. Journal of Applied Behavior Analysis 1993;26(3):379­87.
149 - 1 Morris BA, Trimble NE, Fendley SJ. Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort. Canadian Family Physician 1994;40:1126­31.
163 - 1 Finney JW, Miller KM, Adler SP. Changing protective and risky behaviours to prevent chil-toparent transmissionof cytomegalovirus. Journal of Applied Behaviour Analysis 1993;26:471­2.
150 - 1 Delp C, Jones J. Communicating information to patients: the use of cartoon illustrations to improve comprehension of instructions. Academic Emergency Medicine 1996;3(3):264­70.
165 - 1 Deren S, Davis WR, Beardsley M, Tortu S, Clatts M. Outcomes of a risk-reduction intervention with high-risk populations: the Harlem AIDS project. AIDS Education and Prevention 1995;7(5):379­90.
154 - 1 Richardson JL, Mondrus GT, Danley K, Deapen D, Mack T. Impact of a mailed intervention on annual mammography and physician breast examinations among women at high risk of breast cancer. Cancer Epidemiology, Biomarkers
167 - 1 Campbell JR, Szilagyi PG, Rodewald LE, Doane C, Roghmann KJ. Patient-specific reminder letters and pediatric well-child-care show rates. Clinical Pediatrics 1994;May:268­72.
and Prevention 1996;5(1):71­6.
168 - 1 Schectman G, Hiatt J, Hartz A. Telephone
155 - 1 Shafir MS, Silversides C, Waters I, MacRury K, Frank JW, Becker LA. Patient consent to observation. Responses to requests for written
contacts do not imporove adherence to niacin or bile acid sequestrant therapy. Annals of Pharmacotherapy 1994;28:29­35.
consent in an academic family practice unit. Canadian Family Physician 1995;41:1367­72.
169 - 1 Lipton HL, Bird JA. The impact of clinical pharmacists' consultations on geriatric patients'
156 - 1 Rowan-Szal G, Joe GW, Chatham LR, Simpson DD. A simple reinforcement system for
compliance and medical care use: a randomized controlled trial. Gerontologist 1994;34(3):307­15.
methadone clients in a community-based
170 - 1 Vineis P, Ronco G, Ciccone G, Gogliani F. Home
treatment program. Journal of Substance Abuse Treatment 1994;11(3):217­23.
injuries in children: a population-based intervention trial. Epidemiology 1994;5(3):349­51.
47
Appendix 5
171 - 1 Biger C, Epstein LM, Hagoel L, Tamir A, Robinson E. An Evaluation of an education programe, for prevention and early diagnosis of malignancy in Israel. European Journal of Cancer Prevention 1994;3:305­12. 172 - 1 Moser SE. Effectiveness of post card appointment reminders. Family Practice Research Journal 1994;14:281­8.
194 - 1 Martinez R, Levine DW, Martin R, Altman DG. Effect of integration of injury control information into a high school physics course. Annals of Emergency Medicine 1996;27(2):216­24. 196 - 1 Bullock LF, Wells JE, Duff GB, Hornblow AR. Telephone support for pregnant women: outcome in late pregnancy. New Zealand Medical Journal 1995;108(1012):476­8.
174 - 1 Avila P, Hovell MF. Physical activity training for weight loss in Latinas: a controlled trial. International Journal of Obesity 1994;18:476­82. 176 - 1 Malenka DJ, Baron JA, Johanson S, Wahrenberger JW, Ross JM. The framing effect of relative and absolute risk. Journal General Internal Medicine 1993;8:543­8. 177 - 1 Birkel RC, Golaszewski T, Koman JJ, Singh BK, Catan V, Souply K. Findings from the horizontes acquired immune deficiency syndrome education project: the impact of indigenous outreach workers as change agents for injection drug users. Health Education Quaterly 1993;20:523­38. 179 - 1 Meltzer SB, Hovell MF, Meltzer EO, Atkins CJ, de Peyster A. Reduction of secondary smoke exposure in asthmatic children: parent counseling. Journal of Asthma 1993;30(5):391­400. 180 - 1 Hill D, White V, Marks R, Borland R. Changes in sun-related attitudes and behaviours, and reduced sunburn prevalence in a population at high risk of melanoma. European Journal of Cancer Prevention 1993;2(6):447­56. 181 - 1 Hanna KM. Effect of nurse-client transaction on female adolescent's oral contraceptive adherence. IMAGE: Journal of Nursing Scholarship 1993;25:285­90. 183 - 1 Shore ER. Outcomes of a primary prevention project for business and professional women. Journal of Studies on Alcohol 1994;55(6):657­9. 184 - 1 Kaufman JS, Jason LA, Sawlski LM, Halpert JA. A comprehensive multi-media program to prevent smoking among black students. Journal of Drug Education 1994;24(2):95­108. 190 - 1 Moos MK, Bangdiwala SI, Meibohm AR, Cefalo RC. The impact of a preconceptional health promotion program on intendedness of pregnancy. American Journal of Perinatology 1996;13(2):103­8. 192 - 1 Gilles MT, Crewe S, Granites IN, Coppola A. A community-based, cervical screening program in a remote Aboriginal community in the Northern Territory. Australian journal of Public Health 1995;19:477­81.
197 - 1 Plaskon PP, Fadden MJ. Cancer screening utilization: is there a role for social work in cancer prevention? Social Work in Health Care 1995;21(4):59­70. 198 - 1 Robinson JK, Rademaker AW. Skin cancer risk and sun protection learning by helpers of patients with nonmelanoma skin cancer. Preventive Medicine 1995;24(4):333­41. 200 - 1 Simkin-Silverkin L, Wing RR, Hansen DH, Klem ML, Pasagian-Macauley A, Meilahn EN, Kuller LH. Prevention of Cardiovascular risk factor elevations in healthy premenopausal women. Preventive Medicine 1995;24:509­17. 202 - 1 Gariti P, Alterman AI, Holub-Beyer E, Volpicelli JR, Prentice N, O'Brien CP. Effects of an appointment reminder call on patient show rates. Journal of Substance Abuse Treatment 1995;12(3):207­12. 203 - 1 Urban N, Taplin SH, Taylor VM, Peacock S, Anderson G, Conrad D, Etzioni R, White E, Montano DE, Mahloch J, Majer K. Community organization to promote breast cancer screening among women ages 50­75. Preventive Medicine 1995;24(5):477­84. 205 - 1 Clover K, Redman S, Forbes J, Sanson-Fisher R, Callaghan T. Two sequential randomized trials of community participation to recruit women for mammographic screening. Preventive Medicine 1996;25:126­34. 205 - 2 Clover K, Redman S, Forbes J, Sanson-Fisher R, Callaghan T. Two sequential randomized trials of community participation to recruit women for mammographic screening. Preventive Medicine 1996;25:126­34. 206 - 1 Hoffmeister H, Mensink GBM, Stolzenberg H, Hoeltz J, Kreuter H, Laaser U, Nussel E, Hullemann K-D, Troschke J. Reduction of coronary heart disease risk factors in the German Cardiovascular Prevention study. Preventive Medicine 1996;25:135­45. 207 - 1 Schinke SP, Singer B, Cole K, Contento I. Reducing cancer risk among native American adolescents. Preventive Medicine 1996;25:146­55.
193 - 1 Bazeley P, Kemp L. Increasing attendance
at immunisation clinics: lessons from a trial
48
program that failed. Australian Journal of Public Health 1995;19(5):459­64.
209 - 1 Calfas K, Long B, Sallis J, Wooten W, Pratt M, Patrick K. A controlled trial of physician conseling to promote the adoption of physical activity. Preventive Medicine 1996;25:225­33.
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210 - 1 Brug J, Steenhuis I, Assema P, de Vreis H. The impact of a computer-tailored nutrition intervention. Preventive Medicine 1996;25:236­42. 211 - 1 Voorhees C, Stillman F, Swank R, Heagerty P, Levine D, Becker D. Heart, body and soul: Impact of church based smoking cessation interventions on readiness to quit. Preventive Medicine 1996;25:277­85. 212 - 1 Clayton R, Cattarello A, Johnstone B. The effectiveness of Drug Abuse Resistance Education (Project DARE): 5-year follow-up results. Preventive Medicine 1996;25:307­18. 213 - 1 Morgan G, Noll E, Orleans T, Rimer B, Amfoh K, Bonney G. Reaching midlife and older smokers: tailored interventions for routine medical care. Preventive Medicine 1996;25:346­54. 215 - 1 Cheadle A, Psaty B, Diehr P, Koepsell T, Wagner E, Curry S, Kristal A. Evaluating communitybased nutrition programs: comparing grocery store and individual-level survey measures of program impact. Preventive Medicine 1996;24:71­9. 216 - 1 Schmid T, Jeffery R, Hellerstedt W. Direct mail recruitment to home based smoking and weight control programs: a comparison of strategies. Preventive Medicine 1989;18:503­17. 216 - 2 Schmid T, Jeffery R, Hellerstedt W. Direct mail recruitment to home based smoking and weight control programs: a comparison of strategies. Preventive Medicine 1989;18:503­17. 217 - 1 Flay B, Miller T, Hedeker D, Siddiqui O, Britton C, Brannon B, Johnson C, Hansen W, Sussman S, Dent C. The television, school and family smoking prevention and cessation project. Preventive Medicine 1995;24:29­40. 218 - 1 Mudde A, Vries H, Dolders M. Evaluation of a Dutch community-based smoking cessation intervention. Preventive Medicine 1995;24:61­70. 220 - 1 Edmundson E, Parcel G, Feldman H, Elder J, Perry C, Johnson C, Williston B, Stone E, Yang M, Lytle L, Webber L. The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior. Preventive Medicine 1996;25:442­54.
226 - 1 Hansen W, Graham J. Preventing alcohol, marijuana, and cigarette use among adolescents: peer pressure resistance training versus establishing conservative norms. Preventive Medicine 1991;20:414­30. 229 - 1 Hughes J, Wadland W, Fenwick J, Lewis J, Bickel W. Effect of cost on the self-administration and efficacy of nicotine gum: a prelininary study. Preventive Medicine 1991;20:486­96. 232 - 1 Bastani R, Marcus AC, Maxwell AE, Das IP, Yan KX. Evaluation of an intervention to increase mammography screening in Los Angeles. Preventive Medicine 1994;23(1):83­90. 233 - 1 Mayer J, Jermanovich A, Wright B, Elder J, Drew J, Williams S. Changes in health behaviors of older adults: the San Diego Medicare preventive health project. Preventive Medicine 1994;23:127­33. 234 - 1 Ives DG, Lave JR, Traven ND, Kuller LH. Impact of Medicare reimbursement on influenza vaccination rates in the elderly. Preventive Medicine 1994;23(2):134­41. 235 - 1 Brenner H, Fleischle B. Smoking regulations at the workplace and smoking behavior: a study from Southern Germany. Preventive Medicine 1994;23:230­4. 237 - 1 Van Assema P, Steenbakkers M, Kok G, Erikson M, de Vreis H. Results of the Dutch community project `Healthy Bergeyk'. Preventive Medicine 1994;23:394­401. 238 - 1 Murray DM, Prokhorov AV, Harty KC. Effects of a statewide antismoking campaign on mass media messages and smoking beliefs. Preventive Medicine 1994;23(1):54­60. 239 - 1 Ponsonby A, Dwyer T, Kasl S, Cochrane J, Newman N. An assessment of the impact of public health activities to reduce the prevalence of the prone sleeping position during infacy: the Tasmanian cohort study. Preventive Medicine 1994;23:402­8. 240 - 1 Main DS, Iverson DC, McGloin J, Banspach SW, Collins JL, Rugg DL, Kolbe LJ. Preventing HIV infection among adolescents: evaluation of a school-based education program. Preventive Medicine 1994;23(4):409­17.
222 - 1 O'Loughlin J, Renaud L, Paradis G,
241 - 1 McAuley E, Courneya K, Rudolph D, Lox C.
Meshefedjian G. Screening school personnel for
Enhancing exercise adherence in middle-aged
cardiovascular disease risk factors: short term
males and females. Preventive Medicine
impact on behavior and perceived role as
1994;23:498­506.
promoters of heart health. Preventive Medicine 1996;25:660­7.
242 - 1 Pallonen UE, Leskinen L, Prochaska JO, Willey CJ, Kaariainen R, Salonen JT. A 2-year self-help
223 - 1 Palinkas L, Atkins C, Millers C, Ferreira D. Social
smoking cessation manual intervention among
skills training for drug prevention in high-risk
middle-aged Finnish men: an application of the
female adolescents. Preventive Medicine 1996;25:692­701.
transtheoretical model. Preventive Medicine 1994;23(4):507­14 .
49
Appendix 5
243 - 1 Zapka J, Costanza M, Harris D, Hosmer D, Stoddard A, Barth R, Gaw V. Impact of a breast cancer screening community intervention. Preventive Medicine 1993;22:34­53. 244 - 1 Lewis B, Lynch W. The effect of physician advice on exercise behavior. Preventive Medicine 1993;22:110­21. 245 - 1 Orleans C, Rotberg H, Quade D, Leeds P. A hospital quit-smoking consult service: clinical report and intervention guidelines. Preventive Medicine 1990;19:198­212. 246 - 1 Worden J, Solomon L, Flynn B, Costanza M, Foster B, Dorwaldt A, Weaver S. A communitywide program in breast self-examination training and maintenance. Preventive Medicine 1990;19:254­69. 247 - 1 Graham J, Johnson C, Hansen W, Flay B, Gee M. Drug use prevention programs, gender and ethnicity: evaluation of three seventh-grade project SMART cohorts. Preventive Medicine 1990;19:305­13. 248 - 1 Paskett E, White E, Carter W, Chu E. Improving follow-up after an abnormal Pap smear: a randomised controlled trial. Preventive Medicine 1990;19:630­41. 249 - 1 Secker-Walker R, Flynn B, Solomon L, Vacek P, Bronson D. Predictors of smoking behavior change 6 and 18 months after individual counseling during periodic health examinations. Preventive Medicine 1990;19:675­85. 251 - 1 Pentz M, MacKinnon D, Dwyer J, Wang E, Hansen W, Flay B, Johnson C. Longitudinal effects of the Midwestern Prevention Project on regular and experimental smoking in adolescents. Preventive Medicine 1989;18:304­21. 253 - 1 Crockett S, Mullis R, Perry C, Luepker R. Parent education in youth-directed nutrition interventions. Preventive Medicine 1989;18:475­91. 254 - 1 Hollis J, Lichtenstein E, Mount K, Vogt T, Stevens V. Nurse-assisted smoking counseling in medical settings: minimising demands on physicians. Preventive Medicine 1991;20:497­507. 255 - 1 Murray D, Perry C, Griffin G, Harty K, Jacobs D, Schmid L, Daly K, Pallonen U. Results from a statewide approach to adolescent tobacco use prevention. Preventive Medicine 1992;21:449­72. 255 - 2 Murray D, Perry C, Griffin G, Harty K, Jacobs D, Schmid L, Daly K, Pallonen U. Results from a statewide approach to adolescent tobacco use prevention. Preventive Medicine 1992;21:449­72.
257 - 1 Ives D, Kuller L, Schultz R, Traven N, Lave J. Comparison of recruitment strategies and associated disease prevalence for health promotion in rural elderly. Preventive Medicine 1992;21:582­91. 258 - 1 Winkleby M, Fortmann S, Rockhill B. Trends in cardiovascular disease risk factors by educational level: the Stanford five-city project. Preventive Medicine 1992;21:592­601. 259 - 1 Nilssen O. The Tromso Study: identification of and a controlled intervention on a population of early stage risk drinkers. Preventive Medicine 1991;20:518­28. 260 - 1 Ockene J, Hymowitz N, Lagus J, Shaten J. Comparison of smoking behavior change for SI and UC Study Groups. Preventive Medicine 1991;20:518­28. 261 - 1 Lionis C, Kafatos A, Vlachonikolis J, Vakaki M, Tzortzi M, Petraki A. The effects of a health education intervention program among Cretan adolescents. Preventive Medicine 1991;20(6):685­99. 262 - 1 Olsen G, Lacy S, Sprafka J, Arceneaux T, Potts T, Kravat B, Gondek M, Bond G. A 5-year evaluation of a smoking cessation incentive program for chemical employees. Preventive Medicine 1990;19:774­84. 263 - 1 Henderson MM, Kushi LH, Thompson DJ, Gorbach SL, Clifford CK, Insull W, Moskowitz M, Thompson RS. Feasibility of a randomised trial of a low-fat diet for the prevention of breast cancer: dietary compliance in the women's health trial vanguard study. Preventice Medicine 1990;19:115­33. 264 - 1 Murray DM, Kurth C, Mullis R, Jeffery RW. Cholesterol reduction through low intensity interventions: results from the Minnesota Heart Health Program. Preventive Medicine 1990;19:181­9. 265 - 1 Walker R, Heller R, Redman S, O'Connell D, Boulton J. Reduction of ischemic heart disease risk markers in the teenage children of heart attack patients. Preventive Medicine 1992;21:616­29. 266 - 1 Robinson J. Compensation strategies in sun protection behaviors by a population with nonmelanoma skin cancer. Preventive Medicine 1992;21:754­65.
256 - 1 Hebert J, Kristeller J, Ockene J, Landon J,
268 - 1 Knutsen SF, Knutsen R. The Tromso Survey:
Luippold R, Goldberg R, Kalan K. Patient
the Family Intervention study­the effect of
characteristics and the effect of three physician-
intervention on some coronary risk factors and
50
delivered smoking interventions. Preventive Medicine 1992;21:557­73.
dietary habits, a 6-year follow-up. Preventive Medicine 1991;20(2):197­212.
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269 - 1 Ho EE, Atwood JR, Benedict J, Ritenbaugh C, Sheehan ET, Abrams C, Alberts D, Meyskens FL, Jr. A community-based feasibility study using wheat bran fiber supplementation to lower colon cancer risk. Preventive Medicine 1991;20(2):213­25. 270 - 1 Edmunds M, Conner H, Jones C, Gorayeb R, Waranch H. Evaluation of a multicomponent group smoking cessation program. Preventive Medicine 1991;20:774­84. 273 - 1 Winkleby M, Fortmann S, Rockhill B. Cigarette smoking trends in adolescents and young adults: the Stanford five-city project. Preventive Medicine 1993;22:325­34. 275 - 1 Curry SJ, Taplin SH, Anderman C, Barlow WE, McBride C. A randomized trial of the impact of risk assessment and feedback on participation in mammography screening. Preventive Medicine 1993;22(3):350­60. 276 - 1 Klepp KI, Tell GS, Vellar OD. Ten-year follow-up of the Oslo Youth Study Smoking Prevention Program. Preventive Medicine 1993;22(4):453­62. 277 - 1 Bell RM, Ellickson PL, Harrison ER. Do drug prevention effects persist into high school? How project ALERT did with ninth graders. Preventive Medicine 1993;22(4):463­83. 279 - 1 Alexandrov A, Maslennikova G, Kulikov S, Propirnij G, Perova N. Primary prevention of caridovascular disease: 3-year intervention results in boys of 12 years of age. Preventive Medicine 1992;21:53­62. 280 - 1 Korhonen H, Niemensivu H, Piha T, Koskela K, Wiio J, Johnson C, Puska P. National TV smoking cessation program and contest in Finland. Preventive Medicine 1992;21:74­87. 283 - 1 Maheu M, Gevirtz R, Sallis J, Schneider N. Competition/co-operation in worksite smoking cessation using nicotine gum. Preventive Medicine 1989;18:867­76. 284 - 1 Shipley R, Orleans C, Wilbur C, Piserchia P, McFadden D. Effect of the Johnson and Johnson LIVE FOR LIFE program on employee smoking. Preventive Medicine 1988;17:25­34. 285 - 1 Faivre J, Arveux P, Milan C, Durand G, Lamour J, Bedenne L. Participation in mass screening for colorectal cancer: results of screening and rescreening from the Burgundy study. European Journal of Cancer Prevention 1991;1(1):49­55. 287 - 1 Stevens VJ, Glasgow RE, Hollis JF, Lichtenstein E, Vogt TM. A smoking-cessation intervention for hospital patients. Medical Care 1993;31(1):65­72.
289 - 1 Rickert VI, Gottlieb AA, Jay MS. Is AIDS education related to condom acquisition? Clinical Pediatrics 1992;31(4):205­10. 291 - 1 Clark N, Feldman C, Evans D, Duzey O, Levison M, Wasilewski Y, Kaplan D, Rips J, Mellins R. Managing better: children, parents and asthma. Patient Education and Counseling 1986;8:27­38. 293 - 1 Tietge N, Bender S, Scutchfield FD. Influence of teaching techniques on infant car seat use. Patient Education and Counseling 1987;9:167­75. 294 - 1 Keenan J, Kastner T, Nathanson R, Richardson N, Hinton J, Cress DA. A statewide public and professional education program on fragile X syndrome. Mental Retardation 1992;30(6):355­61. 295 - 1 Mann K, Sullivan P. Effect of task-centred instructional programs on hypertensives' ability to achieve and maiantain reduced dietary sodium intake. Patient Education and Counseling 1987;19:53­72. 296 - 1 Bejes C, Marvel MK. Attempting the improbable: offering colorectal cancer screening to all appropriate patients. Family Practice Research Journal 1992;12(1):83­90. 299 - 1 Rosser WW, Hutchison BG, McDowell I, Newell C. Use of reminders to increase compliance with tetanus booster vaccination. Canadian Medical Association Journal 1992;146(6):911­17. 301 - 1 Quaid K, Faden R, Vining E, Freeman J. Informed consent for a prescription drug: impact of disclosed information on patient understanding and medical outcomes. Patient Education and Counseling 1990;15:249­59. 302 - 1 Hansen BWL. A randomized controlled trial on the effect of an information booklet for young families in Denmanmark. Patient Education and Counseling 1990;16:147­50. 303 - 1 Hawe P, Higgins G. Can medication education improve the drug compliance of the elderly? Evaluation of an In Hospital program. Patient Education and Counseling 1990;16:151­60. 304 - 1 Salleras Sanmarti L, Alcaide Megias J, Altet Gomez MN, Canela Soler J, Navas Alcala E, Sune Puigbo MR, Serra Majem L. Evaluation of the efficacy of health education on the compliance with antituberculosis chemoprophylaxis in school children. A randomized clinical trial [published erratum appears in Tubercle Lung Disease 1993;74(3):217]. Tubercle and Lung Disease 1993;74(1):28­31.
288 - 1 Weinstein ND, Sandman PM, Roberts NE.
305 - 1 Baumann LJ, Zimmerman R, Leventhal H. An
Perceived susceptibility and self-protective
experiment in common sense: education at
behavior: a field experiment to encourage home radon testing. Health Psychology 1991;10(1):25­33.
blood pressure screening. Patient Education and Counseling 1989;14:53­67.
51
Appendix 5
307 - 1 Lierman LM, Young HM, Powell-Cope G, Georgiadou F, Benoliel JQ. Effects of education and support on breast self-examination in older women. Nursing Research 1994;43(3):158­63. 308 - 1 Ogutu RO, Oloo AJ, Ekissa WS, Genga IO, Mulaya N, Githure JI. The effect of participatory school health programme on the control of malaria. East African Medical Journal 1992;69(6):298­302.
325 - 1 Schultz S. Educational and behavioral strategies related to knowledge of and participation in an exercise program after cardiac positron emission tomography. Patient Education and Counseling 1993;22:47­57. 327 - 1 Huss K, Salerno M, Huss RW. Computer-assisted reinforcement of instruction: effects on adherence in adult atopic asthmatics. Research in Nursing and Health 1991;14(4):259­67.
310 - 1 Sutton S, Hallett R. Smoking intervention in the workplace using videotapes and nicotine chewing gum. Preventive Medicine 1988;17:48­59. 311 - 1 Hansen WB, Anderson Johnson C, Flay B, Graham J, Sobel J. Affective and social influences to the prevention of multiple substance abuse among seventh grade students: results from project SMART. Preventive Medicine 1988;17:135­54. 312 - 1 Pietinen P, Nissinen A, Vartiainen E, Tuomilehto A, Uusitalo U, Ketola A, Moisio S, Puska P. Dietary changes in the North Karelia Project (1972­1982). Preventive Medicine 1988;17:183­93. 313 - 1 de Weerdt I, Visser A, Kok G, van der Veen E. Randomized controlled evaluation of an education program for insulin treated patients with diabetes: effects on psychosocial variables. Patient Education and Counseling 1989;14:191­215.
328 - 1 Glasgow R, Toobert D, Hampson S, Brown J, Lewinsohn P, Donnelly J. Improving self care among older patients with Type II Diabetes: The `Sixty Something...' study. Patient Education and Counseling 1992;19:61­74. 329 - 1 Price JH, Krol RA, Desmond SM, Losh DP, Roberts SM, Snyder FF. Comparison of three antismoking interventions among pregnant women in an urban setting: a randomized trial. Psychological Reports 1991;68(2):595­604. 331 - 1 Joffe MD, Luberti A. Effect of emergency department immunization on compliance with primary care. Pediatric Emergency Care 1994;10(6):317­19. 332 - 1 Malloy TR, Wigton RS, Meeske J, Tape TG. The influence of treatment descriptions on advance medical directive decisions. Journal of the American Geriatrics Society 1992;40(12):1255­60.
315 - 1 Ware GJ, Holford NH, Davison JG, Harris RG.
333 - 1 Fabacher D, Josephson K, Pietruszka F, Linder-
Unit dose calendar packaging and elderly patient
born K, Morley JE, Rubenstein LZ. An in-home
compliance. New Zealand Medical Journal
preventive assessment program for independent
1991;104(924):495­7.
older adults: a randomized controlled trial.
316 - 1 Lee CY. A randomized controlled trial to motivate worksite fecal occult blood testing.
Journal of the American Geriatrics Society 1994;42(6):630­8.
Yonsei Medical Journal 1991 Jun;32(2):131­8.
335 - 1 Chirwa B, Briega W, Ramakrishna J. Evaluating
320 - 1 Roca-Cusachs A, Sort D, Altimira J, Bonet R, Guilera E, Monmany J, Nolla J. The impact of a patient education programme in the control of
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336 - 1 Marcus A, Wheeler R, Cullen J, Crane L. Quasi
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experimental evaluation of the Los Angeles
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Know Your Body program: knowledge, beliefs, and self reported behaviors. Preventive Medicine 1987;16:803­15.
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337 - 1 Rutten G, Beek M, van Eijk J. Effects of systematic
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patient education about cogh on the consulting behaviour of a general practice population. Patient Education and Counseling 1993;22:127­32.
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340 - 1 Marin B, Perez-Stable E, Marin G, Hauck W.
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smoking behavior among Hispanics. Am J
324 - 1 Cardenas M, Simons-Morton B. The effect of
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anticipatory guidance on mothers' self-efficacy
341 - 1 Saxon AJ, Calsyn DA. Alcohol use and high-risk
and behavioral intentions to prevent burns
behavior by intravenous drug users in an AIDS
52
caused by hot tap water. Patient Education and Counseling 1993;21:117­23.
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342 - 1 Thomas DR, Winsted B, Koontz C. Improving neglected influenza vaccination among healthcare workers in long-term care. Journal of the American Geriatrics Society 1993;41(9):928­30.
357 - 1 Schwarz-Lookinland S, McKeever L, Saputo M. Compliance with antibiotic regimens in Hispanic mothers. Patient Education and Counseling 1989;13:171­82.
343 - 1 Sachs GA, Stocking CB, Miles SH. Empowerment of the older patient? A randomized, controlled trial to increase discussion and use of advance directives. Journal of the American Geriatrics Society 1992;40(3):269­73.
360 - 1 Werch CE, Young M, Clark M, Garrett C, Hooks S, Kersten C. Effects of a take-home drug prevention program on drug-related communication and beliefs of parents and children. Journal of School Health 1991;61(8):346­50.
345 - 1 Goldberg D, Hoffman A, Farinha M, Marder D, Tinson-Mitchem L, Burton D, Smith E. Physician delivery of smoking-cessation advice based on the stages-of-change model. American Journal of Preventive Medicine 1994;10:267­74.
361 - 1 Elder AD, Zultowsky D. Using written communication with patient groups to promote behavioral change in chronic mentally ill patients. Hospital and Community Psychiatry 1991;42(3):302­4.
348 - 1 Cook B, Noteloviz M, Rector C, Krischer J. An osteoporosis patient education and screening program: results and implications. Patient Education and Counseling 1991;17:135­45.
363 - 1 Oeffinger KC, Roaten SP, Hitchcock MA, Oeffinger PK. The effect of patient education on pediatric immunization rates. Journal of Family Practice 1992;35(3):288­93.
349 - 1 Huws R. Non-attendances at a marital and sexual difficulties clinic: a controlled intervention study. International Journal of Social Psychiatry 1992;38(4):304­8.
364 - 1 Jemmott LS, Jemmott JB, 3rd. Increasing condom-use intentions among sexually active black adolescent women. Nursing Research 1992;41(5):273­9.
350 - 1 Gilbert J, Wilson D, Singer J, Lindsey E, Willms D, Best J, Taylor D. A family physician smoking cessation program: and evaluation of the role of follow up visits. American Journal of Preventive Medicine 1992;8:91­5.
365 - 1 White E, Hurlich M, Thompson RS, Woods MN, Henderson MM, Urban N, Kristal A. Dietary changes among husbands of participants in a lowfat dietary intervention. American Journal of Preventive Medicine 1991;7(5):319­25.
352 - 1 Mayer J, Clapp E, Bartholomew S, Elder J. Facility-based inreached strategies to promote annual mammograms. American Journal of Preventive Medicine 1994;10(6):353­6. 352 - 2 Mayer J, Clapp E, Bartholomew S, Elder J. Facility-based inreached strategies to promote annual mammograms. American Journal of Preventive Medicine 1994;10(6):353­6.
367 - 1 Elder JP, McGraw SA, Rodrigues A, Lasater TM, Ferreira A, Kendall L, Peteron G, Carleton R. Evaluation of two community-wide smoking cessation contests. Preventive Medicine 1987;16:221­34. 367 - 2 Elder JP, McGraw SA, Rodrigues A, Lasater TM, Ferreira A, Kendall L, Peteron G, Carleton R. Evaluation of two community-wide smoking cessation contests. Preventive Medicine
352 - 3 Mayer J, Clapp E, Bartholomew S, Elder J.
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Facility-based inreached strategies to promote annual mammograms. American Journal of Preventive Medicine 1994;10(6):353­6.
369 - 1 Weinberger M, Tierney WM, Booher P, Katz BP. The impact of increased contact on psychosocial outcomes in patients with osteoarthritis: a
353 - 1 Calle E, Miracle-Mcmahill H, Moss R, Heath C.
randomized, controlled trial. Journal of
Personal contact from friends to increase
Rheumatology 1991;18(6):849­54.
mammography usage. American Journal of Preventive Medicine 1994;10(6):361­6.
370 - 1 Shope JT, Dielman TE, Butchart AT, Campanelli PC, Kloska DD. An elementary school-based
354 - 1 Rimer BK, Resch N, King E, Ross E, Lerman C,
alcohol misuse prevention program: a follow-up
Boyce A, Kessler H, Engstrom PF. Multistrategy
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health education program to increase
1992;53(2):106­21.
mammography use among women ages 65 and older. Public Health Reports 1992;107(4):369­80.
371 - 1 Knapp LG. Effects of type of value appealed to and valence of appeal on children's dental health
355 - 1 King A, Carl F, Birkel L, Haskell W. Increasing
behavior. Journal of Pediatric Psychology
exercise among blue collar employees: the
1991;16(6):675­86.
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372 - 1 Gans KM, Lapane KL, Lasater TM, Carleton RA. Effects of intervention on compliance to referral
356 - 1 Evers S, Bass M, Donner A, McWhinney I. Lack of
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cholesterol screening programs. American Journal of Preventive Medicine 1994;10(5):275­82.
53
Appendix 5
373 - 1 Eisen M, Zellman GL, McAlister AL. A Health
391 - 1 Piotrow PT, Kincaid DL, Hindin MJ, Lettenmaier
Belief Model-Social Learning Theory approach
CL, Kuseka I, Silberman T, Zinanga A, Chikara F,
to adolescents' fertility control: findings from a
Adamchak DJ, Mbizvo MT, Lynn W, Kumah OM,
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Kim Y-M. Changing men's attitudes and behavior:
1992;19(2):249­62.
the Zimbabwe Male Motivation Project. Studies in
375 - 1 Leslie M, Schuster P. The effect of contingency
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392 - 1 Koenig MA, Rob U, Khan MA, Chakraborty J, Fauveau V. Contraceptive use in Matlab, Bangladesh in 1990: levels, trends, and explanations.
376 - 1 Lichtenstein E, Hollis J. Patient referral to a
Studies in Family Planning 1992;23(6 Pt 1):352­64.
smoking cessation program: who follows through? Journal of Family Practice 1992;34(6):739­44. 377 - 1 Ward JE, Boyle K, Redman S, Sanson-Fisher RW. Increasing women's compliance with oppor-
393 - 1 Mansfield CJ, Conroy ME, Emans SJ, Woods ER. A pilot study of AIDS education and counseling of high-risk adolescents in an office setting. Journal of Adolescent Health 1993;14(2):115­19.
tunistic cervical cancer screening: a randomized trial. American Journal of Preventive Medicine 1991;7(5):285­91.
394 - 1 Newcomb PA, Klein R, Massoth KM. Education to increase ophthalmologic care in older onset diabetes patients: indications from the Wisconsin
378 - 1 Spaulding SA, Kugler JP. Influenza immunization: the impact of notifying patients of highrisk status. Journal of Family Practice
Epidemiologic Study of Diabetic Retinopathy. Journal of Diabetes and its Complications 1992;6(4):211­17.
1991;33(5):495­8. 380 - 1 Lerman C, Hanjani P, Caputo C, Miller S, Delmoor E, Nolte S, Engstrom P. Telephone counseling improves adherence to colposcopy among lower-income minority women. Journal of Clinical Oncology 1992;10(2):330­3.
395 - 1 Ornstein SM, Garr DR, Jenkins RG, Rust PF, Arnon A. Computer-generated physician and patient reminders. Tools to improve population adherence to selected preventive services. Journal of Family Practice 1991;32(1):82­90.
381 - 1 Fitzgerald ST, Gibbens S, Agnew J. Evaluation of referral completion after a workplace cholesterol screening program. American Journal of Preventive Medicine 1991;7(6):335­40.
396 - 1 Turnin MC, Beddok RH, Clottes JP, Martini PF, Abadie RG, Buisson JC, Soule-Dupuy C, Bonneu M, Camare R, Anton JP, Chrismet CY, Farreny H, Bayard F, Tauber J-PJ. Telematic expert system Diabeto. New tool for diet self-monitoring for
383 - 1 Mayer JA, Kossman MK, Miller LC, Crooks CE,
diabetic patients. Diabetes Care 1992;15(2):204­12.
Slymen DJ, Lee CD, Jr. Evaluation of a mediabased mammography program. American Journal of Preventive Medicine 1992;8(1):23­9. 384 - 1 Baier CA, Grodzin CJ, Port JD, Leksas L, Tancredi DJ. Coronary risk factor behavior change in hospital personnel following a
397 - 1 Ansell D, Lacey L, Whitman S, Chen E, Phillips C. A nurse-delivered intervention to reduce barriers to breast and cervical cancer screening in Chicago inner city clinics. Public Health Reports 1994;109(1):104­11.
screening program. American Journal of Preventive Medicine 1992;8(2):115­22.
398 - 1 Wing RR, Anglin K. Effectiveness of a behavioral weight control program for blacks and whites
385 - 1 Stevens MM, Freeman DH, Jr, Mott LA, Youells
with NIDDM. Diabetes Care 1996;19(5):409­13.
FE, Linsey SC. Smokeless tobacco use among children: the New Hampshire Study. American Journal of Preventive Medicine 1993;9(3):160­7. 386 - 1 Spatz TS. Improving breast self-examination training by using the 4MAT instructional model.
401 - 1 Kohatsu N, Cramer E, Bohnstedt M. Use of a clinician reminder system for screening mammography in a public health clinic. American Journal of Preventive Medicine 1994;10(6):348­52.
Journal of Cancer Education 1991;6(3):179­83.
402 - 1 Ojehagen A, Berglund M. Acceptance, attrition,
387 - 1 McCann S, Weinman J. Empowering the patient in the consultation: a pilot study. Patient Education and Counseling 1996;27(3):227­34.
and outcome in an outpatient treatment programme for alcoholics. A comparison between a randomized and a non-randomized processoutcome study. European Archives of Psychiatry
390 - 1 Heirich MA, Foote A, Erfurt JC, Konopka B.
and Clinical Neuroscience 1992;242(2­3):82­4.
Work-site physical fitness programs. Comparing
the impact of different program designs on
403 - 1 Chen CH. Effects of home visits and telephone
54
cardiovascular risks. Journal of Occupational Medicine 1993;35(5):510­7.
contacts on breastfeeding compliance in Taiwan. Maternal-Child Nursing Journal 1993;21(3):82­90.
Health Technology Assessment 1999; Vol. 3: No. 1
404 - 1 Rimer BK, Ross E, Balshem A, Engstrom PF. The effect of a comprehensive breast screening program on self-reported mammography use by primary care physicians and women in a health maintenance organization. Journal of the American Board of Family Practice 1993;6(5):443­51. 405 - 1 Doi SC, DiLorenzo TM. An evaluation of a tobacco use education-prevention program: a pilot study. Journal of Substance Abuse 1993;5(1):73­8. 407 - 1 Colon HM, Robles RR, Freeman D, Matos T. Effects of a HIV risk reduction education program among injection drug users in Puerto Rico. Puerto Rico Health Sciences Journal 1993;12(1):27­34.
421 - 1 Gastrin G. Preliminary results of primary screening for breast cancer with the Mama Program. Sozial- und Praventivmedizin 1993;38(5):280­7. 423 - 1 Joseph AM. Nicotine treatment at the Drug Dependency Program of the Minneapolis VA Medical Center. A researcher's perspective. Journal of Substance Abuse Treatment 1993;10(2):147­52. 424 - 1 Levy SR, Perhats C, Weeks K, Handler AS, Zhu C, Flay BR. Impact of a school-based AIDS prevention program on risk and protective behavior for newly sexually active students. Journal of School Health 1995;65(4):145­51.
408 - 1 Stehr-Green PA, Dini EF, Lindegren ML, Patriarca PA. Evaluation of telephoned computer-generated reminders to improve immunization coverage at inner-city clinics. Public Health Reports 1993;108(4):426­30. 409 - 1 Devine CM, Olson CM, Frongillo EA, Jr. Impact of the Nutrition for Life program on junior high students in New York State. Journal of School Health 1992;62(8):381­5.
425 - 1 Sikorski J, Wilson J, Clement S, Das S, Smeeton N. A randomised controlled trial comparing two schedules of antenatal visits: the antenatal care project. British Medical Journal 1996;312:546­53. 426 - 1 Norman P. Applying the health belief model to the prediction of attendance at health checks in general practice. British Journal of Clinical Psychology 1995;34:461­70.
411 - 1 Barnwell MD, Chitkara R, Lamberta F.
427 - 1 Kemp R, Hayward P, Applewhaite G, Everitt B,
Tuberculosis prevention project. Journal of the National Medical Association 1992;84(12):1014­18.
David A. Compliance therapy in psychotic patients: randomised controlled trial. Britsih
412 - 1 Freedman JD, Mitchell CK. A simple strategy to
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improve patient adherence to outpatient fecal occult blood testing. Journal of General Internal Medicine 1994;9(8):462­4.
430 - 1 Shiloh S, Reznik H, Bat-Miriam-Katznelson M, Goldman B. Pre-marital genetic counselling to consanguineous couples: attitudes, beliefs and
413 - 1 Merkel PA, Caputo GC. Evaluation of a simple office-based strategy for increasing influenza vaccine administration and the effect of differing
decisions among counselled, noncounselled and unrelated couples in Israel. Social Science and Medicine 1995;41(9):1301­10.
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434 - 1 Llewellyn-Thomas HA, McGreal MJ, Thiel EC. Cancer patients' decision making and trial-entry preferences: the effects of "framing" information
414 - 1 Baum JG, Clark HB, Sandler J. Preventing relapse
about short-term toxicity and long-term survival.
in obesity through posttreatment maintenance
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systems: comparing the relative efficacy of two
levels of therapist support. Journal of Behavioral
438 - 1 Banks SM, Salovey P, Greener S, Rothman AJ,
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Moyer A, Beauvais J, Epel E. The effects of
416 - 1 Clifford PA, Tan S-Y, Gorsuch RL. Efficacy of a self-directed behavioural health change program:
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weight, body composition, cardiovascular fitness, blood pressure, health risk and psychosocial mediating variables. Journal of Behavioural Medicine 1991;14:303­23.
439 - 1 Urban N, Taplin S, Taylor V, Peacock S, Anderson G, Conrad D, Etzioni R, White E, Montano D, Mahloch J, Majer K. Community organisation to promote breast cancer screening
418 - 1 Sumner W. An evaluation of readable preventive health messages. Family Medicine
among women ages 50­75. Preventive Medicine 1995;24:477­84.
1991;23(6):463­6.
440 - 1 Carleton RA, Lasater TM, Assaf AR, Feldman HA,
420 - 1 Myers RE, Ross EA, Wolf TA, Balshem A, Jepson
McKinlay S. The Pawtucket Heart Health
C, Millner L. Behavioral interventions to increase
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adherence in colorectal cancer screening. Medical Care 1991;29(10):1039­50.
risk factors and projected disease risk. American Journal of Public Health 1995;85(6):777­85.
55
Appendix 5
442 - 1 Glasgow RE, Terborg JR, Hollis JF, Severson HH, Boles SM. Take heart: results from the initial phase of a work-site wellness program. American Journal of Public Health 1995;85(2):209­16.
459 - 1 Davis SW, Cummings KM, Rimer BK, Sciandra R, Stone JC. The impact of tailored self-help smoking cessation guides on young mothers. Health Education Quarterly 1992;19(4):495­504.
446 - 1 Trock B, Rimer BK, King E, Balshem A, Cristinzio CS, Engstrom PF. Impact of an HMO-based intervention to increase mammography utilization. Cancer Epidemiology, Biomarkers and Prevention 1993;2(2):151­6.
461 - 1 Hingson R, McGovern T, Howland J, Heeren T, Winter M, Zakocs R. Reducing alcohol-impaired driving in Massachusetts: the Saving Lives Program. American Journal of Public Health 1996;86(6):791­7.
447 - 1 Saunders LD, Irwig LM, Gear JS. Ramushu DL. A randomized controlled trial of compliance improving strategies in Soweto hypertensives. Medical Care 1991;29(7):669­78.
462 - 1 Brownson RC, Smith CA, Pratt M, Mack NE, Jackson-Thompson J, Dean CG, Dabney S, Wilkerson JC. Preventing cardiovascular disease through community-based risk reduction: the
448 - 1 Weinrich SP, Weinrich MC, Boyd MD, Atwood J,
Bootheel Heart Health Project. American Journal
Cervenka B. Teaching older adults by adapting
of Public Health 1996;86(2):206­13.
for aging changes. Cancer Nursing
1994;17(6):494­500.
463 - 1 Kegeles SM, Hays RB, Coates TJ. The Mpower-
449 - 1 Smith NA, Seale JP, Ley P, Mellis CM, Shaw J. Better medication compliance is associated with improved control of childhood asthma. Monaldi
ment Project: a community-level HIV prevention intervention for young gay men. American Journal of Public Health 1996;86(8 Pt 1):1129­36.
Archives for Chest Disease 1994;49(6):470­4.
464 - 1 Young DR, Haskell WL, Taylor CB, Fortmann SP.
450 - 1 Rhodes F, Wolitski RJ, Thornton-Johnson S. An experiential program to reduce AIDS risk among female sex partners of injection-drug users. Health and Social Work 1992;17(4):261­72.
Effect of community health education on physical activity knowledge, attitudes, and behavior. The Stanford Five-City Project. American Journal of Epidemiology 1996;144(3):264­74.
452 - 1 Jin BW, Kim SC, Mori T, Shimao T. The impact of
intensified supervisory activities on tuberculosis
465 - 1 Quirk ME, Godkin MA, Schwenzfeier E. Evalu-
treatment. Tubercle and Lung Disease
ation of two AIDS prevention interventions for
1993;74(4):267­72.
inner-city adolescent and young adult women.
453 - 1 St. Pierre TL, Kaltreider DL, Mark MM, Aikin KJ. Drug prevention in a community setting: a longi-
American Journal of Preventive Medicine 1993;9(1):21­6.
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466 - 1 Garr DR, Ornstein SM, Jenkins RG, Zemp LD. The effect of routine use of computer-generated preventive reminders in a clinical practice. American Journal of Preventive Medicine
454 - 1 Nyamathi AM, Leake B, Flaskerud J, Lewis C,
1993;9(1):55­61.
Bennett C. Outcomes of specialized and traditional AIDS counseling programs for impoverished women of color. Research in Nursing and Health 1993;16(1):11­21.
467 - 1 Brown LK, Barone VJ, Fritz GK, Cebollero P, Nassau JH. AIDS education: the Rhode Island experience. Health Education Quarterly 1991;18(2):195­206.
455 - 1 Winter L, Breckenmaker LC. Tailoring family
planning services to the special needs of
469 - 1 Sclar DA, Chin A, Skaer TL, Okamoto MP,
adolescents. Family Planning Perspectives
Nakahiro RK, Gill MA. Effect of health education
1991;23(1):24­30.
in promoting prescription refill compliance
456 - 1 Rose MA. Evaluation of a peer-education program on heart disease prevention with older
among patients with hypertension. Clinical Therapeutics 1991;13(4):489­95.
adults. Public Health Nursing 1992;9(4):242­7.
470 - 1 Karofsky PS, Rice RL, Hoornstra LL, Slater CJ,
457 - 1 Horowitz LG. Comparing shower-based oral hygiene with traditional and electric toothbrushing. Clinical Preventive Dentistry
Kessinich CA, Goode JR. The effect of the initial family interview on a pediatric practice. Clinical Pediatrics 1991;30(5):290­4.
1992;14(6):11­16.
471 - 1 Sanchez-Craig M, Spivak K, Davila R. Superior
458 - 1 Mermelstein RJ, Riesenberg LA. Changing
outcome of females over males after brief
knowledge and attitudes about skin cancer risk
treatment for the reduction of heavy drinking:
56
factors in adolescents. Health Psychology 1992;11(6):371­6.
replication and report of therapist effects. British Journal of Addiction 1991;86(7):867­76.
Health Technology Assessment 1999; Vol. 3: No. 1
472 - 1 Rost KM, Flavin KS, Cole K, McGill JB. Change in metabolic control and functional status after hospitalization. Impact of patient activation intervention in diabetic patients. Diabetes Care 1991;14(10):881­9. 473 - 1 Lando HA, Pirie PL, McGovern PG, Pechacek TF, Swim J, Loken B. A comparison of self-help approaches to smoking cessation. Addictive Behaviors 1991;16(5):183­93. 475 - 1 Tu KS, McDaniel G, Gay JT. Diabetes self-care knowledge, behaviors, and metabolic control of older adults ­ the effect of a posteducational follow-up program. Diabetes Educator 1993;19(1):25­30.
488 - 1 Llewellyn-Thomas HA, Thiel EC, Sem FW, Woermke DE. Presenting clinical trial information: a comparison of methods. Patient Education and Counseling 1995;25(2):97­107. 489 - 1 Dobs AS, Masters RB, Rajaram L, Stillman FA, Wilder LB, Margolis S, Becker DM. A comparison of education methods and their impact on behavioral change in patients with hyperlipidemia. Patient Education and Counseling 1994;24(2):157­64. 490 - 1 Butler GS, Hurley CA, Buchanan KL, SmithVanHorne J. Prehospital education: effectiveness with total hip replacement surgery patients. Patient Education and Counseling 1996;29:189­97.
478 - 1 Kirby D, Barth RP, Leland N, Fetro JV. Reducing the risk: impact of a new curriculum on sexual risk-taking. Family Planning Perspectives 1991;23(6):253­63. 479 - 1 Xiang M, Ran M, Li S. A controlled evaluation of psychoeducational family intervention in a rural Chinese community. British Journal of Psychiatry 1994;165(4):544­8.
491 - 1 Alcoe SY, Gilbey VJ, McDermot RSR, Wallace DG. The effects of teaching breast self-examination: reported confidence and frequency of practise over a six-year period. Patient Education and Counseling 1993;21:117­23. 492 - 1 Kipke MD, Boyer C, Hein K. An evaluation of an AIDS risk reduction education and skills training (ARREST) program. Journal of Adolescent Health 1993;14(7):533­9.
480 - 1 Slap GB, Plotkin SL, Khalid N, Michelman DF, Forke CM. A human immunodeficiency virus peer education program for adolescent females. Journal of Adolescent Health 1991;12(6):434­42.
493 - 1 Brennan PF, Moore SM, Smyth KA. The effects of a special computer network on caregivers of persons with Alzheimer's disease. Nursing Research 1995;44(3):166­72.
481 - 1 Tanke ED, Leirer VO. Automated telephone
494 - 1 Mittelman MS, Ferris SH, Steinberg G, Shulman E,
reminders in tuberculosis care. Medical Care
Mackell TA, Ambinder A, Cohen J. An interven-
1994;32(4):380­9.
tion that delays institutionalization of Alzheimer's
482 - 1 Myers RE, Balshem AM, Wolf TA, Ross EA, Millner L. Adherence to continuous screening
disease patients: Treatment of spouse-caregivers. Gerontologist 1993;33(6):730­40.
for colorectal neoplasia. Medical Care
495 - 1 Robinson MK, DeHaven MJ, Koch KA. Effects of
1993;31(6):508­19.
the Patient Self-Determination Act on patient
483 - 1 Kimberlin CL, Berardo DH, Pendergast JF, McKenzie LC. Effects of an education program for community pharmacists on detecting drugrelated problems in elderly patients. Medical Care 1993;31(5):451­68.
knowledge and behavior. Journal of Family Practice 1993;37(4):363­8. 502 - 1 Pichert JW, Snyder GM, Kinzer CK, Boswell EJ. Problem-solving anchored instruction about sick days for adolescents with diabetes. Patient Education and Counseling 1994;23(2):115­24.
484 - 1 Marcus AC, Crane LA, Kaplan CP, Reading AE, Savage E, Gunning J, Bernstein G, Berek JS. Improving adherence to screening follow-up among women with abnormal Pap smears:
503 - 1 Wierenga ME. Life-style modification for weight control to improve diabetes health status. Patient Education and Counseling 1994;23(1):33­40.
results from a large clinic-based trial of three intervention strategies. Medical Care 1992;30(3):216­30.
504 - 1 Mesters I, van Nunen M, Crebolder H, Meertens R. Education of parents about paediatric asthma: effects of a protocol on medical consumption.
485 - 1 Walsh DC, Hingson W, Merrigan DM, Levenson
Patient Education and Counseling 1995;25:131­6.
SM. Treating the employed alcoholic: which
506 - 1 Tabak ER. Encouraging patient question asking:
interventions work? Special Focus: Alcohol and
a clinical trial. Patient Education and Counseling
the workplace. Alcohol Health and Research World
1988;12:37­49.
1992;16(2):140­8.
507 - 1 Drossaert CHC, Boer H, Seydel ER. Health
486 - 1 Donnelly BW, Davis BJ. A review of the Chance
education to repeat participation in the Dutch
to Grow Project: a care project for pregnant and
breast cancer screening programmes: evaluation
parenting adolescents. Child and Adolescent Social Work Journal 1994;11(6):493­506.
of a leaflet tailored to previous participant. Patient Education and Counseling 1996;28:121­31.
57
Appendix 5
508 - 1 Paskett ED, Phillips KC, Miller ME. Improving compliance among women with abnormal Papanicolaou smears. Obstetrics and Gynecology 1995;86(3):353­9.
527 - 1 Simmons MS, Nides MA, Rand CS, Wise RA, Tashkin DP. Trends in compliance with bronchodilator inhaler use between follow-up visits in a clinical trial. Chest 1996;109(4):963­8.
509 - 1 Kiefe CI, McKay SV, Halevy A, Brody BA. Is cost a barrier to screening mammography for lowincome women receiving Medicare benefits? A randomized trial. Archives of Internal Medicine 1994;154(11):1217­24. 511 - 1 Montgomery EB, Jr, Lieberman A, Singh G, Fries JF. Patient education and health promotion can be effective in Parkinson's disease: a randomized controlled trial. PROPATH Advisory Board. American Journal of Medicine 1994;97(5):429­35. 512 - 1 Linkins RW, Dini EF, Watson G, Patriarca PA. A randomized trial of the effectiveness of computer-generated telephone messages in increasing immunization visits among preschool children. Archives of Pediatrics and Adolescent Medicine 1994;148(9):908­14. 514 - 1 Campion P, Owen L, McNeill A, McGuire C. Evaluation of a mass media campaign on smoking and pregnancy. Addiction 1994;89(10):1245­54. 515 - 1 Klepp KI, Ndeki SS, Seha AM, Hannan P, Lyimo BA, Msuya MH, Irema MN, Schreiner A. AIDS education for primary school children in Tanzania: an evaluation study. AIDS 1994;8(8):1157­62.
528 - 1 Siegal HA, Falck RS, Carlson RG, Wang J. Reducing HIV needle risk behaviors among injection-drug users in the Midwest: an evaluation of the efficacy of standard and enhanced interventions. AIDS Education and Prevention 1995;7(4):308­19. 529 - 1 Nordblad A, Suominen-Taipale L, Murtomaa H, Vartiainen E, Koskela K. Smart Habit Xylitol campaign, a new approach in oral health promotion. Community Dental Health 1995;12(4):230­4. 530 - 1 Allen RM, Jones MP, Oldenburg B. Randomised trial of an asthma self-management programme for adults. Thorax 1995;50(7):731­8. 533 - 1 Alcoe SY, Gilbey VJ, McDermot RSR, Wallace DG. The practise of breast self examination over a sixyear period following teaching. Patient Education and Counseling 1995;25:183­96. 537 - 1 Kissinger P, Clark R, Rice J, Kutzen H, Morse A, Brandon W. Evaluation of a program to remove barriers to public health care for women with HIV infection. Southern Medical Journal 1995;88(11):1121­5.
516 - 1 Tambor ES, Bernhardt BA, Chase GA, Faden RR, Geller G, Hofman KJ, Holtzman NA. Offering cystic fibrosis carrier screening to an HMO population: factors associated with utilization. American Journal of Human Genetics 1994;55(4):626­37.
541 - 1 Chlebowski RT, Blackburn GL, Buzzard IM, Rose DP, Martino S, Khandekar JD, York RM, Jeffery RW, Elashoff RM, Wynder EL. Adherence to a dietary fat intake reduction program in postmenopausal women receiving therapy for early breast cancer. The Women's Intervention Nutrition Study. Journal of Clinical Oncology
520 - 1 Hansen BL. A health education booklet for
1993;11(11):2072­80.
young families ­ its need, use and effect. Patient
Education and Counseling 1995;25:137­42.
542 - 1 Simel DL, Feussner JR. A randomized controlled
521 - 1 Garcia R, Suarez R. Diabetes education in the elderly: a 5-year follow-up of an interactive approach. Patient Education and Counseling
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543 - 1 Lancaster G, Elton P. Does the offer of cervical
522 - 1 Town GI, Hodges ID, Wilkie AT, Toop LJ, Graham P, Drennan CJ. A community-wide promotion of asthma self-management in New Zealand. Patient Education and Counseling
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544 - 1 Muhlhauser I, Richter B, Kraut D, Weske G,
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545 - 1 Anonymous. HIV prevention through case
526 - 1 Rotheram-Borus MJ, Rosario M, Reid H,
management for HIV-infected persons­selected
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among homosexual and bisexual youths. American Journal of Psychiatry 1995;152(4):588­95.
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546 - 1 Palm BT, Kant AC, van den Bosch WJ, Vooijs GP, van Weel C. Preliminary results of a general practice based call system for cervical cancer screening in The Netherlands. British Journal of General Practice 1993;43(377):503­6.
574 - 1 Hurt RD, Offord KP, Lauger GG, Marusic Z, Fagerstrom KO, Enright PL, Scanlon PD. Cessation of long-term nicotine gum use ­ a prospective, randomized trial. Addiction 1995;90(3):407­13.
550 - 1 Joseph AM, Nichol KL, Anderson H. Effect of treatment for nicotine dependence on alcohol and drug treatment outcomes. Addictive Behaviours 1993;18(6):635­44.
575 - 1 Swaddiwudhipong W, Chaovakiratipong C, Nguntra P, Mahasakpan P, Lerdlukanavonge P, Koonchote S. Effect of a mobile unit on changes in knowledge and use of cervical cancer screen-
553 - 1 Minor MA, Brown JD. Exercise maintenance of persons with arthritis after participation in a class experience. Health Education Quarterly
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Psychological intervention in patients with poor compliance. Journal of Clinical Periodontology 1996;23(3 Pt 2):283­8.
health programs by HMOS ­ evidence from a MEDICAID demonstration. American Journal of
579 - 1 Archibald CP, Chan RK, Wong ML, Goh A, Goh CL. Evaluation of a safe-sex intervention
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and evaluation of a preventive exhibition. Health Education Research 1992;7(1):79­86. 562 - 1 Buischi YA, Axelsson P, Oliveira LB, Mayer MP, Gjermo P. Effect of two preventive programs on oral health knowledge and habits among Brazilian schoolchildren. Community Dentistry and Oral Epidemiology 1994;22(1):41­6. 563 - 1 Clarke JR, Bradnock G, Hamburger R. The uptake and completion of dental treatment using a mobile clinic in central Birmingham, UK. Community Dental Health 1992;9(2):181­5.
581 - 1 Myles PS, Hendrata M, Layher Y, Williams NJ, Hall JL, Moloney JT, Powell J. Double-blind, randomized trial of cessation of smoking after audiotape suggestion during anaesthesia. British Journal of Anaesthesia 1996;76(5):694­8. 585 - 1 Stanton BF, Li X, Galbraith J, Feigelman S, Kaljee L. Sexually transmitted diseases, human immunodeficiency virus, and pregnancy prevention. Combined contraceptive practices among urban African-American early adolescents. Archives of Pediatrics and Adolescent Medicine 1996;150(1):17­24.
564 - 1 Walsh DC, Hingson RW, Merrigan DM, Levenson SM, Cupples LA, Heeren T, Coffman GA, Becker CA, Barker TA, Hamilton SK, McGuire TG, Kelly CA. A randomized trial of treatment options for alcohol-abusing workers. New England Journal of Medicine 1991;325(11):775­82. 566 - 1 Miller MF, Wong JG. Reducing financial barriers enhances the return rate of stool Hemoccult packets. American Journal of the Medical Sciences 1993;306(2):98­100. 570 - 1 Tenn L, Dewis ME. An evaluation of a Canadian peer-driven injury prevention programme for high-risk adolescents. Journal of Advanced Nursing 1996;23(2):329­37.
586 - 1 Kohn MR, Arden MR, Vasilakis J, Shenker IR. Directly observed preventive therapy. Turning the tide against tuberculosis. Archives of Pediatrics and Adolescent Medicine 1996;150(7):727­9. 587 - 1 Wolf AM, Nasser JF, Wolf AM, Schorling JB. The impact of informed consent on patient interest in Prostate-specific antigen screening. Archives of Internal Medicine 1996;156(12):1333­6. 589 - 1 Norman P, Fitter M. Patients' views on health screening. Family Practice 1991;8:129­32. 594 - 1 Sheppard S, Coulter A, Farmer A. Using interactive videos in general practice to inform patients about treatment choices: a pilot study.
572 - 1 Ferson MJ, Fitzsimmons G, Christie D, Woollett H. School health nurse interventions to increase immunisation uptake in school entrants. Public
Family Practice 1995;12:443­7. 600 - 1 Spoth R, Redmond C. Effective recruitment of parents into family-focused prevention research:
Health 1995;109:25­109. 573 - 1 Kamolratanakul P, Ungtavorn P, Israsena S, Sakulramrung R. The influence of dissemination
a comparison of two strategies. Psychology and Health 1994;9:353­70. 601 - 1 Sander RW, Holloway RL, Eliason C, Marbella
of information on the changes of knowledge, attitude and acceptance of hepatitis B
AM, Murphy B, Yuen S. Patient-initiated prevention discussions: two interventions to
vaccination among hospital personnel in Chulalongkorn Hospital. Public Health 1994;108(1):49­53.
stimulate patients to initiate prevention
discussions. Journal Family Practice 1996;43:468­74.
59
Appendix 5
601 - 2 Sander RW, Holloway RL, Eliason C, marbella AM, Murphy B, Yuen S. Patient-initiated prevention discussions: two interventions to stimulate patients to initiate prevention discussions. Journal Family Practice 1996;43:468­74. 606 - 1 Van Heeringen C, Jannes S, Buylaert W, Henderick H, De Bacquer D, Van Remoortel J. The management of non-compliance with referral to out-patient after-care among attempted suicide patients: a controlled intervention study. Psychological Medicine 1995;25(5):963­70. 608 - 1 Turnbull D, Irwig L, Simpson JM, Donnelly N. The psychosocial impact of implementing a mammography screening campaign in an Australian community. Social Science and Medicine 1994;39(4):543­51. 610 - 1 Skinner D, Metcalf CA, Seager JR, de Swardt JS, Laubscher JA. An evaluation of an education programme on HIV infection using puppetry and street theatre. AIDS Care 1991;3(3):317­29. 612 - 1 Ferguson KA, Ono T, Lowe AA, Keenan SP, Fleetham JA. A randomised crossover study of an oral appliance vs nasal-continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea. Chest 1996;109:1269­75. 616 - 1 Rossiter JC. The effect of a culture-specific education program to promote breastfeeding among Vietnamese women in Sydney. International Journal of Nursing Studies 1994;31(4):369­79. 618 - 1 Arinen SS, Sintonen H. The choice of dental-care sector by young- adults before and after subsidazation reform in Finland. Social Science and Medicine 1994;39(2):291­7. 619 - 1 Dubois-Arber F, Masur JB, Hausser D, Zimmermann E, Paccaud F. Evaluation of AIDS prevention among homosexual and bisexual men in Switzerland. Social Science and Medicine 1993;37(12):1539­44. 620 - 1 Norman P. Predicting the uptake of health checks in general practice: invitation methods and patients' health beliefs. Social Science and Medicine 1993;37(1):53­9. 621 - 1 Guptill KS, Esrey SA, Oni GA, Brown KH. Evaluation of a face-to-face weaning food intervention in Kwara State, Nigeria: knowledge, trial, and adoption of a home-prepared weaning food. Social Science and Medicine 1993;36(5):665­72.
623 - 1 Bruce N, Griffioen A. Usefulness of a nonexperimental study design in the evaluation of service developments for infant feeding in a general hospital. Social Science and Medicine 1995;40(8):1109­16. 628 - 1 Rotheram-Borus MJ, Koopman C, Haignere C, Davies M. Reducing HIV sexual risk behaviors among runaway adolescents. JAMA 1991;266(9):1237­41. 629 - 1 Meier DE, Fuss BR, O'Rourke D, Baskin SA, Lewis M, Morrison RS. Marked improvement in recognition and completion of health-care proxies ­ a randmoized controlled trial of counseling by hospital patient representatives. Archives of Internal Medicine 1996;156(11):1227­32. 630 - 1 Sharp DJ, Peters TJ, Bartholomew J, Shaw A. Breast screening: a randomised controlled trial in UK general practice of three interventions designed to increase uptake. Journal of Epidemiology and Community Health 1996;50(1):72­6. 631 - 1 Fortmann SP, Taylor CB, Flora JA, Winkleby MA. Effect of community health education on plasma cholesterol levels and diet: the Stanford Five-City Project. American Journal of Epidemiology 1993;137(10):1039­55. 632 - 1 Sorensen JL, London J, Heitzmann C, Gibson DR, Morales ES, Dumontet R, Acree M. Psychoeducational group approach: HIV risk reduction in drug users. AIDS Education and Prevention 1994;6(2):95­112. 632 - 2 Sorensen JL, London J, Heitzmann C, Gibson DR, Morales ES, Dumontet R, Acree M. Psychoeducational group approach: HIV risk reduction in drug users. AIDS Education and Prevention 1994;6(2):95­112. 633 - 1 Black ME, Ploeg J, Walter SD, Hutchinson BG, Scott EA, Chambers LW. The impact of a public health nurse intervention on influenza vaccine acceptance. American Journal of Public Health 1993;83(12):1751­3. 634 - 1 Torgerson DJ, Donaldson C, Garton MJ, Reid DM, Russell IT. Recruitment methods for screening programmes: the price of high compliance. Health Economics 1993;2(1):55­8. 635 - 1 Malow RM, West JA, Corrigan SA, Pena JM, Cunningham SC. Outcome of psychoeducation for HIV risk reduction. AIDS Education and Prevention 1994;6(2):113­25.
622 - 1 Jones SL, Jones PK, Katz J. Compliance in acute
636 - 1 McCusker J, Stoddard AM, Zapka JG, Lewis BF.
and chronic patients receiving a health belief
Behavioral outcomes of AIDS educational
model intervention in the emergency depart-
interventions for drug users in short-term
60
ment. Social Science and Medicine 1991;32(10):1183­9.
treatment. American Journal of Public Health 1993;83(10):1463­6.
Health Technology Assessment 1999; Vol. 3: No. 1
638 - 1 Wasson J, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HG. Telephone care as a substitute for routine clinic follow-up. JAMA 1992;267(13):1788­93. 639 - 1 Ashworth CS, DuRant RH, Gaillard G, Rountree J. An experimental evaluation of an AIDS educational intervention for WIC mothers. AIDS Education and Prevention 1994;6(2):154­62. 640 - 1 Elder JP, Wildey M, de Moor C, Sallis JF, Jr, Eckhardt L, Edwards C, Erickson A, Golbeck A, Hovell M, Johnston D, Levitz MD, Molgaard L, Young R, Vito D, Woodruff SI. The long-term prevention of tobacco use among junior high school students: classroom and telephone interventions. American Journal of Public Health 1993;83(9):1239­44. 644 - 1 Gomel M, Oldenburg B, Simpson JM, Owen N. Work-site cardiovascular risk reduction: a randomized trial of health risk assessment, education, counseling, and incentives. American Journal of Public Health 1993;83(9):1231­8. 646 - 1 Nyamathi AM, Flaskerud J, Bennett C, Leake B, Lewis C. Evaluation of two AIDS education programs for impoverished Latina women. AIDS Education and Prevention 1994;6(4):296­309. 647 - 1 Kelly JA, St Lawrence JS, Stevenson LY, Hauth AC, Kalichman SC, Diaz YE, Brasfield TL, Koob JJ, Morgan MG. Community AIDS/HIV risk reduction: the effects of endorsements by popular people in three cities. American Journal of Public Health 1992;82(11):1483­9. 648 - 1 Jorenby DE, Smith SS, Fiore MC, Hurt RD, Offord KP, Croghan IT, Hays JT, Lewis SF Baker TB. Varying nicotine patch dose and type of smoking cessation counseling. JAMA 1995;274(17):1347­52. 649 - 1 Bellingham K, Gillies P. Evaluation of an AIDS education programme for young adults. Journal of Epidemiology and Community Health 1993;47(2):134­8. 650 - 1 Berrier J, Sperling R, Preisinger J, Evans V, Mason J, Walther V. HIV/AIDS education in a prenatal clinic: an assessment. AIDS Education and Prevention 1991;3:100­17.
653 - 1 Peeters PH, Beckers CG, Hogervorst JM, Collette HJ. Effect on breast cancer screening response in The Netherlands of inviting women for an additional scientific investigation. Journal of Epidemiology and Community Health 1994;48(2):175­7. 654 - 1 Flowers JV, Booraem C, Miller TE, Iverson AE, Copeland J, Furtado K. Comparison of the results of a standardized AIDS prevention program in three geographic locations. AIDS Education and Prevention 1991;3:189­96. 655 - 1 King R, Estey J, Allen S, Kegeles S, Wolf W, Valentine C, Serufilira A. A family planning intervention to reduce vertical transmission of HIV in Rwanda. AIDS 1995;9(Suppl 1):S45­51. 657 - 1 Warnecke RB, Langenberg P, Wong SC, Flay BR, Cook TD. The second Chicago televised smoking cessation program: a 24-month follow-up. American Journal of Public Health 1992;82(6):835­40. 658 - 1 O'Loughlin J, Paradis G, Kishchuk N, GrayDonald K, Renaud L, Fines P, Barnett T. Coeur en sante St-Henri­a heart health promotion programme in Montreal, Canada: design and methods for evaluation. Journal of Epidemiology and Community Health 1995;49(5):495­502. 659 - 1 Shattuck AL, White E, Kristal AR. How women's adopted low-fat diets affect their husbands. American Journal of Public Health 1992;82(9):1244­50. 660 - 1 Walter HJ, Vaughan RD. AIDS risk reduction among a multiethnic sample of urban high school students. JAMA 1993;270(6):725­30. 662 - 1 Langer LM, Zimmerman RS, Hendershot EF, Singh M. Effect of Magic Johnson's HIV status on HIV-related attitudes and behaviors of an STD clinic population. AIDS Education and Prevention 1992;4(4):295­307. 663 - 1 Aplasca MR, Siegel D, Mandel JS, SantanaArciaga RT, Paul J, Hudes ES, Monzon OT, Hearst N. Results of a model AIDS prevention program for high school students in the Philippines. AIDS 1995;9(Suppl 1):S7­13.
651 - 1 Allen S, Serufilira A, Bogaerts J, Van de Perre P, Nsengumuremyi F, Lindan C, Carael M, Wolf W, Coates T, Hulley S. Confidential HIV testing and condom promotion in Africa. Impact on HIV and gonorrhea rates. JAMA 1992;268(23):3338­43.
665 - 1 Kelly JA, St Lawrence JS, Diaz YE, Stevenson LY, Hauth AC, Brasfield TL, Kalichman SC, Smith JE, Andrew ME. HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis. American Journal of Public Health 1991;81(2):168­71.
652 - 1 Maiman LA, Hildreth NG, Cox C, Greenland P.
667 - 1 Street RL, Jr, Voigt B, Geyer C, Jr, Manning T,
Improving referral compliance after public
Swanson GP. Increasing patient involvement in
cholesterol screening. American Journal of Public Health 1992;82(6):804­9.
choosing treatment for early breast cancer. Cancer 1995;76(11):2275­85.
61
Appendix 5
668 - 1 Velicer WF, Prochaska JO, Bellis JM, Diclemente CC, Rossi JS, Fava JL, Steiger JH. An expert system intervention for smoking cessation. Addictive Behaviours 1993;18(3):269­90. 670 - 1 Ross JD, Scott GR. The association between HIV media campaigns and number of patients coming forward for HIV antibody testing. Genitourinary Medicine 1993;69(3):193­5. 671 - 1 Phatouros CC, Blake MP. How much now to tell? Patients' attitudes to an information sheet prior to angiography and angioplasty. Australasian Radiology 1995;39(2):135­9.
686 - 1 Fletcher SW, Harris RP, Gonzalez JJ, Degnan D, Lannin DR, Strecher VJ, Pilgrim C, Quade D, Earp JA, Clark RL. Increasing mammography utilization: a controlled study. Journal of the National Cancer Institute 1993;85(2):112­20. 688 - 1 Kamenga M, Ryder RW, Jingu M, Mbuyi N, Mbu L, Behets F, Brown C, Heyward WL. Evidence of marked sexual behavior change associated with low HIV-1 seroconversion in 149 married couples with discordant HIV-1 serostatus: experience at an HIV counselling center in Zaire. AIDS 1991;5(1):61­7.
674 - 1 Banahan I, Quenby S, Stewart H, Farquharson R. Preliminary evaluation of the effectiveness of a preoperative clinic for gynaecological surgery. British Journal of Hospital Medicine 1994;52(10):535­8. 675 - 1 Robinson MH, Pye G, Thomas WM, Hardcastle JD, Mangham CM. Haemoccult screening for colorectal cancer: the effect of dietary restriction on compliance. European Journal of Surgical Oncology 1994;20(5):545­8.
690 - 1 Champion VL. Results of a nurse-delivered intervention on proficiency and nodule detection with breast self-examination. Oncology Nursing Forum 1995;22(5):819­24. 691 - 1 Whelan TJ, Levine MN, Gafni A, Lukka H, Mohide EA, Patel M, Streiner DL. Breast irradiation postlumpectomy: development and evaluation of a decision instrument. Journal of Clinical Oncology 1995;13(4):847­53.
676 - 1 D'Souza W, Burgess C, Ayson M, Crane J, Pearce N, Beasley R. Trial of a `credit card' asthma selfmanagement plan in a high-risk group of patients with asthma. Journal of Allergy and Clinical Immunology 1996;97(5):1085­92. 678 - 1 Rowley MJ, Hensley MJ, Brinsmead MW, Wlodarczyk JH. Continuity of care by a midwife team versus routine care during pregnancy and birth: a randomised trial. Medical Journal of Australia 1995;163(6):289­93. 679 - 1 Harrell JS, McMurray RG, Bangdiwala SI, Frauman AC, Gansky SA, Bradley CB. Effects of a school-based intervention to reduce cardiovascular disease risk factors in elementary-school children: the Cardiovascular Health in Children (CHIC) study. Journal of Pediatrics 1996;128(6):797­805. 680 - 1 van Haastrecht HJ, van den Hoek JA, Coutinho RA. Evidence for a change in behaviour among heterosexuals in Amsterdam under the influence of AIDS. Genitourinary Medicine 1991;67(3):199­206.
693 - 1 Esposito L. The effects of medication education on adherence to medication regimens in an elderly population. Journal of Advanced Nursing 1995;21(5):935­43. 695 - 1 Hoare T, Thomas C, Biggs A, Booth M, Bradley S, Friedman E. Can the uptake of breast screening by Asian women be increased? A randomized controlled trial of a linkworker intervention. Journal of Public Health Medicine 1994;16(2):179­85. 696 - 1 O'Donnell L, San Doval A, Duran R, O'Donnell CR. The effectiveness of video-based interventions in promoting condom acquisition among STD clinic patients. Sexually Transmitted Diseases 1995;22(2):97­103. 698 - 1 Doren M, Reuther G, Minne HW, Schneider HP. Superior compliance and efficacy of continuous combined oral estrogen-progestogen replacement therapy in postmenopausal women. American Journal of Obstetrics and Gynecology 1995;173(5):1446­51.
683 - 1 King J, Fairbrother G, Thompson C, Morris DL. Colorectal cancer screening: optimal compliance with postal faecal occult blood test. Australian and New Zealand Journal of Surgery 1992;62(9):714­9.
700 - 1 Butow PN, Dunn SM, Tattersall MH, Jones QJ. Patient participation in the cancer consultation: evaluation of a question prompt sheet. Annals of Oncology 1994;5(3):199­204.
684 - 1 McCusker J, Stoddard AM, Zapka JG, Zorn M. Use of condoms by heterosexually active drug abusers before and after AIDS education. Sexually
702 - 1 Cargill JM. Medication compliance in elderly people: influencing variables and interventions. Journal of Advanced Nursing 1992;17(4):422­6.
Transmitted Diseases 1993;20(2):81­8.
705 - 1 Hughes BR, Altman DG, Newton JA. Melanoma
685 - 1 Winter L, Goldy AS. Effects of prebehavioral
and skin cancer: evaluation of a health education
62
cognitive work on adolescents' acceptance of condoms. Health Psychology 1993;12(4):308­12.
programme for secondary schools. British Journal of Dermatology 1993;128(4):412­17.
Health Technology Assessment 1999; Vol. 3: No. 1
706 - 1 Usherwood TP. Development and randomized controlled trial of a booklet of advice for parents. British Journal of General Practice 1991;41(343):58­62. 707 - 1 DeBusk RF, Miller NH, Superko HR, Dennis CA, Thomas RJ, Lew HT, Berger WE, 3rd, Heller RS, Rompf J, Gee D, Kraemer HC, Bandura A, Ghandour G, Clark M, Shah RV, Fisher L, BarrTaylor C. A case-management system for coronary risk factor modification after acute myocardial infarction. Annals of Internal Medicine 1994;120(9):721­9. 708 - 1 Robertson I, Phillips A, Mant D, Thorogood M, Fowler G, Fuller A, Yudkin P, Woods M. Motivational effect of cholesterol measurement in general practice health checks. British Journal of General Practice 1992;42(364):469­72. 709 - 1 Osler M, Jespersen NB. The effect of a community-based cardiovascular disease prevention project in a Danish municipality. Danish Medical Bulletin 1993;40(4):485­9. 711 - 1 Scivoletto S, De Andrade AG, Castel S. The effect of a `recall-system' in the treatment of alcoholic patients. British Journal of Addiction 1992;87(8):1185­8. 712 - 1 Schapira DV, Kumar NB, Clark RA, Yag C. Mammography screening credit card and compliance. Cancer 1992;70(2):509­12.
726 - 1 Luepker RV, Murray DM, Jacobs DR, Jr, Mittelmark MB, Bracht N, Carlaw R, Crow R, Elmer P, Finnegan J, Folsom AR, Grimm R, Hannan PJ, Jeffrey R, Laubo H, Govern P, Mullis R, Perry CL, Pechacek T, Pirie P, Sprafka M, Weisbrod R, Blackburn H. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. American Journal of Public Health 1994;84(9):1383­93. 727 - 1 Hurley SF, Huggins RM, Jolley DJ, Reading D. Recruitment activities and sociodemographic factors that predict attendance at a mammographic screening program. American Journal of Public Health 1994;84(10):1655­8. 728 - 1 McAvoy BR, Raza R. Can health education increase uptake of cervical smear testing among Asian women? British Medical Journal 1991;302(6780):833­6. 729 - 1 Stephens RC, Feucht TE, Roman SW. Effects of an intervention program on AIDS-related drug and needle behavior among intravenous drug users. American Journal of Public Health 1991;81(5):568­71. 731 - 1 Nutbeam D, Macaskill P, Smith C, Simpson JM, Catford J. Evaluation of two school smoking education programmes under normal classroom conditions. British Medical Journal 1993;306(6870):102­7.
713 - 1 Stewart DE, Buchegger PM, Lickrish GM, Sierra S. The effect of educational brochures on follow-up compliance in women with abnormal Papanicolaou smears. Obstetrics and Gynecology 1994;83(4):583­5. 714 - 1 Nelson EW, Van Cleve S, Swartz MK, Kessen W, McCarthy PL. Improving the use of early followup care after emergency department visits. A randomized trial. American Journal of Diseases of Children 1991;145(4):440­4. 717 - 1 Webster A. The effect of pre-assessment information on clients' satisfaction, expectations and attendance at a mental health day centre. British Journal of Medical Psychology 1992;65(Pt 2):89­93. 720 - 1 Zapka JG, Stoddard AM, McCusker J. Social network, support and influence: relationships with drug use and protective AIDS behavior. AIDS Education and Prevention 1993;5(4):352­66.
732 - 1 Grosskurth H, Mosha F, Todd J, Mwijarubi E, Klokke A, Senkoro K, Mayaud P, Changalucha J, Nicoll A, ka-Gina G, Newell J, Mugeye K, Mabeg D, Hayes R. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet 1995;346(8974):530­6. 733 - 1 Black MM, Nair P, Kight C, Wachtel R, Roby P, Schuler M. Parenting and early development among children of drug-abusing women: effects of home intervention. Pediatrics 1994; 94(4 Pt 1):440­8. 736 - 1 Calsyn DA, Saxon AJ, Freeman G, Jr, Whittaker S. Ineffectiveness of AIDS education and HIV antibody testing in reducing high-risk behaviors among injection drug users. American Journal of Public Health 1992;82(4):573­5.
723 - 1 Fox LJ, Bailey PE, Clarke-Martinez KL, Coello M, Ordonez FN, Barahona F. Condom use among high-risk women in Honduras: evaluation of an AIDS prevention program. AIDS Education and
737 - 1 Wilson TG, Jr, Hale S, Temple R. The results of efforts to improve compliance with supportive periodontal treatment in a private practice. Journal of Periodontology 1993;64(4):311­14.
Prevention 1993;5(1):1­10.
740 - 1 Rossouw JE, Jooste PL, Chalton DO, Jordaan ER,
724 - 1 Windsor RA, Lowe JB, Perkins LL, Smith-Yoder
Langenhoven ML, Jordaan PC, Steyn M,
D, Artz L, Crawford M, Amburgy K, Boyd NR, Jr.
Swanepoel AS, Rossouw LJ. Community-based
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(CORIS). International Journal of Epidemiology 1993;22(3):428­38.
63
Appendix 5
741 - 1 Wenger NS, Linn LS, Epstein M, Shapiro MF. Reduction of high-risk sexual behavior among heterosexuals undergoing HIV antibody testing: a randomized clinical trial. American Journal of Public Health 1991;81(12):1580­5. 742 - 1 Hobfoll SE, Jackson AP, Lavin J, Britton PJ, Shepherd JB. Reducing inner-city women's AIDS risk activities: a study of single, pregnant women. Health Psychology 1994;13(5):397­403. 743 - 1 Miedzybrodzka ZH, Hall MH, Mollison J, Templeton A, Russell IT, Dean JC, Kelly KF, Marteau TM, Haites NE. Antenatal screening for carriers of cystic fibrosis: randomised trial of stepwise v couple screening. British Medical Journal 1995;310(6976):353­7.
758 - 1 Tedesco LA, Keffer MA, Davis EL, Christersson LA. Effect of a social cognitive intervention on oral health status, behavior reports, and cognitions. Journal of Periodontology 1992;63(7):567­75. 759 - 1 Mellanby AR, Phelps FA, Crichton NJ, Tripp JH. School sex education: an experimental programme with educational and medical benefit. British Medical Journal 1995;311(7002):414­7. 760 - 1 Aiken LS, West SG, Woodward CK, Reno RR, Reynolds KD. Increasing screening mammography in asymptomatic women: evaluation of a second-generation, theory-based program. Health Psychology 1994;13(6):526­38.
746 - 1 Kernohan EE. Evaluation of a pilot study for breast and cervical cancer screening with Bradford's minority ethnic women; a community development approach, 1991­93. British Journal of Cancer 1996;74(Suppl 29):S42­6. 747 - 1 Garton MJ, Torgerson DJ, Donaldson C, Russell IT, Reid DM. Recruitment methods for screening programmes: trial of a new method within a regional osteoporosis study. British Medical Journal 1992;305(6845):82­4. 748 - 1 Smith S, Robinson J, Hollyer J, Bhatt R, Ash S, Shaunak S. Combining specialist and primary health care teams for HIV positive patients: retrospective and prospective studies. British Medical Journal 1996;312(7028):416­20. 749 - 1 Jemmott JB, 3rd, Jemmott LS, Fong GT. Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention [published erratum appears in American Journal of Public Health 1992;82(5):684]. American Journal of Public Health 1992;82(3):372­7. 752 - 1 Mant D, Fuller A, Northover J, Astrop P, Chivers A, Crockett A, Clements S, Lawrence M. Patient compliance with colorectal cancer screening in general practice. British Journal of General Practice 1992;42(354):18­20.
762 - 1 Kalichman SC, Kelly JA, Hunter TL, Murphy DA, Tyler R. Culturally tailored HIV-AIDS riskreduction messages targeted to African-American urban women: impact on risk sensitization and risk reduction. Journal of Consulting and Clinical Psychology 1993;61(2):291­5. 763 - 1 Lowe CJ, Raynor DK, Courtney EA, Purvis J, Teale C. Effects of self medication programme on knowledge of drugs and compliance with treatment in elderly patients. British Medical Journal 1995;310(6989):1229­31. 765 - 1 Lombard D, Neubauer TE, Canfield D, Winett RA. Behavioral community intervention to reduce the risk of skin cancer. Journal of Applied Behavior Analysis 1991;24(4):677­86. 766 - 1 St Lawrence JS, Brasfield TL, Jefferson KW, Alleyne E, O'Bannon RE, 3rd, Shirley A. Cognitive-behavioral intervention to reduce African American adolescents' risk for HIV infection. Journal of Consulting and Clinical Psychology 1995;63(2):221­37. 767 - 1 Reading R, Colver A, Openshaw S, Jarvis S. Do interventions that improve immunisation uptake also reduce social inequalities in uptake? British Medical Journal 1994;308(6937):1142­4.
754 - 1 Shannon BM, Tershakovec AM, Martel JK, Achterberg CL, Cortner JA, Smiciklas-Wright HS, Stallings VA, Stolley PD. Reduction of elevated LDL-cholesterol levels of 4- to 10-year-old children through home-based dietary education. Pediatrics 1994;94(6 Pt 1):923­7. 755 - 1 Hanlon P, McEwen J, Carey L, Gilmour H, Tannahill C, Tannahill A, Kelly M. Health checks and coronary risk: further evidence from a randomised controlled trial. British Medical Journal 1995;311(7020):1609­13.
768 - 1 Dungy CI, Christensen-Szalanski J, Losch M, Russell D. Effect of discharge samples on duration of breast-feeding. Pediatrics 1992; 90(2 Pt 1):233­7. 769 - 1 Dale J, Lang H, Roberts JA, Green J, Glucksman E. Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars. British Medical Journal 1996;312(7042):1340­4.
757 - 1 Lerman C, Ross E, Boyce A, Gorchov PM,
770 - 1 Colon HM, Sahai H, Robles RR, Matos TD.
McLaughlin R, Rimer B, Engstrom P. The impact
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of mailing psychoeducational materials to women
risk behaviors among injection drug users in San
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772 - 1 Miller WR, Benefield RG, Tonigan JS. Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles. Journal of Consulting and Clinical Psychology 1993;61(3):455­61. 773 - 1 Pendergrast RA, Ashworth CS, DuRant RH, Litaker M. Correlates of children's bicycle helmet use and short-term failure of school-level interventions. Pediatrics 1992;90(3):354­8. 775 - 1 Li J, Taylor B. Comparison of immunisation rates in general practice and child health clinics. British Medical Journal 1991;303(6809):1035­8. 776 - 1 Kelly JA, Murphy DA, Washington CD, Wilson TS, Koob JJ, Davis DR, Ledezma G, Davantes B. The effects of HIV/AIDS intervention groups for high-risk women in urban clinics. American Journal of Public Health 1994;84(12):1918­22. 777 - 1 West S, Munoz B, Lynch M, Kayongoya A, Chilangwa Z, Mmbaga BB, Taylor HR. Impact of face-washing on trachoma in Kongwa, Tanzania. Lancet 1995;345(8943):155­8. 778 - 1 Thornton JG, Hewison J, Lilford RJ, Vail A. A randomised trial of three methods of giving information about prenatal testing. British Medical Journal 1995;311(7013):1127­30. 779 - 1 Swaddiwudhipong W, Chaovakiratipong C, Nguntra P, Khumklam P, Silarug N. A Thai monk: an agent for smoking reduction in a rural population. International Journal of Epidemiology 1993;22(4):660­5. 780 - 1 Santelli JS, Celentano DD, Rozsenich C, Crump AD, Davis MV, Polacsek M, Augustyn M, Rolf J, McAlister AL, Burwell L. Interim outcomes for a community-based program to prevent perinatal HIV transmission. AIDS Education and Prevention 1995;7(3):210­20. 781 - 1 Lahdensuo A, Haahtela T, Herrala J, Kava T, Kiviranta K, Kuusisto P, Peramaki E, Poussa T, Saarelainen S, Svahn T. Randomised comparison of guided self management and traditional treatment of asthma over one year. British Medical Journal 1996;312(7033):748­52.
788 - 1 Serwint JR, Wilson MH, Duggan AK, Mellits ED, Baumgardner RA, DeAngelis C. Do postpartum nursery visits by the primary care provider make a difference? Pediatrics 1991;88(3):444­9. 789 - 1 Rothman AJ, Salovey P, Turvey C, Fishkin SA. Attributions of responsibility and persuasion: increasing mammography utilization among women over 40 with an internally oriented message. Health Psychology 1993;12(1):39­47. 790 - 1 Bekker H, Modell M, Denniss G, Silver A, Mathew C, Bobrow M, Marteau T. Uptake of cystic fibrosis testing in primary care: supply push or demand pull? British Medical Journal 1993;306(6892):1584­6. 791 - 1 Bhave G, Lindan CP, Hudes ES, Desai S, Wagle U, Tripathi SP, Mandel JS. Impact of an intervention on HIV, sexually transmitted diseases, and condom use among sex workers in Bombay, India. AIDS 1995;9(Suppl 1):S21­30. 792 - 1 Flynn BS, Worden JK, Secker-Walker RH, Badger GJ, Geller BM, Costanza MC. Prevention of cigarette smoking through mass media intervention and school programs. American Journal of Public Health 1992;82(6):827­34. 793 - 1 Anonymous. Effectiveness of a nicotine patch in helping people stop smoking: results of a randomised trial in general practice. Imperial Cancer Research Fund General Practice Research Group. British Medical Journal 1993;306(6888):1304­8. 794 - 1 Katon W, Von Korff M, Lin E, Walker E, Simon GE, Bush T, Robinson P, Russo J. Collaborative management to achieve treatment guidelines. Impact on depression in primary care. JAMA 1995;273(13):1026­31. 795 - 1 Reid GS, Robertson AJ, Bissett C, Smith J, Waugh N, Halkerston R. Cervical screening in Perth and Kinross since introduction of the new contract. British Medical Journal 1991;303(6800):447­50. 796 - 1 Rutten G, Van Eijk J, Beek M, Van der Velden H. Patient education about cough: effect on the consulting behaviour of general practice patients. British Journal of General Practice 1991;41(348):289­92.
783 - 1 Orleans CT, Schoenbach VJ, Wagner EH, Quade D, Salmon MA, Pearson DC, Fiedler J, Porter CQ, Kaplan BH. Self-help quit smoking interventions: effects of self-help materials, social
798 - 1 Gibbins RL, Riley M, Brimble P. Effectiveness of programme for reducing cardiovascular risk for men in one general practice. British Medical Journal 1993;306(6893):1652­6.
support instructions, and telephone counseling. Journal of Consulting and Clinical Psychology 1991;59(3):439­48.
799 - 1 DiClemente RJ, Wingood GM. A randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women.
784 - 1 Sutton S, Bickler G, Sancho-Aldridge J, Saidi
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807 - 1 Maxwell AE, Hunt IF, Bush MA. Effects of a social
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65
Appendix 5
809 - 1 Zapka JG, Harris DR, Hosmer D, Costanza ME, Mas E, Barth R. Effect of a community health center intervention on breast cancer screening among Hispanic American women. Health Services Research 1993;28(2):223­35. 813 - 1 Leigh JP, Richardson N, Beck R, Kerr C, Harrington H, Parcell CL, Fries JF. Randomized controlled study of a retiree health promotion program. The Bank of American Study. Archives of Internal Medicine 1992;152(6):1201­6. 814 - 1 Marcus BH, Stanton AL. Evaluation of relapse prevention and reinforcement interventions to promote exercise adherence in sedentary females. Research Quarterly for Exercise and Sport 1993;64(4):447­52. 815 - 1 Rodriguez JG, Velez M, Serrano E, Casado MP. Adolescent student's compliance with testicular self examination. Boletin ­ Asociacion Medica de Puerto Rico 1995;87(3­4):49­53. 816 - 1 Aaronson NK, Visserpol E, Leenhouts GHMW, Muller MJ, Vanderschot ACM, Vandam FSAM, Keus RB, Koning CCE, Huinink WWT, Vandongen JA, Dubbelman R. Telephone-based nursing intervention improves the effectiveness of the informed consent process in cancer clinical-trials. Journal of Clinical Oncology 1996;14(3):984­96.
817 - 1 McCusker J, Stoddard AM, Zapka JG, Morrison CS, Zorn M, Lewis BF. AIDS education for drug abusers: evaluation of short-term effectiveness. American Journal of Public Health 1992;82(4):533­40. 821 - 1 Williams LR, Ekers MA, Collins PS, Lee JF. Vascular rehabilitation: benefits of a structured exercise/risk modification program. Journal of Vascular Surgery 1991;14(3):320­6. 822 - 1 Kirby D, Waszak C, Ziegler J. Six school-based clinics: their reproductive health services and impact on sexual behavior. Family Planning Perspectives 1991;23(1):6­16. 823 - 1 Anonymous. Effectiveness of a health education curriculum for secondary school students ­ United States, 1986­1989. MMWR ­ Morbidity and Mortality Weekly Report 1991;40(7):113­16. 825 - 1 Guimon J. The use of group programs to improve medication compliance in patients with chronic diseases. Patient Education and Counseling 1995;26:189­93.
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Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 6 Bibliography: studies by author
(Study numbers appear at the end of each reference) Aaonson NK, Visserpol E, Leenhouts GHMW, Muller MJ, Vanderschot ACM, Vandam FSAM, Keus RB, Koning CCE, Huinink WWT, Vandonden JA, Dubbelman R. Journal of Clincal Oncology 1996;14(3):984­96. 816 - 1
Baier CA, Grodzin CJ, Port JD, Leksas L, Tancredi DJ. American Journal of Preventive Medicine 1992;8(2):115­22. 384 - 1 Baker A, Kochan N, Dixon J, Heather N, Wodak A. AIDS Care 1994;6(5):559­70. 525 - 1
Agras WS, Berkowitz RI Arnow BA, Telch CF, Marnell M, Henderson J, Morris Y, Wilfley DE. Journal of Consulting and Clinical Psychology 1996;64(3):610­13. 32 - 1 Aiken LS, West SG, Woodward CK, Reno RR, Reynolds KD. Health Psychology 1994;13(6):526­38. 760 - 1
Banahan I, Quenby S, Stewart H, Farquharson R. British Journal of Hospital Medicine 1994;52(10):535­8. 674 - 1 Banks SM, Salovey P, Greener S, Rothman AJ, Moyer A, Beauvais J, Epel E. Health Psychology 1995;14(2):178­84. 438 - 1
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Alexandrov A, Maslennikova G, Kulikov S, Propirnij G, Perova N. Preventive Medicine 1992;21:53­62. 279 - 1
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Bazeley P, Kemp L. Australian Journal of Public Health 1995;19(5):459­64. 193 - 1
T, Hulley S. JAMA 1992;268(23):3338­43. 651 - 1
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Anonymous. British Medical Journal 1993;306(6888):
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1304­8. 793 - 1
Bekker H, Modell M, Denniss G, Silver A, Mathew C,
Anonymous. MMWR ­ Morbidity and Mortality Weekly Report 1993;42(23):448­9, 455­6. 545 - 1
Bobrow M, Marteau T. British Medical Journal 1993;306(6892):1584­6. 790 - 1
Anonymous. MMWR ­ Morbidity and Mortality Weekly Report 1991;40(7):113­16. 823 - 1 Ansell D, Lacey L, Whitman S, Chen E, Phillips C. Public Health Reports 1994;109(1):104­11. 397 - 1 Aplasca MR, Siegel D, Mandel JS, Santana-Arciaga RT, Paul J, Hudes ES, Monzon OT, Hearst N. AIDS 1995;9 Suppl 1:S7­13. 663 - 1 Archibald CP, Chan RK, Wong ML, Goh A, Goh CL. International Journal of STD and AIDS 1994;5(4):268­72. 579 - 1
Bell RM, Ellickson PL, Harrison ER. Preventive Medicine 1993;22(4):463­83. 277 - 1 Bellingham K, Gillies P. Journal of Epidemiology and Community Health 1993;47(2):134­8. 649 - 1 Berman BA, Gritz ER, Braxton-Owens H, Nisenbaum R. Journal of Cancer Education 1995;10(2):91­101. 72 - 1 Berrier J, Sperling R, Preisinger J, Evans V, Mason J, Walther V. AIDS Education and Prevention 1991;3:100­17. 650 - 1 Bhave G, Lindan CP, Hudes ES, Desai S, Wagle U, Tripathi SP, Mandel JS. AIDS 1995;9(Suppl 1):S21­30.
Arinen SS, Sintonen H. Social Science and Medicine
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Binstock MA, Wolde-Tsadik G. Journal of Reproductive Medicine 1995;40(7):507­12. 83 - 1
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Calsyn DA, Saxon AJ, Freeman G, Jr, Whittaker S. American Journal of Public Health 1992;82(4):573­5. 736 - 1 Campbell JR, Szilagyi PG, Rodewald LE, Doane C, Roghmann KJ. Clinical Pediatrics 1994;May:268­72. 167 - 1 Campion P, Owen L, McNeill A, McGuire C. Addiction 1994;89(10):1245­54. 514 - 1 Cardenas M, Simons-Morton B. Patient Education and Counseling 1993;21:117­23. 324 - 1 Cargill JM. Journal of Advanced Nursing 1992;17(4):422­6. 702 - 1 Carleton RA, Lasater TM, Assaf AR, Feldman HA, McKinlay S. American Journal of Public Health 1995;85(6):777­85. 440 - 1 Champion V, Huster G. Journal of Behavioral Medicine 1995;18(2):169­87. 114 - 1 Champion VL. Oncology Nursing Forum 1995;22(5):819­24. 690 - 1 Cheadle A, Psaty B, Diehr P, Koepsell T, Wagner E, Curry S, Kristal A. Preventive Medicine 1996;24:71­9. 215 - 1 Chen CH. Maternal Child Nursing Journal 1993;21(3):82­90. 403 - 1 Cherkin DC, Deyo RA, Street JH, Hunt M, Barlow W. Spine 1996;21(3):345­55. 63 - 1 Chirwa B, Briega W, Ramakrishna J. Patient Education and Counseling 1988;11:203­13. 335 - 1 Chlebowski RT, Blackburn GL, Buzzard IM, Rose DP, Martino S, Khandekar JD, York RM, Jeffery RW, Elashoff RM, Wynder EL. Journal of Clinical Oncology 1993;11(11):2072­80. 541 - 1
Bruce N, Griffioen A. Social Science and Medicine 1995;40(8):1109­16. 623 - 1 Brug J, Steenhuis I, Assema P, de Vreis H. Preventive Medicine 1996;25:236­42. 210 - 1
Christensen B. Family Medicine 1995;27(8):531­4. 56 - 1 Christianson JB, Lurie N, Finch M, Moscovice S, Hartley D. American Journal of Public Health 1992;82(6):790­6. 554 - 1
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Clark N, Feldman C, Evans D, Duzey O, Levison M, Wasilewski Y, Kaplan D, Rips J, Mellins R. Patient Education and Counseling 1986;8:27­38. 291 - 1
Bullock LF, Wells JE, Duff GB, Hornblow AR. New Zealand Medical Journal 1995;108(1012):476­8. 196 - 1
Clarke JR, Bradnock G, Hamburger R. Community Dental Health 1992;9(2):181­5. 563 - 1
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Clayton R, Cattarello A, Johnstone B. Preventive Medicine 1996;25:307­18. 212 - 1
Butler GS, Hurley CA, Buchanan KL, Smith-VanHorne J. Patient Education and Counseling 1996;29:189­97. 490 - 1
Clifford PA, Tan S-Y, Gorsuch RL. Journal of Behavioural Medicine 1991;14:303­23. 416 - 1
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Calfas K, Long B, Sallis J, Wooten W, Pratt M, Patrick K. Preventive Medicine 1996;25:225­33. 209 - 1
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Cook B, Noteloviz M, Rector C, Krischer J. Patient Education and Counseling 1991;17:135­45. 348 - 1
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Crockett S, Mullis R, Perry C, Luepker R. Preventive Medicine 1989;18:475­91. 253 - 1
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Edmundson E, Parcel G, Feldman H, Elder J, Perry C, Johnson C, Williston B, Stone E, Yang M, Lytle L, Webber L. Preventive Medicine 1996;25:442­54. 220 - 1 Eisen M, Zellman GL, McAlister AL. Health Education Quarterly 1992;19(2):249­62. 373 - 1
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Davis SW, Cummings KM, Rimer BK, Sciandra R, Stone JC. Health Education Quarterly 1992;19(4):495­504. 459 - 1 de Weerdt I, Visser A, Kok G, van der Veen E. Patient Education and Counseling 1989;14:191­215. 313 - 1 DeBusk RF, Miller NH, Superko HR, Dennis CA, Thomas RJ, Lew HT, Berger WE, 3rd, Heller RS, Rompf J, Gee D, Kraemer HC, Bandura A, Ghandour G, Clark M, Shah RV, Fisher L, Barr-Taylor C. Annals of Internal Medicine 1994;120(9):721­9. 707 - 1 Della Valle CJ, Levitz CL, Bora FW, Jr. American Journal of Orthopedics 1995;24(6):483­7. 75 - 1 Delp C Jones J. Academic Emergency Medicine 1996;3(3):264­70. 150 - 1 Deren S, Davis WR, Beardsley M, Tortu S, Clatts M. AIDS Education and Prevention 1995;7(5):379­90. 165 - 1 Detry JM, Block P, De Backer G, Degaute JP. European Journal of Clinical Pharmacology 1995;47(6):477­81. 57 - 1 Devine CM, Olson CM, Frongillo EA, Jr. Journal of School Health 1992;62(8):381­5. 409 - 1 DiClemente RJ, Wingood GM. JAMA 1995;274(16):1271­6. 799 - 1 DiScenza S, Nies M, Jordan C. Public Health Nursing 1996;13(3):209­16. 91 - 1 Dobs AS, Masters RB, Rajaram L, Stillman FA, Wilder LB, Margolis S, Becker DM. Patient Education and Counseling 1994;24(2):157­64. 489 - 1 Doi SC, DiLorenzo TM. Journal of Substance Abuse 1993;5(1):73­8. 405 - 1
El-Chaar GM, Mardy G, Wehlou K, Rubin LG. Pediatric Infectious Disease Journal 1996;15(1):18­22. 6 - 3 Elder AD, Zultowsky D. Hospital and Community Psychiatry 1991;42(3):302­4. 361 - 1 Elder JP, McGraw SA, Rodrigues A, Lasater TM, Ferreira A, Kendall L, Peteron G, Carleton R. Preventive Medicine 1987;16:221­34. 367 - 1 Elder JP, McGraw SA, Rodrigues A, Lasater TM, Ferreira A, Kendall L, Peteron G, Carleton R. Preventive Medicine 1987;16:221­34. 367 - 2 Elder JP, Wildey M, de Moor C, Sallis JF, Jr, Eckhardt L, Edwards C, Erickson A, Golbeck A, Hovell M, Johnston D, Levitz MD, Molgaard L, Young R, Vito D, Woodruff SI. American Journal of Public Health 1993;83(9):1239­44. 640 - 1 Elk R, Schmitz J, Manfredi L, Rhoades H, Andres R, Grabowski J. Addictive Behaviors 1994;19(6):697­702. 71 - 1 Ellerbeck E, Khallaf N, el Ansary KS, Moursi S, Black R. Journal of Tropical Pediatrics 1995;41(2):103­8. 51 - 1 Esposito L. Journal of Advanced Nursing 1995;21(5):935­43. 693 - 1 Evers S, Bass M, Donner A, McWhinney I. Preventive Medicine 1987;16:213­20. 356 - 1 Fabacher D, Josephson K, Pietruszka F, Linderborn K, Morley JE, Rubenstein LZ. Journal of the American Geriatrics Society 1994;42(6):630­8. 333 - 1 Faivre J, Arveux P, Milan C, Durand G, Lamour J, Bedenne L. European Journal of Cancer Prevention 1991;1(1):49­55. 285 - 1
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Ferris DG, Golden NH, Petry LJ, Litaker MS, Nackenson M, Woodward LD. Journal of Family Practice 1996;42(1):43­8. 85 - 1 Ferson MJ, Fitzsimmons G, Christie D, Woollett H. Public Health 1995;109:25­109. 572 - 1 Finney JW, Miller KM, Adler SP. Journal of Applied Behaviour Analysis 1993;26:471­2. 163 - 1
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Appendix 7 Decision details by study design (grouped by health area)
TABLE 25 Description of the decision, the interventions, and the measures recorded in studies: RCTa
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
23 - 1
Adherence to self-care behaviour in adults undergoing radiotherapy
None Cancer
Control ­ routine care for radiation therapy patients Group 1 ­ routine plus video
Age, sex, level of education, marital status, ethnicity, knowledge, usefulness of information
39 - 1
Uptake of cervical cancer screening in adult well women
None Cancer
Control ­ no additional information Group 1 ­ general practitioner (GP) reminder letter Group 2 ­ letter headed by clinic Group 3 ­ additional information leaflet posted
Age, level of education, social class, marital status, actual risk status, medical history, health behaviours-general knowledge, perception of risk, intention
41 - 1
Uptake of mammography in adult well women
None Cancer
Control ­ letter not signed by GP Group 1 ­ letter signed by GP posted to women `refusers'
Age, social class, health behavioursgeneral
52 - 1
Uptake of mammography in well adult women
None Cancer
Control ­ no additional information Group 1 ­ physician reminder telephone calls Group 2 ­ medical assistant telephone call Group 3 ­ reminder letter
Age, social class, marital status, actual risk status, health insurance
85 - 1
Adherence to breast self-
None Cancer
examination (BSE) in adult,
well women
Group 1 ­ information only Group 2 ­ information BSE and prompt on contraceptive pill packet
Age, level of education, ethnicity, health behaviours-general, self-efficacy
108 - 1
Uptake of faecal occult blood (FOB) screening in well adults
None Cancer
Control ­ usual screening pad: manipulation of stools Group 1 ­ experimental testing stools: pad dangled in toilet after bowel movement
Age, sex, health insurance
122 - 1
Colorectal screening in well adults
None Cancer
Group 1 ­ haemoccult kit: manipulation stools and information on diet Group 2 ­ early detector pad: used like toilet paper. Information about diet Group 3 ­ coloscreen: tissue paper placed in toilet after use. Information on diet
Age, sex
316 - 1
Uptake of colorectal screening in well adults (workplace)
None Cancer
Control ­ letter: availability of FOB testing at work Group 1 ­ risk appraisal form assessing personal risk plus letter invite colorectal screening at work
Age, sex, level of education, marital status, ethnicity, actual risk status, family history, health behaviours-general, knowledge, attitudes, perception of risk, intention
509 - 1
Uptake of mammography in well adult women
None Cancer
Group 1 ­ one-to-one counselling, leaflet plus free mammography voucher Group 2 ­ same information as Group 1, no voucher
Age, level of education, social class, marital status, actual risk status, family history, medical history, health behaviours-general, health insurance, living arrangements, knowledge, reasons, health professional measures, efficacy
101 - 1
Uptake of mammography in well women
Framing Cancer information
Control ­ routine letter invitation Group 1 ­ letter plus section on worrisome facts about breast cancer (anxiety condition) Group 2 ­ letter plus encouraging (coping) things about breast cancer
Age, family history, health behavioursgeneral
continued
81
Appendix 7
TABLE 25 contd Description of the decision, the interventions, and the measures recorded in studies: RCTa
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
117 - 1
Uptake of colorectal screening in elderly well adults
Health Cancer promotion
Control ­ routine slide plus tape presentation Group 1 ­ elderly information giver gave talk before slide show (close identity participants) Group 2 ­ adapted slide show, more accessible, more procedural information about screening Group 3 ­ elderly educator and modified slide show
Age, sex, level of education, social class, marital status, ethnicity
197 - 1
Uptake of colorectal cancer screening in well adults
Social Cancer cognition model
Group 1 ­ verbal plus written information about colorectal cancer and screening Group 2 ­ Group 1 plus free screening kit
Sex, level of education, ethnicity, health behaviours-general, perception of risk
275 - 1
Uptake of mammography in well adult women
Social Cancer cognition model
Control ­ routine letter invitation Group 1 ­ letter plus more explanation risk breast cancer Group 2 ­ risk invitation plus self-evaluation risk questionnaire Group 3 ­ risk invitation, risk questionnaire plus personalised risk letter
Age, family history, medical history, reproductive history, health behavioursgeneral
53 - 1
Adherence to medication
None Medicine Control ­ routine medical care
in adults with hypertension
Group 1 ­ telephone link, regular care plus
weekly calls using computerised voice and
touch tone answers for feedback
Age, sex, level of education, social class, marital status, actual risk status
50 - 1
Adherence to health lifestyle, cessation of unhealthy lifestyle in well adults
None Medicine Group 1 ­ illustrated leaflet about cardiovascular disease (CVD) risk-reducing factors Group 2 ­ group counselling (1­2 hours), goal achievement, weight loss programmes
Age, sex, level of education, social class, actual risk status, physiological/ psychological assessment
64 - 1
Cessation of smoking, alcohol and uptake of exercise in medicine well adults
None Medicine Control ­ routine CVD risk examination plus leaflet Group 1 ­ paid GPs, routine examination plus additional counselling, follow-up visit plus patient reimbursement
Age, sex, social class, marital status, ethnicity, actual risk status, health behaviours-general, health insurance
118 - 1
Cessation of smoking in well adults with asthmatic children
None Medicine Control ­ routine smoking risk information plus quit smoking in home advice Group 1 ­ child's physician gave information on passive smoking plus leaflet plus ways reducing child exposure smoke
Age, level of education, marital status, ethnicity, actual risk status
216 - 2
Adherence to cessation of smoking/fatty food programme in well adults
None Medicine Group 1 ­ invitation letter, leaflet on smoking and weight programmes, cost US$5 flat fee Group 1 ­ letter invitation, leaflet and refundable deposit US$60
Age, sex, level of education, actual risk status, physiological/psychological assessment
229 - 1
Cessation of smoking in well adults
None Medicine Group 1 ­ verbal information on smoking and nicotine gum plus free gum Group 2 ­ verbal information on smoking and gum plus gum cost US$6 Group 3 ­ information on smoking and gum plus gum cost US$20
Age, sex, level of education, social class, actual risk status
350 - 1
Cessation of smoking in well patients
None Medicine Group 1 ­ two appointments to discuss quitting and progress, offered gum plus leaflet Group 2 ­ same Group 1 plus offered additional visit
Age, sex, level of education, marital status, actual risk status, health behaviours-general, usefulness information, intention, social reinforcement/norms, motivation
483 - 1
Adherence to medication in elderly adults
None Medicine Control ­ pharmacists informed study but training deferred Group 1 ­ pharmacists trained in workshops in identifying problems with adherence plus leaflets for patients
Age, sex, level of education, social class, marital status, actual risk status, attitudes, usefulness of information
82
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 25 contd Description of the decision, the interventions, and the measures recorded in studies: RCTa
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
648 - 1
Cessation of smoking in well adults (worksite)
None Medicine Group 1 ­ minimal counselling: leaflet plus
Age, sex, level of education, ethnicity,
told to wear nicotine patch (22 mg or
actual risk status, medical history,
44 mg strength)
physiological/psychological assessment,
Group 2 ­ individual counselling: leaflet plus
motivational message by physician plus quit
letter
Group 3 ­ group counselling: leaflet plus attend
clinic for counselling and skill acquisition
793 - 1 Cessation of in well adults None Medicine Group 1 ­ nicotine patch plus usual leaflet Group 2 ­ nicotine patch plus additional information Group 3 ­ placebo patch plus leaflet Group 4 ­ placebo patch plus additional information
Age, sex, actual risk status, perception of well-being
781 - 1
Adherence to selfmanagement in adult with asthma
None Medicine Control ­ routine clinic care Group 1 ­ verbal information selfmanagement, asthma, therapies, feedback on inhaler use
Age, sex, actual risk status, health behaviours-general, physiological/ psychological assessment
755 - 1
Changes to CVD risk factors in well adults
None Medicine Control 1 ­ another company delayed intervention Control 2 ­ delayed intervention within company Group 1 ­ health information Group 2 ­ health information plus cholesterol score feedback Group 3 ­ health information plus cholesterol risk figure Group 4 ­ health information plus cholesterol level plus risk score
Age, sex, social class, actual risk status, health behaviours-general, physiological/psychological assessment
67 - 1
Intention to have cardiopulmonary resuscitation (CPR) in well adults
None Medicine Control ­ no additional information Group 1 ­ leaflet CPR, framed in terms of senility Group 2 ­ leaflet CPR, framed in terms of Alzheimers disease
Age, sex, level of education, social class, marital status, religion, ethnicity, living arrangements knowledge
196 - 1
Cessation of smoking, adherence to diet, use of services in well, pregnant women
None Medicine, Control ­ routine leaflet
obstetrics Group 1 ­ leaflet plus weekly phone call
and
from interviewer
gynaecology
(midwifery)
Age, marital status, ethnicity, reproductive history anxiety ­ state/ trait, depression, other affect, social support/stress
714 - 1
Utilisation of care in
None
parents of children recently
attended emergency
Medicine, surgery (A&E)
Control ­ assessment only Group 1 ­ health professional follow-up phone call to parents to answer any questions
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, health insurance, perceived satisfaction
200 - 1
Adherence to exercise, cessation of poor diet in adult well premenopausal women
None Medicine, Control ­ no additional information
obstetrics Group 1 ­ group programmes by dietician:
and
meal plans, exercise information, goal
gynaecology setting, newsletter
(midwifery)
Age, level of education, social class, marital status, ethnicity, reproductive history, health behaviours-general, physiological/psychological assessment, health professional measures, worry, attitudes, social support/communication, usefulness of information, coping
724 - 1
Cessation of smoking in pregnant women
None Medicine, Control ­ assessment only
Age, level of education, ethnicity,
obstetrics Group 1 ­ routine information plus explanation reproductive history
and
on leaflet use plus follow-up session plus note
gynaecology prompt plus buddy
(midwifery)
581 - 1
Cessation of smoking in adults undergoing minor surgery
None Medicine, Control ­ blank tape played during surgery surgery Group 1 ­ suggestion to give up smoking tape played during surgery
Age, sex, actual risk status, medical history, motivation, awareness of intervention
continued
83
Appendix 7
TABLE 25 contd Description of the decision, the interventions, and the measures recorded in studies: RCTa
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
542 - 1
Participation in clinical trial Framing Medicine Group 1 ­ treatment A twice as effective
in ambulatory adult patients information
Group 2 ­ treatment A half as effective
Age, level of education, social class, ethnicity, medical history reasons
120 - 1
Cessation of alcohol in school children
Health Medicine promotion
Control ­ control group Group 1 ­ modified `alcohol misuse prevention study' information: more role-play against social pressure, interactive sessions with feedback
Sex, knowledge, attitudes, efficacy
301 - 1
Compliance with medication Communi- Medicine in well and epileptic adults cation
Group 1 ­ information medication using standard `medical practice' form Group 2 ­ modified information written for lay person plus risk and side-effect information
Age, sex, level of education, marital status, actual risk status, anxiety ­ state, knowledge, perception of risk
325 - 1
Uptake of exercise in adults with CVD
Shared Medicine consultation
Group 1 ­ leaflet and verbal information on exercise, checking pulse Group 2 ­ Group 1 plus behavioural strategies: goal setting, reinforcement (phone) and diary
Age, sex, level of education, social class, marital status, actual risk status, health behaviours-general, physiological/ psychological assessment, knowledge, social reinforcement/norms
202 - 1
Uptake of appointment in adult substance users
None STDs (HIV) Control ­ no additional contact Group 1 ­ telephone call emphasising importance of attendance
Age, sex, social class, ethnicity, actual risk status, medical history, perceived satisfaction
393 - 1
Cessation of/adherence to None risky/safe sex in adolescents with STD
STDs (HIV)
Control ­ individual risk assessment HIV, leaflet and counselling on condom use/HIV prevention Group 1 ­ routine information plus physician asking about knowledge and skills to modify behaviour
Age, sex, ethnicity, actual risk status, medical history, health behavioursgeneral
741 - 1 Cessation of risky sex/
None STDs (HIV) Control ­ counselling only on HIV risk
uptake of safe sex in adults
factors plus blood test for STD
with STD
Group 1 ­ HIV counselling plus STD blood
plus HIV test
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, medical history, worry, perception of well-being, knowledge
107 - 1
Use of condoms/safer sex in school children
Social cognition model
STDs (HIV)
Control ­ no additional information Group 1 ­ verbal information: sexual development, STD, contraception, skill acquisition in groups and communication skills
Age, sex, social class, actual risk status, health behaviours-general, knowledge, attitudes, self-efficacy
585 - 1
Adherence to safe sex in well adolescents
Social STDs (HIV) cognition model, health promotion
Group 1 ­ video information: HIV risks and behaviour and discussion groups Group 2 ­ information structured by protectionmotivation theory, skill acquisition
Age, sex, actual risk status, knowledge
799 - 1
Changes HIV risky behaviour in well adult women
Social cognition model
STDs (HIV)
Control ­ delayed information Group 1 ­ social skills acquisition, culturally appropriate information on HIV Group 2 ­ HIV information only
Age, level of education, social class, actual risk status, reproductive history, health behaviours-general, living arrangements knowledge, perception of control, self-efficacy, social reinforcement/norms
299 - 1 Uptake of immunisation in None Primary care Control ­ routine
well adults
Group 1 ­ physician reminder ­ printed on
`bill' after consultation
Group 2 ­ telephone call made by nurse
Group 3 - letter signed by physician
Age, sex, actual risk status, reproductive history
378 - 1
Uptake of immunisation in well adults
None Primary care Control ­ routine care
Age, sex, social class
Group 1 ­ reminder postcard to visit physician
638 - 1
Utilisation of services in
None
adult male patients primary
care
Primary care Control ­ usual care Group 1 ­ re-appointment times made and telephone contact made at three time points by physician
Age, marital status, actual risk status, medical history, health behavioursgeneral, perception of well-being, perceived satisfaction
84
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 25 contd Description of the decision, the interventions, and the measures recorded in studies: RCTa
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
387 - 1
Increased participation in consultation in adult general practice patients
Shared consultation
Primary care Control ­ health eating leaflet, note examples high fat foods Group 1 ­ leaflet encouraging patients to be more active in consultation, note concerns for doctor, ask questions diagnosis and treatment (piloted)
Age, sex, social class, health professional measures perception of control, perceived satisfaction, self-efficacy, usefulness of information
333 - 1
Adherence to immunogens in elderly well adults
Health Primary care Control ­ assessment only
promotion
Group 1 ­ verbal information about medication,
appointments, illness
Age, sex, level of education, social class, marital status, actual risk status, medical history, health behaviours-general, physiological/psychological assessment, depression
425 - 1
Uptake of prenatal services None in pregnant well women
Obstetrics and gynaecology (midwifery)
Control ­ usual 13 visits with health professional Group 1 ­ reduced to seven visits with health professional
Age, level of education, social class, marital status, ethnicity, reproductive history, health behaviours-general, physiological/ psychological assessment, health professional measures, worry, attitudes, social support communication, usefulness of information, coping
778 - 1
Uptake of prenatal screening None in well pregnant women
Obstetrics and gynaecology (midwifery), genetics
Control ­ routine care Group 1 ­ additional individual session plus leaflet and verbal information serum screening, ultrasound, carrier testing for cystic fibrosis (CF) Group 2 ­ women attended group sessions plus leaflets
Age, social class, ethnicity, reproductive history, anxiety ­ state, depression, worry
678 - 1 Uptake of antenatal care in None Obstetrics Control ­ usual antenatal care: attend clinics
Age, social class, marital status,
well pregnant women
and
by different professionals
reproductive history, physiological/
gynaecology Group 1 ­ team-care: known team of midwives psychological assessment, autonomy in
(midwifery) provided continuity care throughout pregnancy decision making, perception of informed
consent, perceived satisfaction,
usefulness of information
606 - 1
Uptake of appointments in None adults who attempted suicide
Mental health
Control ­ usual care: patients contact clinic Group 1 ­ nurse visit to patients not attending follow-up appointment
Age, sex, level of education, social class, marital status, actual risk status, medical history, anxiety ­ state, depression
427 - 1
Adherence to medication in psychotic adults
Health Mental promotion health
Control ­ supportive (listening) counselling Group 1 ­ counselling guided by `compliance' therapy: beliefs, coping, attitudes to drug use
Age, sex, ethnicity, actual risk status, medical history, attitudes, disability scale
85
Appendix 7
TABLE 26 Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
352 - 1 Uptake of mammography
None Cancer
Control ­ routine reminder postcard
Age
in well women
Group 1 ­ routine reminder postcard plus
voucher on attendance (US$2)
352 - 2 Uptake of mammography
None Cancer
Control ­ routine reminder postcard
Age
in well women
Group 1 ­ telephone reminder
352 - 3 Uptake of mammography
None Cancer
Control ­ clinic-based reminder letter
Age
in well adults
Group 1 ­ signed letter physician reminder
353 - 1
Uptake of mammography in well women
None Cancer
Control ­ no additional contact Group 1 ­ volunteers `taught' about purpose mammography and to contact five acquaintances to encourage their attendance
Age, level of education, social class, marital status, ethnicity, health behaviours-general
420 - 1
Uptake of colorectal screening in well adults
None Cancer
Control: letter invitation, FOB test plus leaflet plus reminder letter: half receive gain frame, half loss frame information Group 1 ­ routine care plus reminder phone call: gain/loss framed information Group 2 ­ routine plus information leaflet (readability score) about efficacy screening plus phone reminder: gain/loss framing Group 3 ­ routine plus additional leaflet plus reminder phone with additional information on use: gain/loss frame information
Age, sex, reasons
482 - 1
Uptake of colorectal screening in well adults
None Cancer
Control ­ routine care: letter invitation plus
Age, sex
testing kit
Group 1 ­ routine care plus reminder phone call
Group 2 ­ routine care plus leaflet plus reminder call
Group 3 ­ routine care plus leaflet plus `how to use
test' call plus reminder call
653 - 1
Uptake of mammography in well adult women
None Cancer
Control ­ routine letter invitation Group 1 ­ letter invitation plus information on taking part study for `additional scientific investigation'
Age, marital status, ethnicity, living arrangements
675 - 1
Uptake of colorectal screening in well adults
None Cancer
Group 1 ­ perform test over 3 days without diet restriction Group 2 ­ perform test over 6 days without diet restriction Group 3 ­ perform test over 3 days with diet restriction Group 4 ­ perform test over 6 days with diet restriction
Age, sex
683 - 1
Uptake of colorectal cancer None screening in well adults
Cancer
Group 1 ­ signed GP letter plus diet restrictions plus FOB test Group 2 ­ signed GP letter plus faecal kit Group 3 ­ signed letter, leaflet plus FOB testing kit Group 4 ­ signed letter plus instructions to phone for free kit Group 5 ­ letter signed by `professor' and FOB testing kit
Age, sex, marital status
491 - 1
Uptake of BSE in well women (work)
None Cancer
Control ­ group session on BSE, video plus leaflet plus practice movement Group 1 ­ control plus feedback on BSE on model Group 2 ­ control plus Group 2 plus individual session plus intensive feedback
Age, level of education, marital status, ethnicity, health behaviours-general, physiological/psychological assessment
533 - 1
Uptake of BSE in well women
None Cancer
Control ­ verbal, video and leaflet information on BSE and `over-clothing' technique Group 1 ­ control plus individual supervision on model with lumps Group 2 ­ Group 1 plus individual counselling
86
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
566 - 1
Returning colorectal screening cards in well adults
None Cancer
Control ­ hemoccult cards by post, no stamped addressed envelope Group 1 ­ hemoccult cards sent with stamped addressed envelopes
Age, sex, marital status, ethnicity, health insurance
705 - 1
Adherence to safe-sun behaviours in well adolescents
None Cancer
Control ­ questionnaire only Group 1 ­ read through leaflet Group 2 ­ read leaflet plus video Group 3 ­ read leaflet plus designed poster Group 4 ­ leaflet plus discussion one week later
Age, sex, actual risk status, knowledge, attitudes
728 - 1
Uptake of cervical smear in well women
None Cancer
Control ­ usual care Group 1 ­ leaflet plus fact sheet by post (available in several Asian languages) Group 2 ­ personal visit plus fact sheet plus video Group 3 ­ personal visit plus fact sheet plus leaflet
Age, social class, marital status, religion, ethnicity, actual risk status, usefulness of information
630 - 1
Uptake of breast screening None well women non-attendees
Cancer
Group 1 ­ home visits by nurse, ascertained reasons non-attendance and information on screening Group 2 ­ home visit nurse, ascertained reasons non-attendance Group 3 ­ signed reminder letter GP
Age, perception of control, self-esteem
285 - 1
Uptake of colorectal cancer None screening in well adults
Cancer
Group 1 ­ letter to all households plus leaflet information colorectal cancer screening, media campaign plus refund for buying test Group 2 ­ Group 1 plus given free test at surgery Group 3 ­ Group 1 plus test sent by post to non-attendees
Age, sex
727 - 1
Uptake of mammography in well women
None Cancer
Group 1 ­ free screening plus media information Age plus open invitation letter to non attendees Group 2 ­ Group 1 plus fixed appointment letter
543 - 1
Uptake of cervical smear in well women
None Cancer
Control ­ routine breast screening appointment Group 1 ­ timed cervical screening appointment as well as breast screening
Age, ethnicity, health behavioursgeneral
587 - 1
Uptake of in prostate screening in well male adults
None Cancer
Group 1 ­ verbal information availability screening Age, level of education, social class, Group 2 ­ description of procedure screening ethnicity, family history, health insurance
713 - 1
Uptake of cervical smears None in well women with screenpositive smears
Cancer
Control ­ routine care Group 1 ­ information leaflet
Age, level of education, marital status, worry, knowledge
48 - 1
Uptake of cervical screening None in well women
Cancer
Control ­ comparison women in hospital ward Group 1 ­ offered smear in hospital Group 2 ­ offered leaflet when discharged
Age, level of education, marital status, ethnicity, reproductive history, health professional measures
488 - 1
Uptake of hypothetical medication trial in adults with cancer
None Cancer
Group 1 ­ audio-tape plus verbal information cancer, trial and treatment provided Group 2 ­ computer screen touch control, programme same information as Group 1
Age, sex, level of education, knowledge, perceived satisfaction, usefulness of information
86 - 1
Uptake of breast and cervical screening in well adult women
Health Cancer promotion
Control ­ information about community living Group 1 ­ information about the importance of screening, BSE, nutrition and attending health centres
Age, level of education, social class, marital status, ethnicity, attitudes, health behaviours-general, service utilisation of, health insurance, knowledge, reasons, self-efficacy
114 - 1
Uptake of mammography in adult well women
Social Cancer cognition model
Control ­ no additional information Group 1 ­ belief intervention:`stages of change/ HBM' assessment, tailored belief intervention plus leaflet plus professional contact Group 2 ­ information only: facts, timing and procedure mammography Group 3 ­ Group 1 plus 2: facts on procedure plus targeted beliefs
Age, level of education, ethnicity, health behaviours-general, knowledge, attitudes, perception of risk, reasons, operationalised model, motivation
continued
87
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
232 - 1
Uptake of mammography in well women
Social Cancer cognition model
Control ­ leaflet by post: breast cancer plus thank you for questionnaire completion Group 1 ­ extra leaflet: importance screening, procedure and attendance encouragement plus thank you note
Age, education, social class, marital status, ethnicity, health behaviours, insurance, knowledge, attitudes, perception of risk, reasons, intent, efficacy
438 - 1
Uptake of mammography in well adult women (workplace)
Framing Cancer information
Group 1 ­ video: positive frame mammography screening (saves lives) Group 2 ­ video: negative frame mammography screening (not attend is life threatening)
Age, level of education, social class, marital status, religion, ethnicity, family history, health behaviours-general, knowledge, attitudes, perception of risk, self-efficacy, intention , efficacy, other affect
784 - 1
Uptake of mammography in well women
Social Cancer cognition model
Control ­ women not interviewed until after screening Group 1 ­ women interviewed before screening Group 2 ­ postal questionnaire sent before screening
Age, level of education, social class, marital status, religion, ethnicity, family history, medical history, health behavioursgeneral, physiological/psychological assessment, living arrangements, reproductive history, perception of well-being, attitudes, perception of risk, perception of susceptibility, intention, efficacy
700 - 1
Participation in consultation in adults with cancer
Shared Cancer consultation
Group 1 ­ informed cancer services are available Group 2 ­ information encouraged writing questions down before consultation
Age, sex, actual risk status, medical history, living arrangements, anxiety ­ state, knowledge, preference consultation style, perceived satisfaction, disability scale, coping
789 - 1
Uptake of mammography in well women
Attribution theory
Cancer
Group 1 ­ neutral information video about breast screening Group 2 ­ video plus internal responsibility frame to get mammography Group 3 ­ video plus external (physician) responsibility frame to order mammography
Age, level of education, social class, marital status, religion, ethnicity, actual risk status, family history, medical history, perception of well-being, relief/ reassurance, regret/responsibility, knowledge, attitudes, usefulness of information
207 - 1
Cessation of smoking/ adherence to diet in well children
Social Cancer, learning medicine theory
Control ­ questionnaire only
Age, sex, knowledge, attitudes
Group 1 ­ verbal information: tobacco prevention
plus culturally appropriate peer volunteer in school
Group 2 ­ information to improve diet
Group 3 ­ information aimed at diet and smoking
288 - 1
Uptake of radon testing in well adults
Social Cancer, cognition other model
Group 1 ­ telephoned adults plus leaflet plus advised to test home Group 2 ­ telephoned adults plus leaflet plus encourage house testing plus told high risk area and house likely to have radon
Age, sex, level of education, reproductive history, health behavioursgeneral, perception of risk, perception of susceptibility, reasons
690 - 1 Uptake of BSE
Social Cancer cognition model
Control ­ data collection only Group 1 ­ belief targeted verbal plus leaflets (HBM): breast cancer and BSE Group 2 ­ routine information plus skills on BSE Group 3 ­ Groups 1 plus 2
Age, level of education, ethnicity, attitudes, perception of risk, perception of susceptibility, reasons, operationalised model, motivation
458 - 1
Cessation of skin cancer risks in well adolescents
Social Cancer cognition model
Control ­ assessment only Group 1 ­ videotape risks skin cancer, selfassessment form, feedback and ways change behaviour
Age, sex, level of education, actual risk status, health behaviours-general, knowledge, attitudes, perception of susceptibility, intention, social reinforcement/norms
307 - 1
Uptake of BSE in older well women
Social Cancer cognition model
Control ­ basic one-to-one BSE instruction Group 1 ­ peer BSE `buddy' selected Group 2 ­ women brought partner of choice for BSE buddy
Age, level of education, marital status, attitudes, self-efficacy
140 - 1
Cessation of smoking in adults with cancer
Social Cancer, cognition medicine model
Control ­ routine care Group 1 ­ leaflet plus quit smoking sessions plus trained health professional
Age, sex, level of education, marital status, actual risk status, medical history, physiological/psychological assessment, knowledge, attitudes, operationalised model
continued 88
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
757 - 1
Uptake of mammography in well women
Framing Cancer information
Control ­ no assessment Control 2 ­ assessment only Group 1 ­ leaflet mammography negatively framed plus invitation letter Group 2 ­ leaflet positively framed plus letter
Age, level of education, ethnicity, actual risk status, medical history
434 - 1
Uptake of trial cancer treatment in adults with cancer
Framing Cancer information
Group 1 ­ scenario: surgical removal intestine followed by chemotherapy, neutrally framed Group 2 ­ scenario: surgery followed by chemotherapy positively framed Group 3 ­ scenario: surgery followed by chemotherapy negatively framed
Age, sex, level of education, actual risk status, medical history, attitudes, autonomy in decision making
816 - 1
Participation in clinical trials in adults with cancer
Shared Cancer consultation
Control ­ routine informed consent procedures Group 1 ­ control plus follow-up phone calls by research nurses (information giving)
Age, sex, level of education, marital status, actual risk status, medical history, anxiety ­ state, perceived satisfaction, memory, awareness intervention
667 - 1
Participation in decision making in women with breast cancer
Shared Cancer consultation
Group 1 ­ leaflet breast cancer treatments and Age, level of education, ethnicity, actual
others experience
risk status, knowledge, autonomy in
Group 2 ­ computer interaction, pictures and text decision making
671 - 1
Cancellation surgery in adults with CVD
None Medicine Group 1 ­ information: procedure, side-effects and complications Group 2 ­ more information risks and complications
Age, sex, level of education, actual risk status, medical history, anxiety ­ state, disability scale, usefulness of information
1-1
Uptake of exercise in well None Medicine Control ­ usual care: GP suggests changes weight, Age, sex
adults with risk factors
exercise, and smoking
for CVD
Group 1 ­ control plus attendance at local group
session led by a health professional
10 - 1
Use of health care by medicine male patients
None Medicine Control ­ internist recommends specialist to patients when attend primary care Group 1 ­ evaluation patient's needs, develop personalised care plan, nurse coordinated care from clinic.
Age, level of education, social class, marital status, ethnicity, actual risk status, depression, perception of well-being, disability scale, social support/communication
28 - 1
Use of health services in adult patients with Parkinson's disease
None Medicine, Control ­ usual care
Age, sex, level of education, social class,
mental
Group 1 ­ propath programme: provide in-depth marital status, ethnicity, actual risk
health
advice on coping with Parkinson's disease, use status, perception of well-being, other
leaflet and video.
affect, perceived satisfaction, disability
scale
63 - 1
Uptake of exercise in adult back pain patients
None Medicine Control ­ routine care
Age, sex, level of education, social class,
Group 1 ­ control plus leaflet information on
marital status, ethnicity, actual risk
back pain and coping techniques
status, health behaviours-general,
Group 2 ­ Group 1 information delivered by nurse depression, perception of well-being,
plus telephone call for additional information
knowledge, perceived satisfaction
47 - 1
Uptake of immunisations and CVD risk factor reduction in well adults
None Medicine, Group 1 ­ health screening by local hospital primary Group 2 ­ health screening by physician care
Age, sex, level of education, social class, marital status, medical history, health insurance, living arrangements
55 - 1
Cessation of smoking in adult well children
None Medicine Control ­ routine information giving video Group 1 ­ culturally sensitive video
Age, sex, level of education, social class, knowledge, usefulness of information
55 - 2
Cessation of smoking in adult well children
None Medicine Control ­ discussion group about smoking
Age, sex, level of education, social
Group 1 ­ showing previously developed videos class, ethnicity, self-efficacy, usefulness
of information
57 - 1
Adherence to medication
None Medicine Group 1 ­ medication once per day
in adults with hypertension
Group 2 ­ medication twice a day
Age, sex, physiological/psychological assessment
88 - 1
Adherence to medication
None Medicine Control ­ medication only
in adult medicine physically
Group 1 ­ medication plus information about
ill sample
side-effects, name, adherence to regimen
Age, medical history, knowledge
continued
89
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
102 - 1
Cessation of smoking in well adults
None Medicine Control ­ smoking status assessed
Age, sex, level of education, social class,
Group 1 ­ US$10 incentive plus win `ex-smoker actual risk status, intention
of the month' money
105 - 1
Adherence to medication in medicine adults
None Medicine Control ­ usual medication regimen Group 1 ­ same packaging but twice daily pill taking Group 2 ­ modified information and twice daily dosing
Age, sex, ethnicity, actual risk status, perception of well-being, perception of risk, disability scale
110 - 1
Cessation of smoking/ adherence to healthy lifestyle in medicine well population
None Medicine Control ­ informed that a programme running Age, sex, level of education, actual risk
and health claims monitored
status, health behaviours-general,
Group 1 ­ underwent risk appraisal, personalised physiological/psychological assessment,
risk feedback, letters, leaflets
stress
Group 2 ­ underwent risk appraisal only
147 - 1
Cessation of fatty diet in well adults
None Medicine Control ­ recorded and weighed food Group 1 ­ group counselling by nutritionist, feedback on fat intake, asked to make changes
Age, sex, actual risk status, attitudes, reasons
155 - 1
Consent to participate in well adults
None Medicine Group 1 ­ patient consent to observation only Age, sex, level of education, other Group 2 ­ consent to observation plus videotape affect, perceived satisfaction
183 - 1
Cessation of alcohol use in well adult women
None Medicine Control ­ newsletters of `dummy' interests
Age, level of education, social class,
Group 1 ­ newsletter included articles on alcohol marital status, ethnicity, actual risk
use and abuse
status, knowledge, attitudes, reasons
216 - 1 Adherence to cessation of None Medicine Group 1 ­ letter invitation, leaflet smoking and Age, sex, level of education, actual risk
smoking and poor diet in
weight loss programme, incentive (US$) option status, physiological/psychological
well adults
and/or flat fee payment to programme
assessment
Group 2 ­ invitation letter, programme leaflets
sent if returned further information card
217 - 1
Cessation of smoking in well adolescents
None Medicine Control ­ no intervention
Sex, level of education, ethnicity, actual
Group 1 ­ group sessions: smoking, skills to resist risk status, knowledge, self-efficacy,
smoking, feedback
intention, coping
Group 2 ­ media intervention
Group 3 ­ health information plus Group 1
Group 4 ­ Group 1 plus Group 2 plus Group 3
249 - 1
Cessation of smoking in well adults
None Medicine Control ­ routine physician advice Group 1 ­ routine plus two-part counselling with trained `smoking' counsellor
Age, sex, level of education, social class, actual risk status, medical history, health behaviours-general, perception of well-being, self-efficacy, intention, motivation, stress
259 - 1
Cessation of alcohol use in well adult women
None Medicine Control ­ no additional contact
Age, sex, level of education, social class,
Group 1 ­ leaflet information about alcohol level actual risk status, health behaviours-
screen positive, cessation of, follow-up letter
general, physiological/psychological
Group 2 ­ reasons screen positive, asked about assessment
drinking habits, monthly consultations
279 - 1
Cessation of smoking/ adherence to healthy lifestyle in well children
None Medicine Control ­ screening only
Actual risk status, physiological/
Group 1 ­ verbal and leaflet information on diet, psychological assessment
exercise regimens and smoking ; obese children
additional counselling
356 - 1
Cessation of salt in diet ­ adults with hypertension
None Medicine Control ­ no intervention
Age, level of education, marital status
Group 1 ­ nurses trained information on: addition
salt, diet and hypertension, take blood pressure
574 - 1
Cessation of smoking in well adults
None Medicine Group 1 ­ immediate cessation of counselling
Age, sex, actual risk status, depression,
Group 2 ­ tailored cessation of plus placebo gum perception of well-being, other affect
Group 3 ­ tapered quitting plus active gum
652 - 1 Attendance of follow-up
None Medicine Control ­ routine testing plus leaflet
Age, sex, level of education, social class,
cholesterol screening
Group 1 ­ letter plus notification receive US$17 marital status, actual risk status, medical
appointment in well adults
food coupon on attendance
history, health behaviours-general
(mobile unit in car-park)
Group 2 ­ reminder letter to attend
90
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
679 - 1
Uptake of exercise in well children
None Medicine Control ­ routine health instruction and assessment Group 1 ­ trained teacher, leaflets on: diet, smoking and exercise plus extra exercise classes
Age, sex, social class, ethnicity, health behaviours-general, physiological/ psychological assessment, living arrangements, knowledge
489 - 1
Uptake of cessation of lifestyle change in adults with hyperlipidaemia
None Medicine Control ­ content unclear
Age, sex, level of education, marital
Group 1 ­ patient-designed intervention to reduce status, actual risk status, family history,
CVD risk factors delivered by health professionals medical history, health behaviours-
Group 2 ­ professional-designed programme
general, perception of risk, reasons, self-
carried out by same health professionals, no
efficacy, operationalised model
further information given
772 - 1
Cessation of drinking in adult problem drinkers
None Medicine Control ­ waiting list control
Age, sex, level of education, marital
Group 1 ­ directive style consultation: drinking status, actual risk status, family history,
defined as a problem, advice total giving up
attitudes
Group 2 ­ patient-centred: reflective listening,
not labelled alcoholics, not confront problem
807 - 1
Adherence to selfmanagement in adults with medicine
None Medicine Control ­ training programme only Group 1 ­ training programme plus support groups
447 - 1
Adherence to medication
None
in adults with hypertension
Medicine
Control ­ health education package Group 1 ­ letter before appointment, follow-up on non-attendance plus card with clinic details
Age, sex, social class, marital status, medical history, health behavioursgeneral, physiological/psychological assessment
783 - 1
Cessation of smoking in well adults
None Medicine Control ­ enhanced usual care: leaflet and access Age, sex, level of education, marital
self-help materials
status, ethnicity, actual risk status,
Group 1 ­ leaflet plus self-quitting guidelines:
medical history, health behaviours-
coping techniques plus manual plus no smoking general, attitudes, reasons, self-efficacy,
prompts plus feedback cards to return
intention
Group 2 ­ Group 1 plus letter encouraging
adoption smoker buddy
Group 3 ­ Group 2 plus additional telephone
contact with counsellor
336 - 1
Cessation of/adherence to None lifestyle CVD factors in well adolescents
Medicine
Control ­ assessment only Group 1 ­ assessment plus screening Group 2 ­ know your body information: lifestyle behaviours and changes in diet, exercise, smoking Group 3 ­ assessment plus screening plus Group 2
Age, sex, ethnicity, physiological/ psychological assessment, knowledge, attitudes, social reinforcement/norms
530 - 1
Compliance with medication in adults with asthma
None Medicine Control ­ assessment only Group 1 ­ four asthma management sessions: lectures, leaflet and feedback skills
Age, sex, level of education, marital status, ethnicity, physiological/ psychological assessment knowledge
564 - 1
Cessation of drinking in adults with drinking habit (workplace)
None Medicine Group 1 ­ hospitalisation plus attendance
Age, sex, social class, ethnicity, actual
AA on release
risk status, health behaviours-general,
Group 2 ­ attended AA only
law infringements
Group 3 ­ offered choice of AA, hospitalisation,
alternative counselling or no treatment
702 - 1
Adherence to medication in medicine patients
None Medicine Control ­ routine care Group 1 ­ teaching session plus pill review Group 2 ­ Group 1 plus follow-up phone call
Age, actual risk status
213 - 1
Cessation of smoking in elderly adults
None Medicine Control ­ delayed intervention group Group 1 ­ physician trained on quitting plus leaflet for older adults (readability) plus letter
Age, sex, actual risk status
327 - 1
Adherence to self-care in adults with asthma
None Medicine Control ­ routine verbal plus leaflet information: Sex, level of education, social class,
house mites and asthma
marital status, actual risk status
Group 1 ­ control plus computer programme
feedback given on responses (piloted)
continued
91
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
328 - 1
Adherence to self-care in adults with medicine
None Medicine Control ­ delayed intervention
Age, sex, actual risk status, medical
Group 1 ­ verbal information by health pro-
history, physiological/psychological
fessional: diet, exercise, self-monitoring, adherence assessment, self-efficacy
to medication plus skills plus group meetings
612 - 1
Adherence to minor surgical therapy in adults with sleep apnoea
None Medicine Group 1 ­ oral `snore-guard' used when sleeping Age, sex, actual risk status,
Group 2 ­ use nasal continuous positive airway physiological/psychological assessment
pressure treatment
perception of well-being, attitudes,
perceived satisfaction
629 - 1
Uptake of advance directives in elderly adults with acute illness
None Medicine Control ­ routine care Group 1 ­ counsellor information on health proxy, noted in charts
Age, sex, ethnicity, actual risk status, health insurance, physiological/psycho logical assessment, perception of well-being
268 - 1
Cessation of CVD risk
None
factors in men at increased
risk CVD and families
Medicine
Control ­ screened but not informed at risk Group 1 ­ physician letter about family risk by lifestyle plus physician/ dietician counselling plus newsletter prompt
Actual risk status, health behavioursgeneral, physiological/psychological assessment
395 - 1
Uptake of screening/ immunisation in well adults
None Medicine, Control ­ routine care
Age, sex, ethnicity, health behaviours-
cancer,
Group 1 ­ computer/note prompt for physician general, health insurance
primary Group 2 ­ computer/note prompt plus patient
care
reminder letter
Group 3 ­ patient reminder letter
396 - 1
Self-management/diet in adults with medicine
None Medicine Control ­ delayed information Group 1 ­ use of computer and diet package to check diet
Age, sex, social class, actual risk status, medical history, physiological/ psychological assessment knowledge, perceived satisfaction
398 - 1
Diet/exercise adherence to None in adults with medicine
Medicine
Group 1 ­ behaviour therapy plus low calorie diet (1200 kcal per day) Group 2 ­ behaviour therapy plus very low calorie diet (500 kcal on alternate days)
Age, sex, level of education, actual risk status, medical history, physiological/ psychological assessment depression
402 - 1 Adherence to treatment in None Medicine Group 1 ­ all patients offered same behavioural
adult alcoholics
programme
Group 2 ­ patients randomised to either
psychiatric or behavioural therapy
439 - 1
Uptake of CVD screening/ None utilisation of service in well elderly adults
Medicine
Control ­ routine Group 1 ­ staff training, counselling about CVD risks and prevention, Medicaid voucher, free screening
Age, sex, level of education, social class, marital status, actual risk status, health insurance, health behaviours-general, living arrangements anxiety ­ state, depression, perception of well-being
527 - 1
Adherence to medication in adults with chronic obstructive pulmonary disease
None Medicine, Control ­ yearly assessment plus inhaler
Age, sex, level of education, ethnicity,
cancer
Group 1 ­ intensive smoking cessation of, health actual risk status, medical history
professional contact and feedback every 4 months
plus inhaler with medication or placebo
168 - 1
Adherence to medication in adults with hypercholesterolaemia
None Medicine Control ­ routine drug allocation
Age, ethnicity, actual risk status, medical
Group 1 ­ drug allocation plus five phone calls history, physiological/psychological
assessment
265 - 1
Cessation of CVD risks in None children with family history CVD
Medicine
Control ­ re-assessed at one year only
Age, sex, actual risk status, knowledge,
(and matched)
health behaviours-general, physiological/
Group 1 ­ home visits, letter and phone calls:
psychological assessment
information shopping, cooking, signing diet contracts
Group 2 ­ Group 1 but delayed start intervention
365 - 1
Dietary change in well men None
Medicine
Control ­ assessment only Group 1 ­ information from nutritionist ­ dietary changes
Age, level of education, social class, actual risk status, family history, medical history, health behaviours-general
372 - 1
Utilisation of services/ lifestyle change in adults screened positive for cholesterol
None Medicine Control ­ usual care
Age, sex, level of education, social class,
Group 1 ­ patient level: personalised risk letter, marital status, ethnicity, actual risk
reminder for doctor, fridge magnet
status, family history, physiological/
Group 2 ­ doctor received patient pack: letter psychological assessment, health
for patient, result screening test
insurance
Group 3 ­ Group 1 plus Group 2
92
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
263 - 1
Changes in diet in well women at risk for breast cancer
None Medicine, Control ­ assessment only
cancer
Group 1 ­ group sessions ­ weekly sessions
with nutritionist
Age, level of education, social class, actual risk status, family history, physiological/psychological assessment
693 - 1
Adherence to medication in elderly patients
None Medicine Group 1 ­ leaflet
Age, sex, level of education,
Group 2 ­ leaflet plus researcher explaining
physiological/psychological assessment,
information
knowledge
Group 3 ­ Group 2 plus medication prompt plus
additional home visits
Group 4 ­ Group 3 plus additional information
about medication
137 - 1
Adherence to medication in breast-feeding women requiring antibiotics
None Medicine, Group 1 ­ information about safety antibiotics
obstetrics while breast feeding
and
Group 2 ­ Group 1 plus information about
gynaecology diarrhoea in babies as side-effect
(midwifery)
Age, sex
139 - 1
Adherence to selfmanagement in elderly adults with medicine
None Medicine Control ­ routine care
Age, sex, ethnicity, actual risk status,
Group 1 ­ monthly phone calls reminding clinic physiological/psychological assessment
appointments, encouragement healthy lifestyle and perceived satisfaction
drug adherence
143 - 1
Cessation of smoking in well adults
None Medicine Group 1 ­ television-based information and leaflet Age, sex, level of education, social class,
Group 2 ­ Group 1 plus monthly newsletters plus ethnicity, actual risk status, self-efficacy,
support line numbers
awareness intervention
668 - 1 Cessation of smoking
Social Medicine cognition model
Group 1 ­ routine smoking leaflet by post Group 2 ­ `appropriate' leaflet to stages of change of smoker Group 3 ­ `appropriate' leaflet plus report of progress Group 4 ­ `appropriate' leaflet plus feedback progress plus phone call
Age, sex, social class, marital status, ethnicity, actual risk status, reasons
332 - 1
Uptake of living will in well elderly adults
Framing Medicine information (prospect theory)
Group 1 ­ positively framed information: PVS, Age, sex, level of education, religion,
stroke, dementia and living wills (vignettes
living arrangements
readability)
Group 2 ­ Group 1 information, negatively framed
Group 3 ­ Group 1 information, in style of medical
guidelines
20 - 1
Use of services in adults with sickle cell
Health Medicine, promotion sickle cell
Control ­ disease education information Group 2 ­ disease information plus training in cognitive coping skills for pain
Age, sex, level of education, social class, marital status, actual risk status, disability scale, coping
27 - 1
Adherence to self-care behaviour in adult patients with arthritis
Shared Medicine, consult- primary ation care
Control ­ patients only contacted for assessment Group 1 ­ symptom monitoring (placebo): asked about symptoms, no mention arthritis Group 3 ­ counselling group: skills talking with doctor plus clarifying information about disease and medication plus reality therapy focusing on behaviour change
Age, sex, level of education, ethnicity, actual risk status, other affect, disability scale, social support/communication
104 - 1
Self-maintenance in adults with medicine
Health Medicine promotion
Control ­ routine clinic care Group 1 ­ compliance: focus on medication behaviours Group 2 ­ behavioural: focus on behavioural strategies to change behaviour Group 3 ­ Group 2 plus instruction: focus on behaviour strategies plus write contract
Age, sex, social class, marital status, actual risk status, physiological/ psychological assessment
220 - 1
Adherence to exercise and healthy diet in well children
Social Medicine cognition model
Control ­ school-based health education only Age, sex, ethnicity, actual risk status,
Group 1 ­ Child and Adolescent Trial for
knowledge, attitudes, self-efficacy, social
Cardiovascular Health (CATCH) programme:
support/communication, intention,
specific CVD risk factor information plus feedback social reinforcement/norms
over 3 years plus no smoking policy plus alter food
available in school
continued
93
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
233 - 1
Adherence to exercise and healthy diet in well adults
Health Medicine promotion
Control ­ assessment only: no feedback or information Group 1 ­ assessment plus face-to-face information plus feedback on adherence to exercise and diet plus phone call
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, medical history, physiological/ psychological assessment
241 - 1
Adherence to exercise in well adults
Social Medicine learning theory
Control ­ leaflet plus video plus lectures: exercise, Age, sex, actual risk status, health
diet, smoking, use gym
behaviours-general, physiological/
Group 1 ­ tailored self-efficacy theory information: psychological assessment, self-efficacy
log exercise achieved plus feedback from instructor
plus social modelling plus further explanation
exercises plus buddy groups
276 - 1
Cessation of smoking in well adolescents
Health Medicine promotion
Control ­ no additional information Group 1 ­ information given by older students plus skills to resist smoking plus no smoking contract
Sex, actual risk status, knowledge, attitudes, social reinforcement/norms
295 - 1
Adherence to diet in adults with hypertension
Health Medicine promotion
Control ­ no additional information Group 1 ­ task-centred instruction (Glaser): less emphasis on knowledge disease more on ways of coping/functioning Group 2 ­ task centred plus goal setting plus self-monitoring (use contract)
Age, sex, level of education, actual risk status, physiological/psychological assessment, knowledge
305 - 1
Adherence to screening/ healthy lifestyle in adults with hypertension (workplace)
Lay model Medicine illness
Control ­ routine information hypertension:
Age, sex, ethnicity, actual risk status,
definition, link with disease, importance health health behaviours-general, physiological/
checks, reduction lifestyle behaviours
psychological assessment, knowledge,
Group 1 ­ action plan message: control plus leaflet attitudes, self-efficacy, coping
plus illustrations on reducing risk factors
Group 2 ­ wellness thinking: routine plus information
on experience of hypertension (no symptoms) plus
emphasis on health, feeling good, visual information
on enjoying exercise
321 - 1
Adherence to exercise in well women
Social Medicine learning theory
Group 1 ­ exercise instruction plus verbal reinforcement Group 2 ­ exercise instruction plus verbal reinforcement plus positive cognitive statements
Age, physiological/psychological assessment, anxiety ­ state/trait, depression, perception of control, motivation, personality type
157 - 1
Cessation of smoking in
Health
well women with children promotion
(effects passive smoking)
Medicine
Control ­ data collection only
Age, level of education, ethnicity,
Group 1 ­ social learning theory verbal plus leaflet actual risk status, medical history,
(piloted): skills to maintain smoke-free environment reproductive history, health
plus memory prompt plus feedback plus nurse behaviours-general
home visits
376 - 1
Attendance at smoking cessation programme in well adults
Social Medicine cognition model
Control ­ physician advise to quit plus health counsellor session Group 1 ­ control plus quitting leaflets Group 2 ­ control plus video cessation of group from former quitter plus told sessions free plus additional leaflets Group 3 ­ control plus video plus choice of self-quitting leaflets or group counselling
Age, sex, ethnicity, actual risk status, perception of well-being, self-efficacy, operationalised model, motivation
469 - 1
Medication compliance in adults with hypertension
Health Medicine promotion
Control 1 ­ new patients: no additional information Group 1 ­ new patients: medication plus leaflet: importance adhering and lifestyle change plus monthly newsletter Control 2 ­ existing patients: no additional information Group 2 ­ existing patients plus Group 1 information
Age, sex, actual risk status
502 - 1
Self-management in children with medicine
Framing Medicine information
Control ­ small group instructions: lecture plus video plus feedback Group 1 ­ video plus lecture framed using anchored instructions and context patient's life
Age, sex, actual risk status, knowledge, reasons
94
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
503 - 1
Uptake of/adherence to lifestyle in adults with medicine
Social Medicine cognition model
Control ­ no details Group 1 ­ nurse counselling: modifying eating/ exercise plus monitor calorie intake plus social support plus identify barriers
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, health behaviours-general, physiological/psychological assessment, perception of well-being, knowledge, social support/communication
707 - 1
Cessation of/adherence to lifestyle behaviours in adults following infarction
Social Medicine learning theory
Control ­ usual care verbal information: smoking, nutrition and exercise Group 1 ­ self-efficacy based information: feedback, skill acquisition, additional contact. HCP.
Age, sex, level of education, social class, ethnicity, actual risk status, physiological/psychological assessment
158 - 1
Cessation of smoking in well adults
Social cognition model, attrib. theory
Medicine
Control ­ generic health letter
Age, sex, actual risk status
Group 1 ­ personalised, theoretically driven leaflet
plus signed letter
158 - 2
Cessation of smoking in well adults
Social cognition model, attrib. theory
Medicine
Control ­ questionnaires only Group 1 ­ tailored letter and personal details
Age, sex, level of education, actual risk status
210 - 1
Uptake of/cessation of healthy diet in well adults (workplace)
Social Medicine learning theory
Group 1 ­ standard healthy eating leaflets Group 2 ­ information tailored to results preliminary questionnaire
Age, sex, level of education, actual risk status, attitudes, physiological/ psychological assessment, usefulness of information, intention
211 - 1
Cessation of smoking in well adults (church based)
Social Medicine cognition model
Group 1 ­ `fair' to provide health feedback self-help leaflet Group 2 ­ fair, sermons, additional volunteers, audio-tapes, script-guided information
Age, sex, level of education, actual risk status, operationalised model
644 - 1
Cessation of smoking/ CVD risk factor reduction in well adults (workplace)
Social Medicine cognition model
Group 1 ­ risk assessment and feedback Group 2 ­ Group 1 plus leaflet and video information: risk factors Group 3 ­ Group 2 plus behavioural counselling: target setting based on stages change model Group 4 ­ Group 3 plus financial incentives
Age, sex, level of education, social class, marital status, physiological/ psychological assessment
269 - 1
Adherence to diet in elderly well adults
Health Medicine, promotion cancer
Control ­ routine letter to double fibre rate Group 1 ­ leaflet plus free fibre supplement plus group counselling plus newsletters plus recipe competitions Group 2 ­ letter plus fibre supplement free for 3 months
Age, sex
291 - 1
Adherence to selfmanagement in parents of children with asthma
Social Medicine learning theory
Control ­ routine medical care Group 1 ­ family counselling: self-management, feedback and skill acquisition
Age, sex, ethnicity, worry
541 - 1
Adherence to/cessation of healthy diet in women with breast cancer
Social Medicine, learning cancer theory
Control ­ routine nutritional information
Age, actual risk status, medical history,
Group 1 ­ fat content information common foods health behaviours-general, physiological/
plus food diary plus counselled to reduce fat intake psychological assessment
255 - 2
Cessation of smoking in well adolescents
Health Medicine promotion
Control Group 1 ­ Minnesota smoking prevention campaign (social influences model) Group 2 ­ shorter version Group 1 Group 3 ­ smoke free generation programme
Age, sex, actual risk status, social reinforcement/norms
145 - 1
Cessation of smoking in well adolescents
Social Medicine cognition model, health promotion
Control ­ assessment smoking behaviour only Age, sex, actual risk status, other affect,
Group 1 ­ group lessons: smoking, skill acquisition, perception of risk, social reinforcement/
changing social norms over 3 years
norms, stress, personality type
continued
95
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
264 - 1
Cessation of/adherence to diet and exercise in well adults
Social Medicine learning theory
Control ­ exercise intervention programme
Age, sex, level of education, actual risk
Group 1 ­ information about healthy diet and food status, health behaviours-general,
preparing skills
physiological/psychological assessment
Group 2 ­ information about healthy diet
Group 3 ­ information weight management
and exercise
659 - 1
Change in diet in well men
Expected Medicine utility theory
Control ­ assessment only Group 1 ­ women attended small group sessions weekly
Age, education, social class, risk status, medical history, health behaviours, perception of well-being, knowledge, attitudes, social reinforcement/norms
622 - 1
Adherence to treatment in adults with acute and chronic illness
Social Medicine, cognition surgery model (A&E)
Control ­ routine care Group 1 ­ routine care plus phone call information based on HBM Group 2 ­ routine care plus HBM clinic intervention Group 3 ­ routine plus HBM clinic intervention plus phone call
Age, sex, level of education, marital status, ethnicity, actual risk status, medical history, knowledge, perception of risk, perception of susceptibility, reasons, operationalised model
814 - 1
Uptake of exercise in well adult women
Social Medicine learning theory
Control ­ exercise classes only Group 1 ­ information based on relapse prevention plus exercise class Group 2 ­ Group 1 plus incentive
Age, physiological/psychological assessment
490 - 1
Uptake of rehabilitation exercise in adults with hip replacements
Stress ­ Medicine, coping surgery model
Control ­ routine `pre surgery' information Group 1 ­ routine `pre-surgery' information plus further information on hip replacement
Age, sex, anxiety ­ state, perceived satisfaction, waiting time/consultation, usefulness of information, stress
22 - 1
Uptake of condoms in well adults
None STDs (HIV) Control ­ no health information
Age, sex, level of education, anxiety ­
Group 1 ­ house campaigns plus community plus state, knowledge
calendars/T-shirts plus posters plus leaflets: HIV,
condom use and prevention information
732 - 1
Cessation of risky risk in well adults
None STDs (HIV) Control ­ comparison, delayed intervention community Group 1 ­ STD information plus leaflets plus medication plus free condoms
Sex, actual risk status, medical history
736 - 1
Cessation of risky HIV
None
behaviours/uptake of safer
practices in adult drug users
STDs (HIV)
Control ­ waiting list control Group 1 ­ group education session on HIV Group 2 ­ group counselling session plus opportunity to be tested
Age, sex, level of education, social class, marital status, actual risk status, medical history, health behaviours-general
341 - 1
Cessation of drug use in adult substance users
None STDs (HIV) Control ­ interview plus waiting list
Age, sex, level of education, marital
Group 1 ­ information HIV (video, feedback) plus status, ethnicity, actual risk status,
waiting list for test counselling
health behaviours-general, knowledge,
Group 2 ­ HIV information plus counselling about attitudes, perception of risk
having test plus test
156 - 1
Cessation of drug use in adult drug users
None STDs (HIV) Control ­ reward for `drug free' behaviour delayed 3 months Group 1 ­ high reward: 4 stars for a prize for drug free behaviour Group 2 ­ low reward: 8 stars for a prize for drug free behaviour
Age, sex, marital status, ethnicity, actual risk status, physiological/psychological assessment
212 - 1
Cessation of drug use in well adolescents
None STDs (HIV) Control ­ school curriculum: might be similar to Sex, ethnicity, actual risk status, health
intervention group
behaviours-general, attitudes, social
Group 1 ­ Drug Abuse Resistance Education
reinforcement/norms
(DARE) project: skill acquisition, drug use
lesson-based information
639 - 1
Cessation of/adherence to HIV behaviours in well mothers
None STDs (HIV) Group 1 ­ leaflets and opportunity to ask questions Age, level of education, ethnicity,
Group 2 ­ video-tape information
reproductive history, worry, knowledge,
Group 3 ­ nurse educator
attitudes
289 - 1
Adherence to safe sex/ uptake of HIV testing in well young adults
None STDs (HIV) Control ­ assessment plus free condoms
Age, sex, social class, actual risk status
Group 1 ­ anticipatory guidance: lecture plus
video: efficacy condoms, individual counselling
plus free condoms
Group 2 ­ Group 1 plus individual counselling by
peer plus free condoms
96
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
465 - 1
Cessation of/adherence to risky/safe sex in well women
None STDs (HIV) Group 1 ­ peer educator information, video, leaflet Age, ethnicity, knowledge, attitudes Group 2 ­ health professional trained to provide brief information
733 - 1 Cessation of drug use/
None STDs (HIV), Control ­ no additional visits
Age, level of education, marital status,
attendance post-natal care
obstetrics Group 1 ­ health professional visited client for actual risk status, medical history,
in women drug-abusers
and
18 months: support plus information plus
health behaviours-general, other affect,
gynaecology problem solving
attitudes, reproductive history, stress
(midwifery)
4-1
Cessation of cocaine/
adherence to therapy
sessions in adult
cocaine users
Social STDs (HIV) cognition model, health promotion
Control ­ 90-min counselling session twice a week Group 1 ­ 120-min session, five times a week
Sex, level of education, social class, ethnicity, actual risk status, family history, health behaviours-general, personality
24 - 1
Intention to use condoms in adult well males
Health STDs (HIV) Control ­ given non-alcoholic drink
promotion
Group 1 ­ given alcoholic drink
Age, level of education, marital status, ethnicity, health behaviours, knowledge, attitudes, perception of susceptibility, reasons, efficacy
223 - 1
Cessation of drug use in female adolescent users
Health STDs (HIV), promotion medicine
Control ­ verbal information: prevalence drug use, teenage development and sexual behaviour Group 1 ­ group plus individual sessions tailored to drug use, skills acquisition, problem solving
Age, level of education, social class, marital status, ethnicity, actual risk status, reproductive history
226 - 1
Cessation of drug use in well adolescents
Health STDs (HIV), promotion medicine
Control ­ information: health and social consequences drug use Group 1 ­ information: consequences drugs plus resistance skills Group 2 ­ information aimed at beliefs: drug use, norms within school Group 3 ­ resistance skills plus targeted information
Sex, social class, ethnicity, actual risk status
247 - 1
Cessation of drug use in well adolescents
Health STDs (HIV), promotion medicine
Group 1 ­ social skills: resist drug taking Group 2 ­ affect management: focus decision making skills plus stress management Group 3 ­ social skills plus affect management
Sex, ethnicity, actual risk status, health behaviours-general
277 - 1
Cessation of drug use in well adolescents
Health STDs (HIV), promotion medicine
Control ­ no additional information Group 1 ­ health belief model information by teachers: smoking, marijuana and alcohol use, resistance skills Group 2 ­ Group 1 information plus peer volunteer
Sex, level of education, ethnicity, actual risk status, knowledge, attitudes, perception of risk, self-efficacy, intention, social reinforcement/norms
424 - 1
Cessation of/adherence to risky/safe sex in children (school)
Social cognition model
STDs (HIV)
Control ­ delayed programme Group 1 ­ video plus classroom information: HIV and skill acquisition plus competitions plus feedback plus training teacher Group 2 ­ Group 1 plus parents encouraged to attend and help child with homework
Sex, ethnicity, actual risk status, knowledge, attitudes, health behaviours-general, reasons, intention, social reinforcement/norms
478 - 1
Cessation of/adherence to risky/safe sex in well adolescents (school)
Social learning theory
STDs (HIV)
Control ­ routine curriculum Group 1 ­ information based on social learning theory: contraception plus role-play plus skill acquisition
Sex, education, religion, ethnicity, family history, knowledge, attitudes, selfefficacy, social support/communication, intention, social reinforcement/norms
600 - 1
Participation in research/ cessation of substance abuse in well adolescents
Social cognition model
STDs (HIV), medicine
Group 1 ­ letter plus leaflet plus questionnaire completion plus option to take part in counselling (TRS) Group 2 ­ Group 1 information plus no choice about counselling
685 - 1
Uptake of condoms in well female adolescents
Social cognition model
STDs (HIV)
Control ­ family planning professional information: condom use plus demonstration Group 1 ­ control plus encouraged client to handle condom Group 2 ­ Group 1 plus feedback plus elicitation clients condom use self-efficacy
Age, actual risk status, reproductive history, knowledge, attitudes, selfefficacy
continued 97
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
742 - 1
Cessation of/uptake of safer sex in pregnant women
Social learning theory
STDs (HIV)
Control ­ no additional information Group 1 ­ general health promotion video plus role play plus peer volunteer Group 2 ­ Group 1 delivery information but specifically about AIDS
Age, level of education, social class, ethnicity, actual risk status, reproductive history, health behaviours-general, knowledge, perception of risk, social support/communication, intention
492 - 1
Cessation of/adherence to risky sex in well adolescents
Social cognition model, social learning theory
STDs (HIV)
Control ­ delayed intervention Group 1 ­ information: HIV and condoms plus overcoming barriers plus skill acquisition
Age, sex, ethnicity, health behavioursgeneral, knowledge, attitudes, perception of risk, self-efficacy, intention
766 - 1
Cessation of/adherence to risky/safe sex in well adolescents
Health STDs (HIV) promotion, social learning theory
Group 1 ­ Group discussion information: HIV and AIDS Group 2 ­ information plus skills acquisition: decision making and communication plus support and exposure to peers with HIV
Age, sex, actual risk status, health behaviours-general, knowledge, attitudes, reasons, self-efficacy, social support/communication, efficacy
776 - 1
Change of sex behaviour in `high risk' women
Social cognition model
STDs (HIV)
Control ­ `placebo' information: nutrition, child and family care Group 1 ­ HIV-AIDS information plus skill acquisition plus support
Actual risk status, health behavioursgeneral, knowledge, perception of risk, social support/communication
165 - 1
Cessation of risky drug use in drug users
Social learning theory
STDs (HIV)
Control ­ no group sessions Group 1 ­ Group session information AIDS Group 2 ­ Group 1 plus additional sessions on skill acquisition
Age, sex, level of education, social class, ethnicity, actual risk status, health insurance, living arrangements, law infringements
632 - 1
Cessation of/adherence to HIV risk behaviours in adult drug users
Social cognition model, social learning theory
STDs (HIV)
Group 1 ­ leaflets Group 2 ­ leaflets plus group discussion information: HIV and prevention, skill acquisition plus homework
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, anxiety ­ state, knowledge, attitudes, perception of susceptibility, selfefficacy, social support/communication, sexual orientation, efficacy
632 - 2
Cessation of/adherence to for drug using adults
Social cognition model, social learning theory
STDs (HIV)
Group 1 ­ leaflets Group 2 ­ group discussion plus leaflet information (social learning theory): HIV risks and prevention plus homework
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, anxiety ­ state, knowledge, attitudes, perception of susceptibility, self-efficacy, social support/ communication, alienation
635 - 1
Cessation of risky sex/ drug use in black, male adult drug users
Social cognition model, social learning theory
STDs (HIV)
Group 1 ­ group information session viewing video plus leaflets Group 2 ­ psychologist led group session plus leaflet plus skill acquisition plus feedback
Age, education, physiological/ psychological assessment, anxiety ­ state, knowledge, perception of susceptibility, self-efficacy, social support/communication, efficacy
636 - 1
Cessation of risky sex/ drugs in adult drug users
Social cognition model
STDs (HIV)
Group 1 ­ HIV information in first week Group 2 ­ HIV information in second week Group 3 ­ enhanced theory-based group information plus additional counselling
Age, sex, education, ethnicity, actual risk status, living arrangements, law infringements
525 - 1
Cessation of risky drug use in adult substance users
Social STDs (HIV) cognition model, health promotion
Control ­ assessment of risk Group 1 ­ stages change assessment to tailor cognitive-behaviour intervention
Age, sex, education, social class, marital status, actual risk status, health behaviours-general, living arrangements, reasons, operationalised model
660 - 1
Change in HIV risk factors amongst well adolescents
Social cognition model, social learning theory
STDs (HIV)
Control ­ assessment only Group 1 ­ group information guided by theory plus skill acquisition
Age, sex, level of education, ethnicity, knowledge, attitudes, self-efficacy, social reinforcement/norms
98
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
454 - 1
Changes in HIV risks in well women
Stress ­ coping model
STDs (HIV)
Control ­ information: culturally sensitive HIV prevention plus free condoms plus free test plus free bleach Group 1 ­ control plus more information specific to the woman's problems plus skill acquisition plus leaflet
Age, level of education, social class, marital status, ethnicity, actual risk status, anxiety ­ trait, depression, worry, knowledge, attitudes, perception of risk, reproductive history, stress, coping
706 - 1
Utilisation of primary care None in mothers of children with childhood illnesses
Primary Control ­ no information or questionnaire
care,
Group 1 ­ questionnaire plus leaflet (readability
paediatrics plus piloting)
Age, level of education, marital status, reproductive history
6-1
Adherence to medicine
None Primary Control ­ `official' drug
Age, sex
in physically ill children
care
Group 1 ­ generic or alternative to official drug
6-2
Adherence to medication
None Primary Control ­ official drug
in physically ill children
care
Group 1 ­ generic product, not official
Age, sex
6-3
Adherence to medication
None Primary Control ­ official drug
in physically ill children
care
Group 1 ­ generic,`non-official' group
Age, sex
32 - 1
Compliance with healthier None Primary Group 1 ­ regular food/time: usual food depends Age, level of education, actual risk
diet in adult obese women
care,
on weeks of treatment
status, medical history, attitudes,
medicine Group 2 ­ regular food/weight: usual food
perception of control, disability scale,
depending on reaching target weight
social support/communication
Group 3 ­ stimulus/time: new diet depends on
weeks of treatment
Group 4 ­ stimulus/weight: new diet depends on
reaching target weight
51 - 1
Adherence to medication
None Primary
in children with pneumonia
care
Group 1 ­ medication given a syrup and cup to take medication Group 2 ­ medication in the form of a syrup and a spoon Group 3 ­ medication in tablet form Group 4 ­ medication given as a powdered sachet
Age, sex, level of education, actual risk status, living arrangements
174 - 1
Uptake of exercise and diet None in obese women
Primary care, medicine
Control ­ cancer screening plus information plus option to attend delayed intervention Group 1 ­ group plus one-to-one counselling: weight issues plus ways to change diet/ increase exercise plus feedback plus problem solving plus buddy support system
Age, level of education, social class, marital status, ethnicity, physiological/ psychological assessment, knowledge, self-efficacy
302 - 1
Utilisation of service in well adult parents
None Primary care
Control ­ kept diary children's illnesses Group 1 ­ diary children's illness plus leaflet on management common illness (piloted)
Age, level of education, social class, family history, reproductive history, reasons
589 - 1
Uptake of health screening in well adults
None Primary care
Group 1 ­ signed letter invitation with fixed appointment Group 2 ­ prompt on GPs notes to encourage screening
Health behaviours-general, physiological/psychological assessment, worry, attitudes, usefulness of information
572 - 1
Uptake of immunisation well children
None Primary care
Control ­ non-attendees sent reminder letter Group 1 ­ letter plus leaflet plus phone call
747 - 1
Uptake of osteoporosis screening in well women
None Primary care
Group 1 ­ fixed time letter plus leaflet Group 2 ­ fixed appointment but needed to confirm plus leaflet Group 3 ­ letter requiring women to make appointment plus leaflet
Social class
769 - 1
Use of primary care service in patients attending A&E
None Primary Group 1 ­ patient in A&E seen by GP
care,
Group 2 ­ A&E patient seen by senior house
medicine officer
Group 3 ­ A&E patient seen by registrar
Perceived satisfaction
520 - 1
Utilisation of doctor in parents of ill children
None Primary Control ­ usual care
Age, level of education, social class,
care,
Group 1 ­ leaflet on common childhood illnesses medical history, living arrangements,
paediatrics and symptoms
worry, perception of well-being, percep-
tion risk, perception of susceptibility,
continued
99
Appendix 7
100
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
234 - 1
Uptake of influenza vaccine in elderly well patients
337 - 1
Utilisation of physician in adults with coughs
796 - 1
Utilisation of primary care in adults with coughs
414 - 1
Adherence to therapy/ diet in obese adults
553 - 1
Adherence to exercise in adults with arthritis
408 - 1 19 - 1
Uptake of immunisation in well children Uptake of hypothetical treatments in male geriatric patients
167 - 1
Adherence to well-child clinic in well parents
357 - 1
Adherence to medication in women with children acute otitis media
426 - 1
Uptake of health screening in well adults
506 - 1
Participation in consultation in physically ill patients
633 - 1
Uptake of flu vaccine in well elderly
369 - 1
Adherence to medication in adults with osteoarthritis
620 - 1
Uptake of health check in well adult males
Theory Health area
Comparison groups
Variables referred to
None Primary Control ­ newsletter on vaccine plus results of Age, sex, level of education, marital status,
care
health status
medical history, health insurance
Group 1 ­ newsletter on vaccine plus free
immunisation at hospital
Group 2 ­ newsletter on vaccine plus free
immunisation by primary care physician
None Primary Control ­ assessment only
Age, sex, actual risk status,
care
Group 1 ­ leaflet: causes coughs, self-care
health insurance
remedies, when contact physician plus explained
by nurse/physician
None Primary Control ­ no additional information after
Age, sex, actual risk status,
care
contact GP
health insurance
Group 1 ­ doctor explained leaflet in consultation
None Primary Group 1 ­ exercise classes plus leaflet weight loss Age, sex, health behaviours-general,
care,
plus group discussion diet plus minimum support: physiological/psychological assessment,
medicine weekly letter and feedback weight loss
depression
Group 2 ­ Group 1 plus 2 plus booster sessions:
feedback and skill acquisition plus phone contact
None Primary Control ­ usual treatment: relaxation
Age, sex, ethnicity, actual risk status,
care
Group 1 ­ aerobic walking: exercise to increase physiological/psychological assessment,
heart rate
anxiety ­ state, depression, perception
Group 2 ­ water aerobics: same as Group 1 but of well-being, disability scale, social
in water
support/communication
None Primary care
Control ­ routine information
Age, sex, ethnicity, actual risk status
Group 1 ­ telephone reminder recorded message
Framing Primary inform- care ation
Group 1 ­ survival data of therapies presented as point estimates Group 2 ­ survival data presented in the form of a curve
Age, sex, level of education, medical history
Social Primary Control ­ no additional information
cognition care,
Group 1 ­ letter reminder informed by HBM
model paediatrics Group 2 ­ postcard reminder prompt
Age, level of education, social class
Health Primary promotion care
Control ­ routine care: verbal information plus explanation syringe use in Spanish Group 1 ­ written leaflet (readability score) plus leaflet with pictures plus verbal information
Age, ethnicity, reproductive history
Social Primary cognition care, model medicine
Control ­ letter invite to make an appointment Group 1 ­ letter invite with fixed appointment
Attitudes, perception of risk, perception of susceptibility, reasons, intention, efficacy
Communi- Primary cation care
Control ­ placebo leaflet: description clinics available Group 1 ­ leaflet encouraging question asking (readability)
Age, sex, level of education, social class, health insurance, perceived satisfaction, awareness intervention
Social Primary cognition care model
Control ­ nurse visit plus information on safety Age, sex, actual risk status, perception Group 1 ­ nurse visit plus vaccine information of well-being
Stress ­ Primary coping care model
Control ­ routine care Group 1 ­ monthly phone call Group 2 ­ information within clinic Group 3 ­ information in clinic plus phone call
Age, sex, level of education, social class, ethnicity, perception of well-being, perceived satisfaction, disability scale, social support/communication
Social Primary cognition care, model medicine
Group 1 ­ invitation letter Group 2 ­ invitation within surgery
Age, worry, attitudes, perception of control, perception of susceptibility, reasons, operationalised model, intention, efficacy
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
135 - 1
Decision to breast feeding in pregnant well women
698 - 1
Adherence to hormone replacement therapy (HRT) in well women
634 - 1
Uptake of osteoporosis screening in well women
768 - 1
Maintenance of breast feeding in well women
616 - 1
Uptake of breast feeding in well women
403 - 1
Uptake of breast feeding in well women
562 - 1
Adherence to teeth hygiene in well children
576 - 1
Adherence to oral hygiene in well adults
758 - 1
Uptake of oral hygiene in adults with gingivitis
371 - 1
Adherence to dental care in well adolescents
457 - 1
Adherence to dental hygiene in well adults
304 - 1
Adherence to medication in children screened positive for tuberculosis (TB) bacteria
Theory Health area
Comparison groups
Variables referred to
None Obstetrics Control ­ usual care groups: breast feeding vs. Knowledge, attitudes, social
and
formula feeding plus leaflets on breast pump plus support/communication, intention
gynaecology T-shirts plus posters
(midwifery) Group 1 ­ feedback groups: fears, misperceptions
and positioning advice plus breast pump and wipes
plus free football ticket for husband plus peer
counsellor
None Obstetrics Control ­ no HRT
Age, medical history, reproductive
and
Group 1 ­ HRT that induces cyclical withdrawal history, physiological/psychological
gynaecology menorrhoea
assessment, perception of well-being,
(midwifery) Group 2 ­ HRT induces complete amenorrhoea reasons
None Obstetrics Group 1 ­ open letter: contact clinic to
and
make appointment
gynaecology Group 2 ­ letter with fixed appointment time
(midwifery)
Social class
Expected utility theory
Obstetrics and gynaecology (midwifery)
Group 1 ­ commercial pack containing formula only Group 2 ­ pack contained breast pump, pads and cream (no formula)
Age, level of education, social class, marital status, religion, ethnicity, actual risk status, attitudes, intention
Health Obstetrics promotion and gynaecology (midwifery)
Control ­ leaflets only Group 1 ­ culturally sensitive video-tape plus three group discussions
Age, level of education, social class, marital status, ethnicity, health behaviours-general, knowledge, attitudes, reproductive history, intention
Health Obstetrics promotion and gynaecology (midwifery)
Control ­ routine information Group 1 ­ women phoned by nurses Group 2 ­ women visited by nurse
Age, level of education, social class, medical history, reproductive history, attitudes, stress
None Dentistry Control ­ no additional information
Knowledge, reasons
Group 1 ­ school lecture to parents and children,
small group discussion and feedback skills
for children
Group 2 ­ lecture information only
Health Dentistry promotion
Control ­ routine dental care Control 2 ­ routine plus patient phone in results of `plaque test' Group 1 ­ additional consultation plus feedback from health professional Group 2 ­ Group 1 plus checklist of tasks
Social Dentistry cognition model
Control ­ routine dental hygiene instructions Group 1 ­ video-tape information plus feedback session with hygienist
Age, sex, social class, actual risk status, physiological/psychological assessment, self-efficacy, attitudes, perception of risk, intention, social reinforcement/norms, motivation
Social Dentistry cognition model
Control ­ information about teeth Group 1 ­ verbal information: teeth, prevention, health and social factors
Knowledge, intention
Social Dentistry learning theory
Control ­ toothbrush only Group 1 ­ electric toothbrush and gel toothpaste Group 2 ­ shower-based oral hygiene system: toothbrush, paste and mouth rinse
Attitudes, perceived satisfaction
None Infectious Control ­ no additional information
disease
Group 1 ­ telephone call every 3 months to
encourage drug adherence
Group 2 ­ nurse visited child's home every
3 months
Group 3 ­ child saw doctor every 3 months
continued
101
Appendix 7
TABLE 26 contd Description of the decision, the interventions, and the measures recorded in studies: RCTb
Study Summary decision number and area of health
308 - 1
Adherence to anti-malaria procedures in well children
96 - 1
Adherence to medication in adult psychotic patients
479 - 1
Adherence to medication in adults with schizophrenia
511 - 1 494 - 1
Adherence to exercise/ health care/utilisation of in adults with Parkinson's disease Utilisation of services in adult carers of patients with Alzheimer's disease
554 - 1
Utilisation of services in adults with mental health disabilities
794 - 1
Adherence to medication in adults with depression
493 - 1
Decision confidence/skill in carers of people with Alzheimer's disease
176 - 1 150 - 1
Choice of hypothetical medication in adult well patients Adherence to wound care in adults with emergency lacerations
Theory Health area None Infectious disease None Mental health None Mental health None Mental health None Mental health None Mental health Health Mental promotion health Expected Mental utility health theory Framing Other (prospect theory) None Surgery (A&E)
Comparison groups
Variables referred to
Control ­ assessment only Group 1 ­ small group teaching about malaria
Age, actual risk status, knowledge
Group 1 ­ counselling about schizophrenia with family: one family per clinician Group 2 ­ counselling about schizophrenia: six families per counsellor
Age, sex, level of education, social class, marital status, ethnicity, medical history, utilisation of services
Control ­ routine medication Group 1 ­ medication plus family counselling: group meetings plus visit by health professional
Age, sex, actual risk status, medical history, physiological/psychological assessment, attitudes, disability scale plus supervision
Control ­ delayed onset trial Group 1 ­ signed physician letter plus leaflet: exercise, diets and side-effects plus bi-monthly feedback by physician
Age, actual risk status, medical history, health behaviours-general, self-efficacy, stress
Control ­ non-active counselling: carers told where to obtain information Group 1 ­ counselling on getting support plus obtained information plus counselling with carer plus family plus directive means to encourage attendance
Age, sex, level of education, social class, religion, ethnicity, actual risk status, depression, perception of well-being, perception of risk, disability scale, social support/communication
Control ­ usual services of Medicaid beneficiaries Group 1 ­ Medicaid beneficiaries enrolled in pre-paid services and advice on selecting services
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, living arrangements anxiety ­ state, depression, perception of well-being, social support/communication
Control ­ routine care Group 1 ­ trained physicians plus patient watched video plus question form for participation in consultation
Age, sex, level of education, social class, marital status, actual risk status, anxiety ­ state, depression, other affect, perceived satisfaction
Control ­ assessment only Group 1 ­ trained to use computer decision programme: information, decision tree, elicitation utilities and best outcome plus computer installation
Age, sex, depression, other affect, perception of control, usefulness of information, alienation
Group 1 ­ choice of two medications for hypothetical disease framed risk figures using either relative or absolute figures.
Age, sex, level of education, actual risk status, medical history, reasons
Control ­ leaflet on wound care (readability formula applied) Group 1 ­ leaflet plus cartoon illustration
Age, sex, level of education, ethnicity, waiting time/consultation, perceived satisfaction
102
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 27 Description of the decision, the interventions, and the measures recorded in studies: RCTc
Study Summary decision number and area of health
Theory Health area
37 - 1 Uptake of cervical cancer None screening in adult well women
Cancer
154 - 1 Uptake of mammography None in well women with family history breast cancer
Cancer
296 - 1 Adherence to colorectal None screening in well adults
Cancer
377 - 1 Uptake of cervical screening in well women
None
Cancer
412 - 1 Uptake of colorectal
None
screening in well adults
Cancer
695 - 1 Uptake of mammography None in well Asian women
Cancer
712 - 1 Uptake of mammography None in well women
Cancer
310 - 1 Cessation of smoking in None well adults (workplace)
Cancer, medicine
752 - 1 Colorectal cancer
None
screening/health checks
in well adults
Cancer, medicine, primary care
691 - 1 Choice irradiation therapy in women with breast cancer
Shared consultation
Cancer
248 - 1
Attendance for follow-up appointment in adult women with screenpositive cervical smear
Social cognition model
Cancer
354 - 1 Uptake of mammography in well women
Social
Cancer
cognition
model,
health
promotion
Comparison groups Control ­ no additional information Group 1 ­ video information (culturally sensitive) displayed in waiting area before physician appointments Control ­ letter invitation plus questionnaire Group 1 ­ written plus audio-tape information: screening, breast cancer plus feedback BSE plus decision making kit (reasons for having mammography: information aid not decision aid) Control ­ no additional information Group 1 ­ physician trained plus verbal information plus screening leaflet plus free kit Group 2 ­ Group 1 plus reminder letter Group 1 ­ immediate offer smear by physician, if refused made appointment to re-attend Group 2 ­ physician offered smear immediately plus discussion about refusal plus encouragement to have test immediately Control ­ return hemoccult cards in person Group 1 ­ return in addressed envelope Group 2 ­ return in stamped addressed envelope Control ­ routine invitations only Group 1 ­ volunteer attend women's home plus verbal information breast cancer Group 1 ­ reminder card and appointment date Group 2 ­ Group 1 plus additional reminder letter Group 3 ­ reminder letter Group 4 ­ verbal recommendation to attend for follow-up Control ­ placebo video: seat-belt use Group 1 ­ video: man with lung cancer explains risks Group 2 ­ Group 1 video plus increase self-efficacy message Group 3 ­ Group 1 video with `gruesome' scene taken out Group 4 ­ information about smoker who had both legs amputated from smoking Group 1 ­ hemoccult test posted Group 2 ­ Group 1 plus letter invite health check Group 3 ­ invite health check plus explanation hemoccult test Group 4 ­ invite health check Control ­ routine consultation Group 1 ­ clinician given checklist prompt Group 2 ­ consultation plus checklist plus women used a decision board Control ­ routine letter invitation Group 1 ­ letter plus leaflet explaining cervical smear results Control ­ letter about survey plus incentive to return questionnaire Group 1 ­ letter plus video plus group discussions plus leaflets (piloted and informed by health belief model) plus times mammography
Variables referred to Age, ethnicity, health insurance Age, level of education, marital status, actual risk status, family history, health behaviours-general, attitudes, perception of risk, efficacy Age, sex, actual risk status, health professional measures Age, marital status, actual risk status, medical history, attitudes Age, sex, ethnicity, health behavioursgeneral, health insurance Age, ethnicity, knowledge Age, reasons, usefulness of information Age, sex, social class, perception of risk, intention Age, sex Age, level of education, marital status, actual risk status, knowledge, attitudes autonomy in decision making, preference consultation style, reasons, usefulness of information Age, level of education, social class, marital status, ethnicity, medical history, reproductive history, health behaviours-general Age, level of education, marital status, ethnicity, actual risk status, family history, health behaviours-general knowledge, attitudes, perception of risk, reasons continued
103
Appendix 7
104
TABLE 27 contd Description of the decision, the interventions, and the measures recorded in studies: RCTc
Study Summary decision number and area of health
Theory Health area
380 - 1 Adherence to colposcopy Communi- Cancer in women with screen- cation positive smears
484 - 1 Uptake of cervical smears Social
Cancer
in well women
cognition
model
507 - 1
Uptake of mammography in well adult women
Social cognition model
Cancer
508 - 1 Uptake of cervical
Expected Cancer
screening in adult women utility
with dysplasia/atypia
theory
303 - 1 Adherence to medication None in elderly patients
Medicine
320 - 1 Cessation of/adherence None to healthy lifestyle and attendance clinic in adults with hypertension
381 - 1
Attendance referral appointment in adults with raised cholesterol (workplace)
None
Medicine Medicine
471 - 1 Cessation of alcohol use in well adults
None
Medicine
473 - 1 Cessation of smoking in well adults
None
Medicine
475 - 1 Uptake of self-care in elderly adults with medicine
None
Medicine
485 - 1 Cessation of alcohol use None in well adults
Medicine
763 - 1 Adherence to medication None in elderly discharged hospital patients
Medicine
Comparison groups Control ­ routine phone call to reschedule appointment Group 1 ­ counselling confronting barriers to attendance Group 1 ­ signed letter plus brief explanation smear plus leaflet Group 2 ­ free bus tickets mailed plus letter Group 3 ­ video in waiting room on cervical screening Control ­ routine leaflet plus letter Group 1 ­ tailored leaflet (social cognition model): positive framing previous screening experiences Group 2 ­ Group 1 plus opinion of GP and peer member in glossier leaflet Control ­ routine consultation Group 1 ­ piloted leaflets explaining about dysplasia/atypia Control ­ general health information given by nurse in groups Group 1 ­ control plus leaflet plus personalised prompt of current medication Control ­ routine clinic visit Group 1 ­ letter invitation for patient plus relatives plus written and verbal information. hypertension, medication, diet plus feedback Control ­ leaflet plus screening plus feedback on raised cholesterol level Group 1 ­ screening leaflet plus feedback screen positive plus letter of cholesterol figure plus leaflet explaining link between cholesterol and CVD Group 1 ­ self-help leaflet: steps to sensible drinking plus routine therapy session Group 2 ­ brief summary information in leaflet during routine therapy sessions Group 3 ­ additional counselling as required Control ­ no additional information Group 1 ­ quit for good illustrated leaflets: reasons for quitting, minimising weight increase, people to contact, coping skills Group 2 ­ quit and win illustrated leaflets: identify problems, structured quitting Control ­ no additional information Group 1 ­ patients contacted by phone for 4 weeks after discharge, additional information given as needed Group 1 ­ inpatient rehabilitation Group 2 ­ advised attend alcoholics anonymous Group 3 ­ advice from counsellors plus offered either AA or hospital Control ­ routine care: medication administered by nurses Group 1 ­ pharmacist discussed medication patients plus nurse supervised patient self-medication plus memory prompt
Variables referred to Age, level of education, marital status, ethnicity, reasons Age, level of education, marital status, ethnicity, actual risk status, health insurance Age, level of education, marital status, attitudes, perceived satisfaction, self-efficacy, intention, social reinforcement/norms Age, level of education, marital status, ethnicity, actual risk status, reproductive history, health behaviours-general, health insurance Age, sex, marital status, actual risk status, knowledge, self-efficacy Age, sex, actual risk status, health behaviours-general, physiological/ psychological assessment Age, sex, actual risk status, family history, medical history, health behaviours-general, reasons, intention Age, sex, level of education, social class, marital status, actual risk status, physiological/psychological assessment Age, sex, level of education, social class, marital status, actual risk status, perception of risk, self-efficacy, usefulness of information, intention, social reinforcement/norms, awareness intervention, coping Age, sex, level of education, social class, marital status, ethnicity, actual risk status, health behaviours-general, physiological/psychological assessment, knowledge Age, sex, level of education, social class, marital status, ethnicity, actual risk status, health behaviours-general, depression, perceived satisfaction, stress Age, sex, marital status, actual risk status, waiting time/consultation, knowledge continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 27 contd Description of the decision, the interventions, and the measures recorded in studies: RCTc
Study Summary decision number and area of health 459 - 1 Cessation of smoking in women with children
Theory None
754 - 1 Changes diet in children None with high cholesterol
708 - 1 Changes CVD risk factors None in well adults
711 - 1 Adherence to treatment None in adult substance users
170 - 1 Accident prevention
None
in well parents
343 - 1 Uptake of advance
None
directives in geriatric
patients
Health area Medicine Medicine Medicine Medicine Medicine, other Medicine
Comparison groups Group 1 ­ leaflet for young mothers on quitting (readability) Group 2 ­ general giving up smoking leaflet Group 3 ­ illustrated and coloured leaflets Control ­ screened negative controls Control 2 ­ screened positive control group Group 1 ­ leaflet information (social cognitive theory): diet and cholesterol plus audio-taped feedback Group 2 ­ counselling with dietician plus specific dietary instructions plus leaflets plus phone contact Control ­ health information plus cholesterol test (no feedback) Group 1 ­ health information plus reading plus feedback of cholesterol Group 1 ­ routine care Group 2 ­ introduction of a follow-up telephone call for patients Control ­ no additional information Group 1 ­ counselling by nurse plus leaflets: cessation of smoking, effects passive smoking and prevention home injuries Control ­ notes used for analysis Group 1 ­ information advance directives, copies forms, reminder card to discuss with physician
56 - 1
Attendance for CVD risk screening in adult well males
472 - 1 Involvement in consultation in adults with diabetes
Social
Medicine
cognition
model
Shared consultation
Medicine
Group 1 ­ invitation to attend free screening for CVD risk factors Group 2 ­ invitation to attend for screening but charged US$40 Control ­ routine consultation Group 1 ­ health professional consultation plus decision tree plus active role in treatment information plus skill acquisition plus audio and leaflet home package plus prompt for next consultations
72 - 1
Cessation of smoking well adults via schoolbased programme
Social
Medicine
cognition
model
Control ­ screening session only Group 1 ­ screening plus leaflet plus group counselling plus feedback
242 - 1 Cessation of smoking in well male adults 254 - 1 Cessation of smoking in well adults 375 - 1 Adherence to exercise in adults with CVD
Social
Medicine
cognition
model
Social
Medicine
cognition
model
Social learning theory
Medicine
Control ­ usual care Group 1 ­ self-help leaflet tailored to stages of change on smoking Control ­ `stop smoking' statement plus leaflet Group 1 ­ self-quit advice statement plus decision to quit video plus quitting aids plus calendar prompt plus leaflet Group 2 ­ group recruitment: advice statement plus attendance group video plus offer free group plus leaflet Group 3 ­ Group 1 plus 2 Control ­ routine group information on medication, diet and exercise Group 1 ­ additional control information by health professional plus an exercise contract
Variables referred to Age, level of education, ethnicity, actual risk status, reasons, usefulness of information Age, sex, ethnicity, knowledge Age, sex, social class Age, sex, social class, marital status Level of education, social class Age, sex, social class, marital status, ethnicity, actual risk status, medical history, health insurance perception of well-being, attitudes, reasons Age, social class, marital status, actual risk status, health behaviours, physiological/psychological assessment Age, sex, level of education, social class, actual risk status, medical history, physiological/psychological assessment, depression, worry, need cognition, autonomy in decision making, preference consultation style, perceived satisfaction, alienation Age, sex, level of education, marital status, ethnicity, actual risk status, health behaviours-general, health insurance, knowledge, operationalised model Age, actual risk status, medical history, operationalised model, usefulness information Age, sex, level of education, social class, ethnicity, actual risk status, physiological/ psychological assessment, perception of well-being Age, sex, actual risk status, knowledge, disability scale continued
105
Appendix 7
106
TABLE 27 contd Description of the decision, the interventions, and the measures recorded in studies: RCTc
Study Summary decision number and area of health 792 - 1 Cessation of smoking in adolescents
Theory Health area
Social
Medicine
cognition
model
Comparison groups Control ­ usual lesson Group 1 ­ media plus school-based information based on social cognition models
640 - 1 Cessation of smoking in well adolescents
Social learning theory
Medicine
Control ­ no additional information Group 1 ­ peer volunteer group information: tobacco use plus T-shirts plus skill acquisition plus video plus feedback plus competitions plus letter plus phone booster messages
287 - 1 Cessation of smoking in adult hospital patients
Social
Medicine
cognition
model
Control ­ assessment only Group 1 ­ stage of change assessed and targeted video plus verbal plus leaflet information plus free gum plus telephone contact
169 - 1 Adherence to medication Communi- Medicine
in elderly patients
cation
Control ­ routine verbal plus leaflet information Group 1 ­ leaflet plus contact pharmacist to discuss medication
405 - 1 Cessation of smoking in well adolescents
Health Medicine promotion
Control ­ assessment only Group 1 ­ peer volunteer group information on cessation of smoking plus skill acquisition
442 - 1 Changes in CVD risk factors in well adults (work)
Social
Medicine
cognition
model
Control ­ delayed intervention Group 1 ­ assessed stage of change plus target information: CVD risks plus skill acquisition plus changes workplace
360 - 1 Cessation of alcohol, smoking and drug use in well children
Health Medicine, promotion STDs (HIV)
Control ­ waiting list control Group 1 ­ weekly lessons: alcohol, tobacco and marijuana plus skill refusal acquisition plus key-ring prompts plus stickers
115 - 1 Adherence to healthy diet in pregnant women
Social cognition model
Medicine, obstetrics and gynaecology (midwifery)
Group 1 ­ self-assessment `quiz' plus leaflet plus shopping list pad plus stickers Group 2 ­ letter from GP plus leaflet with recipes and stickers
329 - 1 Cessation of smoking in pregnant women
Social cognition model
Medicine, obstetrics and gynaecology (midwifery)
Control ­ routine no smoking information by physician Group 1 ­ health professional explained no smoking leaflet plus feedback Group 2 ­ video informed by HBM (piloted) plus leaflet plus opportunity for feedback
80 - 1
Adherence to healthy lifestyles, cessation of unhealthy lifestyle in coronary artery by-pass graft patients
Health Medicine, promotion surgery
Control ­ routine care and assessments Group 1 ­ routine plus behavioural education programme: goal setting, feedback, additional contact, group exercise sessions
649 - 1 Uptake of safer sex in
None
STDs (HIV) Control ­ questionnaires only
well adults
Group 1 ­ comic of `real-life' stories plus leaflet
plus group discussions plus feedback plus skill
acquisition
684 - 1 Uptake of safe sex in adult drug abusers
None
STDs (HIV) Group 1 ­ information about HIV
Group 2 ­ enhanced information: emphasis on
skill acquisition
720 - 1 Cessation of HIV risk in None adult substance users
STDs (HIV)
Control ­ video and group routine information about HIV Group 1 ­ control plus additional sessions plus feedback plus skills
Variables referred to Age, level of education, social class, ethnicity, health behaviours-general, attitudes, reasons, social reinforcement/ norms Age, sex, ethnicity, actual risk status, social reinforcement/norms Age, sex, level of education, actual risk status, medical history Age, sex, level of education, actual risk status, medical history, living arrangements, knowledge, disability scale Sex, knowledge, attitudes Sex, social class, ethnicity, health behaviours-general Age, sex, level of education, ethnicity, actual risk status, knowledge, attitudes, self-efficacy, social reinforcement/norms Age, social class, marital status, reproductive history, health behavioursgeneral, knowledge, attitudes, reasons, intention, social reinforcement/norms Age, level of education, marital status, ethnicity Age, sex, level of education, social class, marital status, physiological/ psychological assessment, anxiety ­ state, depression, perception of well-being Age, sex, actual risk status, knowledge, attitudes, intention Age, level of education, marital status, ethnicity, actual risk status, health behaviours-general, living arrangements, attitudes, perception of susceptibility, selfefficacy, social support/communication, social reinforcement/norms Age, sex, level of education, social class, marital status, ethnicity, actual risk status, reproductive history, health behaviours-general, social support/ communication, social reinforcement/ norms, living arrangements continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 27 contd Description of the decision, the interventions, and the measures recorded in studies: RCTc
Study Summary decision number and area of health
407 - 1 Cessation of risky HIV behaviours in adult substance users
181 - 1 Adherence to oral contraception in female adolescents
762 - 1
Cessation of/adherence to sexual and drug behaviour in adult well women
528 - 1 Cessation of risky HIV behaviours in adult drug users
646 - 1
Cessation of risky HIV behaviours in Latino adult female drug users
696 - 1 Uptake of condoms in adults with STDs
817 - 1 Cessation of risky drug use in adult substance users 749 - 1 Adherence to/cessation of risky sex behaviour in well male adolescents 777 - 1 Uptake of face washing in children treated for trachoma 172 - 1 Attendance for appointment in well adults (primary care) 363 - 1 Uptake of immunisation rates in well women with children 470 - 1 Uptake of primary care health services in well adults 512 - 1 Uptake of immunisation in well children
98 - 1
Adherence to selfmanagement in adult patients with arthritis
601 - 1 Request information/ change lifestyle in well adults
Theory Health area
Comparison groups
None
STDs (HIV) Control ­ usual counselling
Group 1 ­ HIV skill information: use condoms,
bleaching and risk reduction
Communi- STDs (HIV) Control ­ routine contraception information
cation
Group 1 ­ additional nurse information: examine
barriers to adherence, ways of coping
Social
STDs (HIV)
cognition
model,
framing
information
Control ­ usual public health video (white males in video) Group 1 ­ video: black women gave information Group 2 ­ video: black women with more culturally specific message (piloted)
Social cognition model
STDs (HIV)
Group 1 ­ verbal plus leaflet plus video information (HBM): HIV test, condom and safe drug use Group 2 ­ Group 1 plus additional follow-up visits plus specialist information
Health STDs (HIV) promotion, stress ­ coping model
Control ­ routine video information: HIV and risk reduction Group 1 ­ culturally sensitive video plus peer volunteer plus leaflet plus discussion: coping and skill acquisition plus leaflet plus free condoms and bleach
Social cognition model
STDs (HIV)
Control ­ routine clinic information Group 1 ­ watched video based on theory reasoned action Group 2 ­ video plus group discussion
Social
STDs (HIV) Group 1 ­ information based on HBM,TRA
cognition
Group 2 ­ enhanced information (relapse
model
prevention): additional contact plus skill building
Social
STDs (HIV) Control ­ career planning and opportunities
cognition
information
model
Group 1 ­ information HIV, skill acquisition, feedback
None
Primary
Control ­ treatment trachoma only
care,
Group 1 ­ treatment trachoma plus face-washing
surgery information
None
Primary
Control ­ no additional invitation
care
Group 1 ­ postcard reminder
None
Primary
care
None
Primary
care
None
Primary
care
Health Primary promotion care
Shared consultation
Primary care, medicine
Control ­ no additional information Group 1 ­ discussion with nurse and GP plus leaflet (readability) plus reminder letter Control ­ routine `new patient' treatment Group 1 ­ new patients interviewed by physician and nurse Control ­ no additional information Group 1 ­ pre-recorded general reminder plus recall message Group 2 ­ pre-recorded specific recall plus reminder message Control ­ saw physiotherapist only Group 1 ­ physiotherapist plus group sessions, feedback, information on arthritis, coping and problem solving, relaxation Control ­ consent form only Group 1 ­ prompt card asking questions/ brief information CVD
Variables referred to Age, sex, level of education, actual risk status Age, marital status, actual risk status, attitudes, efficacy Age, level of education, social class, marital status, actual risk status, health behaviours-general, anxiety ­ state, knowledge, attitudes, perception of risk, usefulness of information Age, sex, level of education, social class, ethnicity, actual risk status, health behaviours-general, living arrangements Age, level of education, social class, marital status, religion, actual risk status, health behaviours-general, depression, worry, perception of well-being, knowledge, attitudes, stress, coping, self-esteem Sex, ethnicity, knowledge, attitudes, perception of risk, self-efficacy Sex, level of education, ethnicity, actual risk status, health behaviours-general, knowledge, attitudes, perception of risk, perception of susceptibility, self-efficacy Age, level of education, actual risk status, health behaviours-general, knowledge, attitudes, intention, personality type Age, sex, actual risk status Satisfaction, health insurance, health professional measures, awareness of intervention Age, ethnicity, reproductive history Age, sex, ethnicity, actual risk status, living arrangements Age, sex, actual risk status, medical history, physiological/psychological assessment, anxiety ­ state, depression, knowledge, self-efficacy, disability scale Age, sex continued
107
Appendix 7
108
TABLE 27 contd Description of the decision, the interventions, and the measures recorded in studies: RCTc
Study Summary decision number and area of health
601 - 2 Request information/ change lifestyle in well adults
83 - 1
Utilisation of (prenatal) services amongst pregnant women
106 - 1 Attendance postpartum appointment in adolescents
788 - 1 Utilisation of postnatal care in new mothers
481 - 1
Attendance for appointment in adults with TB
411 - 1 Adherence to treatment in adults with TB 743 - 1 Uptake of CF carrier screening in pregnant/ well adults 790 - 1 Uptake of carrier testing (CF) in well adults 293 - 1 Uptake of infant car seat in well mothers 349 - 1 Attendance for sexualdifficulties clinic in well adults 58 - 1 Having donor card in well adults 324 - 1 Adherence to safety advice in well mothers 717 - 1 Utilisation of health care in adults with mental health problems
Theory Health area
Comparison groups
Variables referred to
Shared consultation
Primary care, medicine
Control ­ consent only Group 1 ­ nurse prepared patients for consultation using script to discuss health behaviours
Age, sex
None
Obstetrics Control ­ routine visits from health professionals
and
plus informed study
gynaecology Group 1 ­ reduced visits: consultation focused on
(midwifery) `prenatal milestones' plus leaflets
Age, medical history, reproductive history, physiological/psychological assessment, health insurance, knowledge, usefulness of information
None
Obstetrics Control ­ routine care
and
Group 1 ­ routine care plus teddy bear
gynaecology
(midwifery)
Age, marital status, ethnicity, reproductive history, health behavioursgeneral, health insurance, alienation
None
Obstetrics Control ­ routine nursery care
Age, level of education, ethnicity,
and
Group 1 ­ health professional information: caring
medical history, reproductive history,
gynaecology new-born plus feedback plus 24 hour phone access anxiety ­ state, depression, knowledge,
(midwifery) plus appropriate utilisation of services
social support/communication
None
Infectious Control ­ no reminder message
Age, sex, ethnicity, attitudes
disease
Group 1 ­ pre-recorded telephone message
with appointment time plus clinic number
Group 2 ­ pre-recorded message plus time
appointment plus emphasis government scheme (authority)
Group 3 ­ recorded message plus appointment time
plus emphasis importance attending (importance)
Group 4 ­ recorded message plus appointment time
plus both authority and importance
None
Infectious Control ­ routine information given by clinic staff
disease
Group 1 ­ additional information given by
another professional
Age, sex, level of education, social class, marital status, religion, ethnicity, health insurance, living arrangements, knowledge, attitudes
None
Genetics Group 1 ­ leaflet plus counselling plus offer of
stepwise screening
Group 2 ­ leaflet plus counselling plus couple
testing only
Age, sex, social class, marital status, family history, anxiety ­ state, perception of well-being, knowledge, attitudes, perception of risk, reproductive history, social support/communication, intention
None
Genetics Group 1 ­ letter in year 1
Group 2 ­ letter plus leaflet
Group 3 ­ leaflet at clinic
Group 4 ­ approached researcher plus leaflet
plus explanation plus test
Group 5 ­ invite at clinic plus leaflet plus
explanation plus test appointment
Group 6 ­ letter year 2
Age, sex, anxiety ­ state, knowledge
None
Other,
Control ­ routine care only
obstetrics Group 1 ­ car seat plus information video
and
Group 2 ­ car seat plus video plus instructions
gynaecology
(midwifery)
Age, level of education, social class, ethnicity
None
Other
Control ­ sent appointment times Group 1 ­ questionnaire plus information sheet plus stamped addressed envelope plus appointment
Age, sex, living arrangements, health professional measures
Social
Other
cognition
model
Control ­ no specific information Group 1 ­ leaflet plus inclusion donor cards by post Group 2 ­ trained health professionals to participate in meetings and promote donor cards plus media Group 3 ­ Group 1 plus 2
Age, sex, social class, religion, knowledge, attitudes
Social learning theory
Other
Control ­ questionnaire only Group 1 ­ illustrated leaflet (readability)
Age, level of education, ethnicity, reproductive history, knowledge, attitudes, self-efficacy, social desirability
Communi- Mental
Control ­ appointment letter only
cation health ­ Group 1 ­ letter plus information about services
generalcontinued
Anxiety ­ state, preference consultation style, perceived satisfaction
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 28 Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health
Theory Health area
44 - 1 Uptake of mammography None in adult well women
Cancer
61 - 1 Uptake of cervical
None
cancer screening in
well adult women
203 - 1 Uptake of mammography None in adult well women
Cancer Cancer
243 -1 Uptake of mammography None in adult well women
Cancer
246 - 1 BSE in well adult women None
Cancer
385 - 1 Cessation of tobacco (not smoking) use in well children
None
Cancer
686 - 1 Uptake of mammography None in well adult women
Cancer
171 - 1 Uptake of general cancer prevention in well adult women
None
Cancer
205 - 1 Uptake of mammography None in well women
Cancer
205 - 2 Uptake of mammography None screening in well women
Cancer
397 - 1 Uptake of cervical/breast None screening in well women
Cancer
546 - 1 Uptake of cervical
None
screening in well women
Cancer
Comparison groups
Variables referred to
Control ­ community comparison Group 1 ­ community intervention: posted leaflets plus calendar prompts plus trained health professionals Control ­ no additional information Group 1 ­ letter invitation sent to eligible women
Age, level of education, social class, family history, health behaviours-general, health insurance, knowledge, perception of risk, awareness of intervention Age
Control ­ comparative community
Age
Group 1 ­ increasing awareness in community
(variety methods) plus health professionals
(by letter)
Group 2 ­ increase community awareness plus
women leaflet posted
Control ­ no additional programme Group 1 ­ trained physicians plus leaflet plus community groups plus memory prompts
Age, level of education, social class, actual risk status, family history, health behaviours-general, health insurance, knowledge, attitudes, reasons, social support/communication
Control ­ pre- and post-test measurements only Control 2 ­ annual survey's only Group 1 ­ trained nurse information at women's community groups plus video plus feedback plus calendar reminder plus skill acquisition plus media Group 2 ­ Group 1 plus second maintenance reminder programme
Age, level of education, social class, self-efficacy, social support/ communication, awareness of intervention
Control ­ completed measures Group 1 ­ school-based intervention plus acquisition skills (resisting) plus drug information Group 2 ­ Group 1 plus parental education plus community leader `enforcers'
Age, sex, level of education, actual risk status, reproductive history, health behaviours-general, depression, attitudes, perceived satisfaction, intention, social reinforcement/norms
Control ­ comparison community Group 1 ­ physician information breast cancer screening plus media plus community campaigns plus cheaper mammograms
Age, level of education, social class, ethnicity, health insurance, health professional measures, knowledge, attitudes, intention, awareness intervention
Control ­ no additional information Group 1 ­ cancer-related consultations made priority plus group discussions: self-examination and prevention plus leaflet plus newsletter
Age, level of education, ethnicity, knowledge, awareness of intervention
Group 1 ­ media promotion organised by hospitals Group 2 ­ community: elected representatives from business and social groups plus show videos plus leaflet distribution
Age, awareness of intervention
Group 1 ­ community: elected organisers from business and social groups plus show video plus leaflet distribution Group 2 ­ family practitioner recommend attendance plus notes prompt plus leaflets plus posters in surgery
Age, awareness of intervention
Control ­ no additional information Group 1 ­ opportunistically nurse invitation: information plus free screening plus appointment for next day
Age, ethnicity, actual risk status, knowledge, awareness of intervention
Control ­ routine invitation by national programme Age, medical history, living
Group 1 ­ control plus letter invitation from GP
arrangements
continued
109
Appendix 7
110
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health 448 - 1 Uptake of colorectal cancer screening in elderly well adults
Theory Health area
None
Cancer
418 - 1 Uptake of screening tests in well adults 386 - 1 Uptake of BSE in well women
None
Cancer,
primary
care,
medicine
Health Cancer promotion
760 - 1
Uptake of mammography in well adult women
Social cognition model
Cancer
608 - 1
Uptake of mammography in well adults women
Social cognition model
Cancer
404 - 1 Uptake of mammography Health Cancer
in well women
promotion
446 - 1
Uptake of mammography in well women
Social cognition model
Cancer
136 - 1 Adherence to sun protection in well children
Health Cancer promotion
237 - 1 Adherence to/cessation of to healthy lifestyle in well adults
Social
Cancer,
cognition medicine
model
180 - 1 Uptake of safer sun in well adults
Social
Cancer
cognition
model
45 - 1 Uptake of cholesterol
None
screening in well adults
Medicine
82 - 1 Health care utilisation
None
Medicine
in asthma patients
Comparison groups
Variables referred to
Control ­ routine slide show offer plus free hemoccult kit plus diet change Group 1 ­ control plus elderly framed information plus memory prompts Group 2 ­ Group 1 plus demonstration hemoccult test using peanut butter
Age, sex, level of education, social class, marital status, ethnicity, family history, medical history, physiological/ psychological assessment, perception of well-being, disability scale
Control ­ north clinic: no information Group 1 ­ south clinic: no information Group 2 ­ north clinic: leaflet on screening and health preventive behaviours (readability)
Age, sex, level of education
Control ­ verbal information on placebo topic Group 1 ­ American Cancer Society (ACS) leaflet and verbal information: BSE, cancer plus model demonstration Group 2 ­ ACS information plus additional feedback session
Age, level of education, actual risk status, family history, medical history, reproductive history, health behavioursgeneral, knowledge, efficacy
Control ­ assessment only Group 1 ­ group information (HBM): breast cancer and screening Group 2 ­ Group 1 information plus arguments for and against plus role model plus planning action plus letter
Age, level of education, social class, marital status, ethnicity, health behaviours-general, knowledge, attitudes, perception of risk, perception of susceptibility, reasons, operationalised model, intention
Control ­ usual offer mammography with mobile vans Group 1 ­ routine offer plus media campaign
Age, level of education, social class, ethnicity, living arrangements, worry, knowledge, attitudes, perception of risk, perception of susceptibility, awareness of intervention
Control ­ routine breast screening Group 1 ­ leaflets plus free screening plus faster feedback reports plus reminder letters plus training staff plus staff feedback
Age, level of education, social class, marital status, ethnicity, family history, health professional measures
Control ­ no information Group 1 ­ information leaflet plus GP reminder letter plus counselling by phone
Age, level of education, social class, marital status, ethnicity, health insurance
Control ­ assessment only Group 1 ­ group information plus posters plus free sunscreen Group 2 ­ Group 1 plus skill acquisition plus leaflets plus continued information from teachers
Age, sex, social class, actual risk status, knowledge, attitudes
Control ­ assessment only Group 1 ­ trained group leaders plus leaflet plus verbal group information plus media plus letter plus activities
Age, sex, level of education, social class, marital status, actual risk, health behaviour
Control ­ routine information through schools and media, information on wearing protective clothing and sunscreen Group 1 ­ more intensive programme using more media, message based on theory of identification/ attitude confronting, more shady spaces, reduction in sunscreen prices
Age, sex, knowledge, attitudes, perception of risk, social reinforcement/ norms, motivation, efficacy
Control ­ no additional information Group 1 ­ package intervention: media plus setting up network in community plus workplace plus trained health professionals
Age, sex, ethnicity, medical history, health behaviours-general knowledge, perception of risk
Control ­ no exposure to information Group 1 ­ teaching session on asthma: knowledge and management
Age, sex, actual risk status, medical history, physiological/psychological assessment, knowledge, quality of life
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health 218 - 1 Cessation of smoking in adult smokers 222 - 1 Cessation of/adherence to healthy/risky lifestyle in well adolescents 235 - 1 Cessation of smoking in well adults 245 - 1 Cessation of smoking in CVD adult patients 256 - 1 Cessation of smoking in well adults 258 - 1 Cessation of/adherence to lifestyle in well adults and children 260 - 1 Cessation of smoking in well adult males 280 - 1 Cessation of smoking in well adults 283 - 1 Cessation of smoking 284 - 1 Cessation of smoking in well adults 315 - 1 Adherence to medication in elderly adults 390 - 1 Cessation of/adherence to healthy lifestyle in well adults (workplace)
Theory None
Health area Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
Comparison groups
Variables referred to
Control ­ comparison community Group 1 ­ trained volunteers plus media plus quit-line plus leaflet plus group sessions
Sex, age, level of education, health behaviour, self-efficacy, social norm, awareness of intervention
Control ­ matched no intervention schools Group 1 ­ teachers screened/feedback
Age, sex, level of education, social class, ethnicity, marital status, medical history, physiological/psychological assessment, health behaviours, attitude
Group 1 ­ no restrictions on smoking Group 2 ­ employees agree smoking contract within workplace Group 3 ­ smoking ban imposed
Age, sex, level of education, marital status
Group 1 ­ motivational counselling: health and well-being, anticipation quitting problems Group 2 ­ behavioural counselling: quit date set, abrupt quitting, compliance contract, self-reward and relaxation Group 3 ­ behavioural counselling plus nicotine fading: gradual quitting
Age, sex, level of education, social class, marital status, actual risk status, health behaviours-general, anxiety ­ trait, depression, social support/ communication, coping
Control ­ physician advice only Group 1 ­ advice plus cessation counselling by physicians (behaviour oriented model) Group 2 ­ Group 1 plus prescription nicotine gum
Age, sex, marital status, ethnicity, actual risk status, medical history, health behaviours-general, self-efficacy, social support/communication, intention
Control ­ Group 1 ­ intervention 1980­1986 involved school plus community plus media information
Age, sex, level of education, actual risk status, physiological/psychological assessment
Control ­ usual smoking cessation information by physicians Group 1 ­ intervention by research staff: dosage reduction and coping `risky' situations
Control ­ television based smoking cessation programme Group 1 ­ North Karelia intervention plus control plus best `non smoker' competition Group 2 ­ control plus competition in Turku community
Sex, level of education, actual risk status, awareness of intervention
Group 1 ­ group meetings ­ behavioural strategies to reduce smoking, buddy system, stress management, relaxation, leaflet, gum Group 2 ­ all information Group 1 plus competition for best `no smoker'
Age, sex, level of education, social class, actual risk status, stress
Control ­ health screen only for smokers and non smokers Group 1 ­ health screen plus programmes on healthy lifestyle plus attend in own time programmes about diet, smoking, stress, etc. (buddy systems, ways coping smoking cessation, etc.), smoking areas plus no smoking signs
Age, sex, level of education, social class, actual risk status, medical history, perception of well-being
Control ­ medication prompt card, feedback on taking medication (pills from a bottle) Group 1 ­ medication card, feedback on taking medication and pills in foil packet ­ dates marked so know if taken pill
Age, sex, actual risk status
Control ­ health education plus exercise classes (none attendance) Group 1 ­ workplace introduced a well publicised fitness room Group 2 ­ counselling to high risk factor employees plus encouraged to take up exercise Group 3 ­ counselling plus organised exercise sessions plus buddy system plus fitness facility
Actual risk status, health behavioursgeneral, physiological/psychological assessment
continued
111
Appendix 7
112
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health 504 - 1 Uptake of services in parents with asthmatic children 657 - 1 Cessation of smoking in well adults 731 - 1 Cessation of smoking in well adolescents 740 - 1 Cessation of smoking in well adults 779 - 1 Cessation of smoking in well adults 206 - 1 Cessation of CVD risk factors in well adults 215 - 1 Cessation of fatty diet in well adults 409 - 1 Change diet in well adolescents 312 - 1 Change diet in well adults 273 - 1 Cessation of smoking in well adolescents 394 - 1 Uptake of eye checks in adults with medicine 194 - 1 Intention to drive safely in school children 89 - 1 Adherence to exercise in adult well population 184 - 1 Cessation of smoking in well adolescents
Theory None
Health area Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine
None
Medicine,
surgery
None
Medicine,
other
Social
Medicine
cognition
model
Social
Medicine
cognition
model
Comparison groups
Variables referred to
Control ­ waiting list control Group 1 ­ trained GPs plus parent leaflet (piloted) plus consultation content prompt plus feedback
Age, sex, actual risk status, medical history, perception of risk
Control ­ smokers exposed to the `kick the habit' TV programme Group 1 ­ control plus asked for self-quit leaflet
Sex, level of education, social class, ethnicity, actual risk status, medical history
Control ­ no planned intervention Group 1 ­ family smoking education (no details) Group 2 ­ adolescent focused smoking intervention Group 3 ­ Group 1 plus 2
Age, sex, social class, family history, health behaviours-general, knowledge, attitudes, perception of control, reproductive history, self-esteem
Control ­ cholesterol screening result letter, contact physician Group 1 ­ control plus media campaign: change diet, smoking cessation, exercise uptake. Group 2 ­ Group 1 plus managing risk leaflet plus public meetings plus health professional contact
Age, sex, actual risk status, physiological/ psychological assessment, knowledge
Control ­ comparison village (monk smoking norm) Age, sex, level of education, social class, Group 1 ­ monk discourages smoking in ceremonies actual risk status and asks all new monks to give up smoking
Control ­ national population sample Group 1 ­ health centre/community/social groups plus leaflets plus meetings plus poster information: CVD change, diet, changes in canteens and shops
Age, sex, physiological/ psychological assessment
Control ­ comparison community Group 1 ­ health screenings plus school information plus prompts and healthy changes in grocery stores Group 2 ­ media information plus changes grocery stores Group 3 ­ information diet change at community and health centre levels
Control ­ routine school nutrition information Group 1 ­ trained teachers: nutrition for life programme
Knowledge, attitudes, health professional measures
Control ­ comparison community Group 1 ­ community plus media plus health centres plus workplace plus schools information: reduction CVD risk factors
Age, sex, social class
Control ­ no additional information Group 1 ­ media and school-based information plus leaflets plus peer volunteers
Age, sex, ethnicity, living arrangements
Control ­ interviewed only Group 1 ­ examined eyes at home plus leaflet plus result letter plus phone call reminder
Age, sex, level of education, social class, marital status, ethnicity, medical history, health behaviours-general, physiological/ psychological assessment, knowledge
Control ­ Group 1 ­ information plus skills teaching about driving safety
Sex, level of education, knowledge, attitudes
Control ­ no information about control Group 1 ­ pre-intervention group (same workplace as post-intervention group) Group 2 ­ post intervention group information: feedback risk factors, screening, and CVD risks plus encouraged to attend GP
Age, sex, attitudes, health behavioursgeneral, physiological/psychological assessment, self-efficacy, intention, social reinforcement/norms
Group 1 ­ school intervention plus video plus peers volunteer information plus skill acquisition Group 2 ­ media intervention aimed at adolescents plus competition
Age, sex, social class, ethnicity, actual risk status, health behaviours-general, knowledge, social support/communication, awareness of intervention
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health
Theory Health area
253 - 1 Cessation of/adherence Social
to healthy diet in well
learning
parents of school children theory
Medicine
345 - 1 Cessation of smoking in well adults
Social
Medicine
cognition
model
416 - 1 Adherence to exercise/ diet in overweight adults
Social
Medicine
cognition
model
440 - 1 Cessation of smoking and CVD risk factors in well adults
Social learning theory
Medicine
209 - 1 Uptake of exercise in well adults 631 - 1 Adherence to/cessation of diet in well adults
Social
Medicine
cognition
model
Social learning theory
Medicine
464 - 1 Uptake of exercise in well adults
Social learning theory
Medicine
658 - 1 Cessation of/uptake of lifestyle change in well adults 726 - 1 Cessation of smoking/ adherence to exercise in well adults
Social cognition model, social learning theory
Medicine
Social learning theory
Medicine
255 - 1 Cessation of smoking in well adolescents 313 - 1 Adherence to selfmanagement in adults with medicine
Health Medicine promotion
Social
Medicine
cognition
model
367 - 2 Cessation of smoking in well adults
Social learning theory
Medicine
Comparison groups
Variables referred to
Control ­ assessment only Group 1 ­ trained teachers plus verbal plus leaflet information: change salt, fibre and diet plus parent information plus feedback Group 2 ­ letter information plus newsletter plus classes plus fridge magnet prompt Group 3 ­ Group 1 plus 2
Level of education, social class, living arrangements, ethnicity, knowledge, intention, attitude, self-efficacy, social support
Control ­ routine clinic advice on smoking cessation of Group 1 ­ trained physician assessed and targeted information to patient's stages change smoking cessation
Age, sex, ethnicity, actual risk status, health behaviours-general, health professional measures, reasons, operationalised model, awareness of intervention
Control ­ assessments only Group 1 ­ self-directed change group information: exercise and diet plus skill acquisition plus feedback problem solving plus support Group 2 ­ Group 1 plus individual counselling with health professional Group 3 ­ Group 1 plus individual counselling with peer
Age, sex, level of education, actual risk status, physiological/psychological assessment, health behaviours-general, anxiety ­ state/trait, perception of control, self-efficacy, social support/ communication, motivation, awareness of intervention, stress, coping
Control ­ no additional information Group 1 ­ social learning theory based community group leader information: risk factors and skill acquisition plus support groups
Age, sex, level of education, social class, ethnicity, physiological/psychological assessment
Control ­ routine doctor information on hepatitis B Age, sex, social class, marital status, Group 1 ­ counselling by doctor (stages of change) ethnicity, actual risk status on exercise uptake
Control ­ no media information Group 1 ­ information informed by SLT: media plus leaflet plus group meetings plus letters plus schoolbased information plus memory aids
Age, sex, level of education, physiological/psychological assessment knowledge
Control ­ assessment only Group 1 ­ Stanford five city project 6 year dissemination information: verbal plus leaflets plus media plus posters plus leaders community groups
Age, sex, ethnicity, actual risk status, physiological/psychological assessment, knowledge, attitudes, self-efficacy
Control ­ comparison community Group 1 ­ school-based, community-based, grocery shop changing, healthy restaurant menus, walking clubs, videos, newspapers
Age, sex, level of education, social class, ethnicity, actual risk status, medical history, health behaviours-general, physiological/psychological assessment, awareness of intervention
Control ­ assessment only Group 1 ­ group leaders plus institutions trained about CVD risk and prevention plus introduction screening plus media plus school plus health centres plus communities
Age, sex, actual risk status, medical history, physiological/ psychological assessment, knowledge, attitudes, awareness of intervention
Control ­ comparison community
Age, sex, social reinforcement/norms
Group 1 ­ trained teachers school-based intervention
Control ­ assessment only Group 1 ­ health professional provided information on self-care Group 2 ­ peer provided information about self-care
Age, sex, actual risk status, anxiety ­ state, knowledge, attitudes, perception of risk, perception of control, operationalised model, intention, social reinforcement/norms
Group 1 ­ quit and win programme Group 2 ­ attendees of heart check programme
Age, sex, level of education, marital status, actual risk status
continued
113
Appendix 7
114
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
370 - 1 Cessation of alcohol use in well adolescents
Social learning theory
Medicine
Control ­ school-based assessment information only Actual risk status, knowledge,
Group 1 ­ group lessons: alcohol use plus skill
perception of control, social
acquisition plus booster session
reinforcement/norms
238 - 1 Cessation of smoking in well adolescent
Social learning theory
Medicine
Control ­ comparison community Group 1 ­ leaflet plus verbal information: risks smoking and skill acquisition plus trained teachers plus ban smoking
261 - 1
Change CVD risk factors in well adolescents
Social learning theory
Medicine
Control ­ assessment only Group 1 ­ video plus group information (social learning theory) plus posters plus feedback
Actual risk status, physiological/ psychological assessment knowledge
456 - 1 Change CVD risks in well elderly adults
Social learning theory
Medicine
Control ­ assessment only Group 1 ­ peer-led group information sessions on diet, exercises and stressors
Age, sex, level of education, marital status, medical history, knowledge, self-efficacy
709 - 1 Change CVD risk behaviours in well adults
Social learning theory
Medicine
Control ­ assessment only Group 1 ­ community leaders diffuse information plus media plus exercise classes
Age, sex, level of education, marital status, self-efficacy, social reinforcement/ norms, awareness of intervention
311 - 1 Cessation of substance use in well adolescents
Health Medicine, promotion STDs (HIV)
Control ­ no additional information Group 1 ­ information framed by social influences behaviour plus skill acquisition plus media Group 2 ­ information framed to control affect plus stress management plus decision making
Sex, ethnicity
125 - 1 Cessation of drug use, None adherence to safe sex in adolescent drug users
STDs (HIV) Control ­ waiting list control Group 1 ­ Group format health information HIV plus application problem solving therapy
Age, social class, ethnicity, actual risk status, health behaviours-general, sexual orientation, law infringements
161 - 1 Cessation of/adherence None to safer sex in adults with HIV
STDs (HIV) Control ­ counselling for HIV test only (clinic 1) Group 1 ­ counselling HIV test plus information by trained counsellors on risk reduction (clinic 2)
Age, sex, level of education, marital status, actual risk status, health behaviours-general attitudes
177 - 1 Cessation of drug use
None
STDs (HIV) Group 1 ­ illustrated, leaflet plus verbal information Age, sex, level of education, social class,
and risky sex in drug
presented by sex worker on HIV risks and prevention ethnicity, actual risk status, health
users
plus free condoms plus transport to health centre behaviours-general, knowledge,
Group 2 ­ Group 1 plus additional contact sex
perception of risk
worker and provide feedback on changes
392 - 1 Uptake of safe sex in well, married women
None
STDs (HIV) Control ­ routine government family planning project Age, level of education, actual risk
Group 1 ­ information: family planning plus child
status, reproductive history, health
and parental immunisations plus re-hydration
behaviours-general, perceived
therapy for diarrhoea
satisfaction
791 - 1 Adherence to/cessation None of risky sex in adult well female sex workers
STDs (HIV)
Control ­ routine care Group 1 ­ video plus leaflet plus group discussion: HIV risk factors tailored sex workers plus free condoms plus posters plus feedback
Age, level of education, ethnicity, actual risk status, medical history, reproductive history, knowledge, self-efficacy
555 - 1 Cessation of/adherence None to risky sex in well adolescents
STDs (HIV) Control ­ no additional HIV/STD information Group 1 ­ HIV/STD information given to classes by nurse plus skill acquisition plus free condoms
Age, sex, actual risk status, living arrangements, knowledge, attitudes
665 - 1 Change in sexual practice None in well gay adult males
STDs (HIV)
Control ­ routine leaflets plus posters Group 1 ­ identify group leaders and train about HIV risk factor, prevention and skill acquisition plus place in clubs to disseminate information
Age, ethnicity, knowledge, social reinforcement/norms
579 - 1 Cessation of risky sex
None
STDs (HIV) Control ­ delayed intervention group
Age, level of education, ethnicity,
in adult well women
Group 1 ­ group plus leaflet plus video information: knowledge
(sex workers)
STD and condoms
748 - 1 Utilisation of services in adults with HIV
None
STDs (HIV) Group 1 ­ physician actively involved in patient's
health care
Group 2 ­ physician unaware patient HIV
Group 3 ­ patients not registered GP
Group 4 ­ mixed group of motivated patients
and GPs
Age, sex, social class, ethnicity, actual risk status
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
455 - 1 Adherence to contraception in well adolescent girls
None
STDs (HIV) Control ­ assessment only
Age, religion, ethnicity, knowledge,
Group 1 ­ trained staff on adolescent behaviours perceived satisfaction
plus introduction consultation protocols
71 - 1
Cessation of cocaine use, None attendance sessions in adult, pregnant cocaine users
STDs (HIV), obstetrics and gynaecology (midwifery)
Control ­ routine collection urine samples plus counselling plus coping Group 1 ­ control plus additional management counselling
Level of education, social class, ethnicity, actual risk status, reproductive history, attitudes
486 - 1 Reduction pregnancies in well adolescents
Conflict theory (Janis and Mann)
STDs (HIV), obstetrics and gynaecology (midwifery)
Control ­ baseline measures control group Group 1 ­ counselling (Janis and Mann): decisionmaking skills plus prenatal care plus adoption plus future pregnancies
Age, level of education, social class, marital status, ethnicity, actual risk status, reproductive history, self-efficacy
17 - 1
Cessation of risky sex, adherence to condoms in school children
Social
STDs (HIV) Control ­ question and answers on AIDS
cognition
Group 1 ­ presentation by person with AIDS
model
Group 2 ­ role-play (feedback) plus skill acquisition
Knowledge, attitudes
18 - 1 Cessation of steroids, male school children
Health STDs (HIV) promotion
Control ­ delayed intervention Group 1 ­ Adolescents Training and Learning to Avoid Steroids (ATLAS) classroom information: diet and alternatives to steroids plus skill acquisition plus weight room plus incentives
Level of education, social class, ethnicity, knowledge, attitudes, self-efficacy
240 - 1 Uptake of condoms/ cessation of risky sex in well adolescents
Social
STDs (HIV) Control ­ no additional HIV information
cognition
Group 1 ­ trained teachers skill-based information
model
plus feedback plus video plus skills acquisition
Age, sex, ethnicity, actual risk status, health behaviours-general, knowledge, attitudes, perception of risk, intention
251 - 1 Cessation of drug use in well adolescents
Health promotion
STDs (HIV), medicine
Control ­ no additional information Group 1 ­ school and community based information plus acquisition skills plus norms non-drug use plus media plus peers volunteers
Age, level of education, social class, ethnicity, actual risk status, health behaviours-general, living arrangements
391 - 1 Uptake of safe sex in adult well males
Health STDs (HIV) Control ­ comparative community
promotion
Group 1 ­ male motivation project plus leaflets
plus radio drama plus group discussion
515 - 1 Cessation of risky sex in well adolescents
Social cognition model
STDs (HIV)
Control ­ delayed intervention Group 1 ­ trained teachers group information (theory planned behaviour) plus feedback plus skill acquisition plus parental involvement plus T-shirts
Age, sex, health behaviours-general, living arrangements, knowledge, attitudes, social support/ communication, social reinforcement/ norms, awareness of intervention
759 - 1 Adherence to safe sex in well adolescents
Social learning theory
STDs (HIV), medicine
Control ­ routine sex education ­ matched schools Group 1 ­ verbal group information on puberty, contraception, reproduction and relationships and empowerment skills
Sex, level of education, social class, actual risk status, health behaviours-general, living arrangements, knowledge, attitudes, usefulness of information, social reinforcement/norms
628 - 1 Cessation of/adherence to risky sex
Health STDs (HIV) Control ­ usual information for runaways
promotion
Group 1 ­ additional counselling plus video: HIV
risk and prevention plus feedback plus skills
Age, sex, ethnicity, actual risk status, sexual orientation
780 - 1 Cessation of/adherence to risky/safe sex in well adults
Social learning theory
STDs (HIV)
Control ­ comparison community Group 1 ­ comics plus newsletters plus free condoms plus house call information on HIV risk factor cessation
Age, sex, level of education, social class, marital status, ethnicity, actual risk status, reproductive history, knowledge, self-efficacy
463 - 1 Cessation of risky sex in gay well males
Health STDs (HIV) Control ­ delayed onset intervention
promotion
Group 1 ­ leaflets plus posters in bars plus
university and community areas
Age, level of education, marital status, ethnicity, actual risk status, sexual orientation, self-efficacy, awareness of intervention
663 - 1 Adherence to/cessation of risky/safe sex in well adolescents
Health STDs (HIV) Control ­ assessment only
promotion
Group 1 ­ trained teachers group lessons plus
leaflet plus audio-tape plus skill acquisition
Age, sex, level of education, social class, religion, health behaviours-general, knowledge, attitudes, reasons
continued
115
Appendix 7
116
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
373 - 1 Change sexual activity in well adolescents
Social cognition model
STDs (HIV) Control ­ routine sex information Group 1 ­ verbal plus leaflet plus group information (HBM/SLT) plus skill acquisition plus feedback
Age, sex, ethnicity, reproductive history, knowledge, attitudes, perception of susceptibility, reasons, self-efficacy, operationalised model
453 - 1 Cessation of drug use in well adolescents
Social learning theory
STDs (HIV), medicine
Control ­ assessment only Group 1 ­ peer volunteer verbal information plus skill acquisition Group 2 ­ Group 1 plus booster sessions
Age, sex, ethnicity, actual risk status, living arrangements, health behavioursgeneral, knowledge, attitudes, social reinforcement/norms
822 - 1 Cessation of risky sex in well adolescents
Social cognition model, social learning theory
STDs (HIV)
Group 1 ­ brief verbal information about safe sex (school clinic) Group 2 ­ peer volunteer verbal information: HIV and prevention pregnancy (school clinic) Group 3 ­ pregnancy prevention information plus vouchers for contraception (school clinic) Group 4 ­ target high-risk groups plus provision contraception plus prompt repeat prescriptions (school clinic) Group 5 ­ pregnancy prevention information plus contraception prescribed plus prompt for repeat prescription (school clinic) Group 6 ­ all sex-related information available plus school dispensed contraception
Age, sex, reasons, awareness intervention
823 - 1 Change CVD/HIV risk factors in well adolescents
Health STDs (HIV), Control ­ assessment only promotion medicine Group 1 ­ school based module on teenage health plus skill acquisition
Age, sex, health behaviours-general knowledge, attitudes
813 - 1 Change in CVD risk behaviours in elderly adults
None
Primary
Control ­ assessment only
Age, sex, level of education, actual
care,
Group 1 ­ letters plus leaflets plus newsletter plus risk status, health behaviours-general,
medicine feedback CVD risk from physician
physiological/psychological assessment
146 - 1 Uptake of influenza
None
vaccination in well elderly
adults with a history
pneumonia
Primary care
Control ­ cases documented before intervention Group 1 ­ cases documented after intervention: trained physicians plus reimbursed for vaccine plus patient letter plus media plus leaflet
Age, sex, actual risk status, health behaviours-general
257 - 1 Adherence to health checks in elderly well adults
None
Primary
Group 1 ­ letter invitation
care,
Group 2 ­ letter plus phone call
medicine Group 3 ­ letter plus phone call plus fixed
appointment time
Group 4 ­ Group 3 plus elicited reasons
non-attendance plus encouraged attendance
Age, sex, level of education, medical history, physiological/psychological assessment, health insurance
775 - 1 Uptake of immunisation None in parents of well children
Primary care
Group 1 ­ children registered with general practice Age, living arrangements Group 2 ­ children registered with health clinics
331 - 1 Uptake of immunisation None in parents of children attended A&E
Primary care
Control ­ children attended A&E not immunised Group 1 ­ children attended A&E immunised
Age, sex, actual risk status, physiological/ psychological assessment, health insurance
95 - 1
Adherence to selfmanagement in adults with arthritis
Social learning theory
Primary care
Control ­ no additional information Group 1 ­ group counselling information session for over 6 weeks
Age, sex, level of education, actual risk status, physiological/psychological assessment, self-efficacy, disability scale
3 - 1 Uptake of breast feeding None in adult well women
Obstetrics and gynaecology (midwifery)
Control ­ no additional information Group 1 ­ trained health workers gave verbal information breast feeding plus posters plus leaflets at routine post-natal care visits
Age, level of education, marital status, religion, ethnicity, reproductive history, knowledge, perception of risk
529 - 1 Uptake of xylitol chewing None gum in adolescents
Dentistry
Control ­ no information Group 1 ­ xylitol and oral hygiene information by dental assistance plus free chewing gum
Sex, knowledge
618 - 1 Uptake of dental services Marketing Dentistry in well children and young model adults
Control ­ no change in dentistry practices Group 1 ­ reimbursement costs for children/ adults under 26 years
Age, sex, level of education, health insurance
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 28 contd Description of the decision, interventions and measures recorded in concurrent studies
Study Summary decision number and area of health
Theory Health area
430-1 Reproductive decision in None Tay­Sachs carriers
Genetics
Comparison groups Group 1 ­ genetic counselling information Tay­Sachs and reproductive options
516 - 1 Uptake of carrier testing in well adults
Social
Genetics
cognition
model
Group 1 ­ letter invitation plus if interested counsellor appointment plus leaflet Group 2 ­ approached patients in health centre plus leaflet plus counselled and tested
323 - 1 Adherence to
None
medication and
attendance clinic in
symptomatic adults
586 - 1 Adherence to treatment None in adolescents with TB
452 - 1 Adherence to treatment None in patients with TB
124 - 1 Adherence to
None
medication in adults
with schizophrenia
825 - 1 Adherence to
None
medication in adults
with schizophrenia
335 - 1 Adherence to
None
medication in parents
of children with
diarrhoea
570 - 1 Adherence to safety
None
in well adolescents
773 - 1 Uptake of bicycle safety None in well children plus parents
40 - 1
Reporting symptoms in None adult women with bladder complaints
75 - 1 Use of health care in
None
adult well patients
Infectious disease
Control ­ no additional information Group 1 ­ social network group, researchers attend community group meetings: information plus offer free health centre treatment Group 2 ­ media group: posters plus town criers give same information
Infectious disease
Group 1 ­ directly observed preventive therapy taken within school Group 2 ­ hospital based medication (not observed)
Infectious Routine ­ routine patient care for TB
disease
Group 1 ­ staff training and supervision on TB
Mental health
Control ­ remained on oral medication Group 1 ­ patients changed from oral to injecting medication
Mental health
Control ­ no information about control group Group 1 ­ only told group meetings
Paediatrics Control ­ interviewed only Group 1 ­ posters plus demonstration how to mix salt-sugar solution plus feedback
Other Other Surgery
Control ­ assessment only Group 1 ­ peer presented information: accidents, disabilities and risk taking Group 2 ­ Group 1 information given by health professional Control ­ letter to parents and children plus teen magazine plus voucher for bike shop Group 1 ­ control plus high profile in school: posters, stickers, stunt bike rider demonstration Control ­ paper-pen diary of symptom recording Group 1 ­ computer symptom reporting
Surgery
Group 1 ­ medical assistance and no health insurance Group 2 ­ private insurance
Variables referred to Marital status, ethnicity, attitudes, perception of risk, affect, intentions, autonomy decision making Age, sex, level of education, marital status, ethnicity, reproductive history, knowledge, attitudes, perception of risk, need cognition/certainty, need cognitive closure/ambiguity, intention Age, sex, social class Age, sex, ethnicity Age, sex, actual risk status, medical history, living arrangements Sex, ethnicity, actual risk status Actual risk status, medical history, attitudes, reasons Age, level of education, social class, religion, reproductive history, knowledge Age, sex, level of education, actual risk status, medical history, knowledge, perception of risk, perception of control, reasons, self-efficacy, intention, awareness of intervention Age, sex, social class, family history, health behaviours-general, reasons, knowledge, attitudes, intention, social reinforcement/norms Age, ethnicity, actual risk status, depression, other affect Age, sex, social class, marital status, health insurance attitudes
117
Appendix 7
118
TABLE 29 Description of decision, intervention and measures recorded in studies: before/after different samples
Study Summary decision number and area of health
Theory Health area
Comparison groups
Variables referred to
34 - 1 Uptake of mammography None in adult well women
Cancer
Group 1 ­ prompt on patient's notes
100 - 1 Uptake of mammography None in well women
Cancer
Group 1 ­ letter of invitation
Age, actual risk status, health insurance
192 - 1 Uptake of cervical
None
Cancer
Age
screening in adult
well women
383 - 1 Uptake of mammography None in well based adult women
Cancer
Group 1 ­ reduced-fee mammogram plus media plus presentations in workplaces/health centres
Age, ethnicity, social class, level of education, medical history, knowledge, awareness of intervention
421 - 1 Uptake of mammography/ None BSE in well women
Cancer
Group 1 ­ health professional encouragement plus monthly clinics plus calendar prompts plus selfreferral contact number
Age, level of education, social class, attitude
575 - 1 Uptake of cervical screening in well women
None
Cancer
Group 1 ­ introduction mobile screening unit
plus information
Age, marital status, level of education, social class, knowledge
401 - 1 Uptake of mammography None
Cancer
Group 1 ­ trained staff plus reminder system
Age
in well women
implemented plus prompt sheet in reviewed notes
plus noted women's breast cancer history
765 - 1 Adherence to sun protective behaviours in well adults
Social learning theory
Cancer
Group 1 ­ poster plus leaflet: skin cancer and protection plus feedback plus peer volunteers plus raffle plus free sunscreen
495 - 1 Uptake of living will in
None
Medicine Group 1 ­ leaflet on patient self-determination act
Age, sex, level of education, social class,
recently hospitalised
and information on living will
ethnicity, knowledge, attitudes
adults
340 - 1 Cessation of smoking in well adults
None
Medicine Group 1 ­ community intervention: media plus
posters plus leaflets plus volunteers plus free
cessation classes plus prize-draw
Age, sex, level of education, ethnicity, knowledge, awareness of intervention
423 - 1 Cessation of smoking in None drug dependent adults
Medicine, Group 1 ­ change in hospital policy to no-smoking STDs (HIV) zone plus patients sign no-smoking contract
550 - 1 Cessation of drug use
None
Medicine, Group 1 ­ introduction no-smoking ban in hospital Age, level of education, social class,
in elderly substance
STDs (HIV)
marital status, actual risk status, medical
using men
history, health behaviours-general
514 - 1 Cessation of smoking in None pregnant well women
Medicine, obstetrics and gynaecology (midwifery)
Group 1 ­ media campaign plus trained professionals plus quitline: emphasis quitting not cutting down
Age, social class, level of education, reproductive history, knowledge, attitudes, awareness of intervention
461 - 1 Cessation of drinkdriving in well adults
None
Medicine, Group 1 ­ media campaigns increase seat belt use,
Awareness of intervention
other
maintain speed limits, reduce drunk driving, fines
462 - 1 Cessation of/adherence to CVD risk factors in well adults
Social cognition model, social learning theory
Medicine
Group 1 ­ information based social learning theory: group leaders plus increase exercise clubs plus health fairs plus health checks plus school competitions
Age, sex, level of education, ethnicity
670 - 1 Uptake of HIV screening None in well adults
STDs (HIV) Group 1 ­ all media campaigns over 4-year period
Sexual orientation
680 - 1 Uptake of safe sex/ cessation of risky sex in adults with STDs
None
STDs (HIV) Group 1 ­ media campaigns advocating
condom use
Sex, ethnicity, sexual orientation, medical history, social class
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 29 contd Description of decision, intervention and measures recorded in studies: before/after different samples
Study Summary decision number and area of health 662 - 1 Adherence to safer sex in adults with STDs
Theory Health area
Comparison groups
None
STDs (HIV) Group 1 ­ announcement `magic johnson'
(basketball player) as HIV positive
142 - 1 Change HIV risks in adult None substance users
STDs (HIV) Group 1 ­ introduction of sale syringes in pharmacies within France
619 - 1 Change HIV behaviours None in well adult men
STDs (HIV) Group 1 ­ media plus posters plus group information and feedback sessions
647 - 1 Cessation of risky sex in well gay men
Health STDs (HIV) Group 1 ­ `trend-setter' peer trained to give
promotion
information in clubs, identified by eye-catching
badge to start conversations
193 - 1 Uptake of immunisation None in mothers of new-borns
Primary care, Control ­ noted attendance at clinics paediatrics Group 1 ­ leaflets about childhood immunisations
767 - 1 Uptake of immunisation None in parents of well children
Primary care Group 1 ­ region-based intervention: feedback non attendees to health professional plus trained health professionals
413 - 1 Uptake of immunisation None in well adults (high-risk influenza)
Primary care Group 1 ­ introduction of immunisation status in notes
623 - 1 Uptake of breast feeding None in well women
Obstetrics and gynaecology (midwifery)
Group 1 ­ introduction new staff position for baby feeding and changes on ward
26 - 1 Breast feeding in adult well women
Marketing model
Obstetrics and gynaecology (midwifery)
Group 1 ­ trained health professionals plus leaflets and video in clinic increased profile breast screening plus prompts in notes
97 - 1 Adherence to dental hygiene in well adults
None
Dentistry Group 1 ­ large public campaign media plus
posters plus leaflets
737 - 1 Attendance for dental
None
check ups in well adults
Dentistry Group 1 ­ verbal information on importance periodontal care plus made fixed appointments
563 - 1 Utilisation of services and None uptake of dental treatment in well children
Dentistry Group 1 ­ changed examination/treatment from attending fixed clinic to attending mobile unit
239 - 1 Adherence to sleeping
None
Paediatrics Group 1 ­ home visit midwife information plus
position baby in
feedback plus telephone contact
adolescent mothers
294 - 1 Utilisation of services
None
plus testing for fragile X
in well adults
674 - 1 Attendance for surgery None in women undergoing hysterectomies
149 - 1 Uptake of bicycle helmet None in school children
Genetics
Group 1 ­ dissemination fragile X video and leaflet information by agencies
Surgery
Group 1 ­ introduction nurse information at pre-operative assessment clinic
Other
Group 1 ­ media plus posters plus leaflets plus community events plus verbal information plus feedback plus reduction price helmets plus changing roads for bike paths
Variables referred to Age, sex, level of education, marital status, ethnicity, actual risk status, health behaviours-general, reasons, living arrangements knowledge, attitudes, perception of risk, perceived satisfaction Age, sex, level of education, social class, marital status, ethnicity, actual risk status, medical history, reproductive history, health behaviours-general, living arrangements, knowledge Age, social class, reasons, living arrangements, sexual orientation Age, sex, ethnicity, knowledge, social norms Age, level of education, social class, ethnicity, reproductive history, health behaviours-general, memory, reasons Deprivation indices Reasons Perceived satisfaction Age, social class, religion, reproductive history, health insurance, perception of risk, reasons Knowledge Age, ethnicity Age, marital status, level of education, social class, health behaviour, physiological/psychological assessment, reasons, knowledge Usefulness information Satisfaction, anxiety Age, sex
119
Appendix 7
120
TABLE 30 Description of decision, intervention and measures recorded in studies: before/after same sample
Study Summary decision number and area of health
Theory Health area
Comparison groups
99 - 1 Uptake of mammography None in adult well women
Cancer
Group counselling with feedback and ways to overcome barriers to screening (devised a board game)
266 - 1 Adherence to safe sun None in adults with skin cancer
Cancer
Verbal plus leaflet information on sun protection following removal of non-melanoma skin cancer plus feedback own behaviour
746 - 1 Uptake of breast and cervical screening in well adult women
None Cancer
Trained volunteers plus community workshops plus posters plus media plus video
815 - 1 Uptake of testicular self-examination in well adolescents
None Cancer
Leaflet plus lecture from health professional on testicular self-examination
795 - 1 Uptake of cervical
None
screening in well women
Cancer
GP contract plus computerised systems
809 - 1 Uptake of mammography None in well women
Cancer
One-to-one counselling plus trained health professional plus posters plus leaflets plus media plus prompt on notes plus reminders
133 - 1 Adherence to/cessation of healthy lifestyle in school children
None
Cancer, medicine
Schools funded projects, trained teachers information: heart disease, cancer nutrition and exercise programmes
466 - 1 Uptake of screening/ immunisation in well adults
None
Cancer,
Group 1 ­ prompt in notes for GP: screenings
primary care, and immunisations
medicine
46 - 1
Uptake of mammography in adult well women (family history breast cancer)
Self-
Cancer
regulation
theory
Group 1 ­ targeted women family history breast cancer: diet, BSE, and mammography
126 - 1 Uptake of mammography and BSE in well women
Expected Cancer utility theory
Group 1 ­ leaflets about mammography and BSE
198 - 1 Adherence to safe sun in adults with skin cancer
Social Cancer cognition model
Group 1 ­ trained volunteer plus leaflet information skin care
42 - 1 74 - 1 79 - 1
Utilisation of services and adherence to medication
None
Adherence to
None
medication adult patients
with medicine
Adherence to lifestyle None in school children
Medicine Medicine Medicine
Patient chart with personalised medication details, symptoms and course of action Self-management educational control programme Video information: diet, exercise, smoking cessation plus additional exercise activities
111 - 1 Completion advance directives in patients with haemodialysis
None Medicine
Leaflet on advance directives plus opportunity to talk with nurse
244 - 1 Uptake of exercise in well adults
None Medicine
Trained physicians plus leaflet plus verbal information exercise plus follow-up phone call plus note prompt
Variables referred to Age, knowledge, attitudes Age, sex, ethnicity, medical history, actual risk Age, sex, ethnicity, knowledge, reasons Knowledge, attitudes Age Age, health insurance Actual risk status, health behavioursgeneral, physiological/psychological assessment, knowledge, attitudes Age, sex, ethnicity, health insurance Knowledge, attitudes, perception of risk Age, level of education, ethnicity, attitudes, perception of susceptibility, efficacy Age, sex, level of education, social class, health behaviour, knowledge, attitudes, self-esteem, perception of control, perception of risk Actual risk status, health behaviours-general Age, sex, physiological/psychological assessment knowledge Age, sex, level of education, ethnicity, actual risk status, family history, health behaviours-general, physiological/ psychological assessment, attitudes, perception of risk, stress Age, sex, level of education, marital status, religion, ethnicity, actual risk status, medical history, knowledge, attitudes, reasons Age, sex, level of education, social class, marital status, living arrangement, health insurance, social norms, self-efficacy continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 30 contd Description of decision, intervention and measures recorded in studies: before/after same sample
Study Summary decision number and area of health 270 - 1 Smoking cessation of in well adults
Theory Health area None Medicine
Comparison groups Group 1 ­ verbal information plus group sessions plus self-monitoring plus skill acquisition
355 - 1 Uptake of exercise in well men (worksite)
None Medicine
Group 1 ­ free exercise classes plus group activities plus feedback plus prize for weight loss
384 - 1
Uptake of screening, cessation of/adherence to healthy lifestyle in well adults (workplace)
None
521 - 1 Self-care in elderly adults None with medicine
676 - 1 Self-management in adults with asthma
None
Medicine Medicine Medicine
522 - 1 Adherence to selfmanagement in adults with asthma
None
544 - 1 Adherence to selfmanagement in adults with asthma
None
262 - 1 Smoking cessation of
None
in well adults (workplace)
Medicine Medicine Medicine
Group 1 ­ free screening plus health professional feedback on blood pressure, cholesterol levels and lifestyles changes Group 1 ­ group counselling plus self care skill acquisition for medicine Group 1 ­ self-management `credit card' to record peak flow rates and other self-management behaviours Group 1 ­ asthma action plan: checklist for patients and GPs to assess together plus media Group 1 ­ self-monitoring skills plus information asthma plus summary management plan Group 1 ­ smoking cessation information plus buddy system plus gum
449 - 1 Adherence to medication None in children with asthma
Medicine
Group 1 ­ leaflet plus diary card plus feedback on medication within daily routine
798 - 1 Change in CVD behaviours in well adult males
None Medicine
Group 1 ­ information about CVD risks and screening
821 - 1 Uptake of exercise/ cessation of smoking in adults with CVD
None Medicine
Group 1 ­ information CVD risk and prevention plus exercise programme
621 - 1 Uptake of weaning food in children of well adults
None
Medicine, obstetrics and gynaecology (midwifery)
Group 1 ­ piloted and culturally appropriate information on making weaning food, groups, skill acquisition
348 - 1
Uptake of/cessation of lifestyle and osteoporosis screening in women
None
Medicine,
Group 1 ­ leaflet plus opportunity group
primary care information plus free screening
162 - 1 Adherence to healthy diet in elderly, physically ill adults
None
Medicine, primary care
Group 1 ­ nurse education programme plus memory prompts plus media plus change menu in residential home plus social reinforcement plus incentive game
84 - 1 Cessation of drink-driving None in adolescents
Medicine, other
Nurse information on car crashes injuries plus interactive sessions on prevention
594 - 1 Adherence to medication in adults with hypertension
Framing information, shared consultation
Medicine
Group 1 ­ interactive video, content depends on disease type: mild hypertension, alter risk through lifestyle change; BPH, encouraging systematic decision making of all alternatives
Variables referred to Age, sex, ethnicity, level of education, social class, affect, reasons, perceived satisfaction Age, level of education, social class, ethnicity, marital status, health behaviour, physiological/ psychological assessment Age, sex, ethnicity, social class, family history, medical history, physiological/ psychological assessment Physiological/psychological assessment, knowledge, affect, coping Age, sex, ethnicity, actual risk status, physiological/ psychological assessment Age, sex, physiological/psychological assessment Age, sex, social class, actual risk status, medical history, knowledge Age, sex, social class, ethnicity, actual risk status, physiological/ psychological assessment Age, sex, medical history Age, actual risk status, health behaviours-general, physiological/ psychological assessment Age, sex, actual risk status, medical history, physiological/psychological assessment Age, level of education, social class, actual risk status, reproductive history, reasons, knowledge, attitudes, awareness of intervention Age, level of education, social class, family history, health behaviours, health insurance knowledge Age, sex Age, sex, level of education, actual risk status, medical history, physiological/ psychological assessment, worry, attitudes, perception of risk, need cognitive closure, autonomy in decision making, usefulness of information continued
121
Appendix 7
122
TABLE 30 contd Description of decision, intervention and measures recorded in studies: before/after same sample
Study Summary decision number and area of health 179 - 1 Cessation of smoking in adults with asthmatic children 367 - 1 Cessation of smoking in well adults
91 - 1
Use of condoms, cessation of risky sex in adults with HIV
38 - 1
Uptake of condoms, cessation of risky sex in school children
49 - 1
Cessation of risky sex, uptake of condoms in school children
123 - 1 Adherence to safer sex, cessation of drug use in adolescent gay males
Theory Health area Health Medicine promotion
Social learning theory None
Medicine STDs (HIV)
None STDs (HIV)
None STDs (HIV)
None STDs (HIV)
Comparison groups Group 1 ­ counselling sessions advising patients risk smoking plus coping strategies Group 1 ­ up in smoke ­ no-smoking groups, lottery incentive, recruited through media HIV patients counselled about HIV and high-risk behaviours Introduction health centres at schools plus routine visits scheduled plus information about safer sex AIDS information given by medical students plus interactive sessions plus video Peer volunteer plus video plus group information: on safe sex and drug use
159 - 1 Cessation of/adherence to safer sex in well adult men
None
STDs (HIV) Group 1 ­ workshops discussing risky sex plus skills acquisition
480 - 1 Cessation of/adherence to safe sex in well adolescent women
None
651 - 1 Adherence to safe sex/ None HIV testing in adult well plus seropostive women
655 - 1 Uptake of contraception None in well women
688 - 1 Condom use in seropositive adults (work)
None
729 - 1 Cessation of risky needle behaviour in drug using adults 770 - 1 Change HIV behaviours in drug using adults
None None
610 - 1 Cessation of/adherence None to risky sex in well adults
467 - 1 Adherence to/cessation of HIV risk factors in well adolescents
None
723 - 1 Use condoms in female None sex workers with STD
545 - 1 Cessation of risky sex in adults with HIV
None
650 - 1 Cessation of risky HIV behaviours in pregnant women
None
STDs (HIV) Group 1 ­ peer volunteer individual counselling plus leaflet on HIV risks
STDs (HIV) Group 1 ­ video plus Group discussions led by physician plus free condoms plus spermicides
STDs (HIV) STDs (HIV) STDs (HIV)
Group 1 ­ contraception video plus free contraception Group 1 ­ counselling couples to use condoms plus free condoms plus calendar to mark off when used condoms Group 1 ­ verbal information on HIV, drug and sex behaviour plus clean needles and cleaning kit
STDs (HIV) STDs (HIV) STDs (HIV)
Group 1 ­ trained outreach workers plus additional visits to drug users plus free bleach and condoms plus leaflets plus free transport to centre Group 1 ­ use of puppets show: seriousness, transmission, avoidance of HIV (shows video) Group 1 ­ video plus leaflet plus group discussion about HIV
STDs (HIV) STDs (HIV) STDs (HIV), obstetrics and gynaecology (midwifery)
Group 1 ­ free condoms plus group discussions plus design poster Group 1 ­ HIV counselling and testing plus scheduling follow-up visit (no details information) Group 1 ­ group session HIV/AIDS transmission and testing
Variables referred to Actual risk status Age, sex Age, sex, ethnicity, knowledge Age, social class, medical history, reproductive history, health behaviours-general Age, sex, knowledge, attitudes, perception of risk Age, level of education, social class, marital status, ethnicity, actual risk status, health behaviours-general knowledge, attitudes Age, ethnicity, level of education, social class, marital status, sexual orientation, religion, health behaviours, actual risk attitudes, knowledge, self-efficacy, intentions Age, ethnicity, health insurance, level of education, social class, knowledge Age, marital status, actual risk status, medical history Age, marital status, actual risk status, reproductive history, reasons Age, sex, marital status, medical history, reasons Age, sex, ethnicity, actual risk knowledge Age, sex, level of education, social class, actual risk Age, sex, ethnicity, worry, knowledge, perception of risk, usefulness of information Age, sex, social class, knowledge, attitudes, perception of risk Age, level of education, marital status, knowledge, living arrangements, efficacy Age, sex, ethnicity, actual risk status Age, marital status, ethnicity, knowledge, attitudes, intention continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 30 contd Description of decision, intervention and measures recorded in studies: before/after same sample
Study Summary decision number and area of health 537 - 1 Attendance clinic in adults with HIV
35 - 1
Uptake of condoms, cessation of risky sex in school children
Theory Health area
Comparison groups
None
STDs (HIV), primary care
Group 1 ­ separate waiting area for women and children plus increase female staff plus free transport plus onsight colposcopy
None
STDs (HIV)
Group 1 ­ video plus leaflets plus large and small group information plus peer volunteer plus skills training
364 - 1 Adherence to safer sex in adult well women
Social learning theory
STDs (HIV)
Group 1 ­ small group plus video social cognition theory driven information (piloted): skill acquisition plus exercises plus HIV and condom use
526 - 1
Adherence to/ cessation of risky sex in gay adolescent males
Social cognition model, social learning theory
STDs (HIV)
Group 1 ­ video plus small group information plus art plus skill acquisition plus confronting barriers information plus access to services
654 - 1
Cessation of/ adherence to HIV behaviours in gay well adult males
New model testing
STDs (HIV)
Group 1 ­ Stop AIDS project: group information HIV and testing plus skill acquisition plus feedback plus `contract' to change behaviour
450 - 1
Change HIV risks in women with substance using partners
Social cognition model, social learning theory
STDs (HIV)
Group 1 ­ HIV information plus skill acquisition plus free bleach plus condoms plus incentives
573 - 1 Uptake of immunisation None in well adults
Primary care Group 1 ­ lecture plus group discussions plus leaflet
342 - 1 Uptake of immunisation None (influenza) in well adults
Primary care Group 1 ­ information by physician at day health centre plus free vaccine
132 - 1 Uptake of breast feeding None in well women
Obstetrics and gynaecology (midwifery)
Trained health professionals on breast feeding and skills plus encourage `rooming in' in hospital plus encourage support groups
163 - 1 Adherence to
None
handwashing in pregnant
women with children
Obstetrics and gynaecology (midwifery)
Group 1 ­ information on transmission of cytomegalovirus and affects fetus plus provision latex gloves plus liquid soap
361 - 1 Adherence to behavioural None therapy programme in mentally ill adults
Mental health
Group 1 ­ discussion of patient targets within group plus problem solving
Variables referred to Age, sex, ethnicity, actual risk status Age, sex, ethnicity, actual risk status, health behaviours-general, reproductive history, attitudes, social reinforcement/ norms Age, level of education, religion, knowledge, attitudes, self-efficacy, perception of norms Age, actual risk, health behaviour, knowledge, perception of risk, self efficacy, perception of control, social support, perception of norms, stress, coping, anxiety, depression Age, ethnicity, knowledge, attitudes, self-efficacy Level of education, social class, ethnicity, actual risk status, reproductive history, perception of control Knowledge, attitudes Social class, attitudes, reasons Reasons Age Age, sex, marital status, level of education, actual risk
123
Health Technology Assessment 1999; Vol. 3: No. 1
Appendix 8 Intervention details by study design (grouped by health area in same order as appendix 7)
TABLE 31 Description of the quality of the study and summary results: RCTa
Study Intervention Sample size number level
Summary of results
23 - 1 Patient
? / 69 / ? Convenience sample
Intervention associated with increase in amount of self-care behaviours
39 - 1 Patient
878 / 659 / ? Total sample available
Signed letter by GP more likely to increase self-report smear attendance than letter sent by clinic or information alone
41 - 1 Patient
? / 465 / 450 Total sample available
Signed letter by GP increased uptake of refusers from 10% to 21%
52 - 1 Patient
151 / 151 / 151 Total sample available
Uptake of mammography greater with telephone call reminder irrespective of identity caller. Medical assistant group most cost-effective
85 - 1 Patient
907 / 722 / 722 Total sample available
Authors claim prompt on contraceptive packet increased performance of BSE (57% vs. 49% at 6 months). Both interventions increased adherence to BSE after intervention. Note: large attrition and only a random sample of women's results reported
108 - 1 Patient
? / 283 / 283 Convenience sample
Uptake of FOB testing not associated with manipulation of stools or simplification of screening technique
122 - 1 Patient
? / 1842 / 1842
Uptake of colorectal cancer screening not associated with type of screening method
Not adequately described
316 - 1 Patient
1455 / 278 / 212 Systematic sample
No significant increase in attendance for colorectal screening following the letter-based information intervention (4% vs. 9%)
509 - 1 Patient
153 / 119 / 105 Total sample available
Voucher intervention increased attendance for mammography (44% vs. 10%)
101 - 1 Patient
150 / 150 / 150 Total sample available
Intervention not associated with uptake of mammography. Note: positively framed message associated with greater intention to attend than the routine letter
117 - 1 Other
228 / 171 / 171 Total sample available
Elderly educator and modified information was associated with increased adherence to screening
197 - 1 Patient
100 / 81 / 81 Systematic sample
Supplying screening kit plus information increased uptake of colorectal screening from 0% to 51%. HBM operationalised
275 - 1 Patient
2076 / 2076 / 1476 Total sample available
Interventions not associated with differential uptake rates (49%, 41%, 42%, 45%)
53 - 1 Patient
? / 267 / ? Total sample available
Adherence to self-report medication improved from 12% to 18% with use of the computerised telephone (p = 0.03)
50 - 1 Patient
184 / 184 / ? Total sample available
Counselling group reported changes in exercise uptake (16% vs. 50%), diet (19% vs. 33%) but no changes for smoking or alcohol intake. Biophysical markers not associated with changes
64 - 1 Patient
5282 / 4195 / 1098 Total sample available
Trend towards significance for smoking cessation but no significant difference on alcohol use and exercise uptake
118 - 1 Other
92 / 72 / 72 Systematic sample
Intervention associated with increase in number of quit attempts and a trend towards significance for smoking outside the home
216 - 2 Not recorded ? / ? / ?
Flat fee intervention had higher uptake than refundable deposit intervention (p < 0.0001)
Not adequately described
continued
125
Appendix 8
126
TABLE 31 contd Description of the quality of the study and summary results: RCTa
Study Intervention Sample size number level
Summary of results
229 - 1 Patient
386 / 106 / 106 Total sample available
No differences in number people quitting smoking. Note, increasing cost of nicotine gum associated with decreasing attempts at obtaining gum and quit attempts
350 - 1 Patient
? / 647 / 647 Convenience sample
Both physician-based information intervention groups associated with the same rate of cessation (approximately 11%)
483 - 1 Other
762 / 410 / 352 Convenience sample
No association between training pharmacists and patient adherence
648 - 1 Patient
? / 504 / 398 Convenience sample
No differential effects groups on smoking cessation (56% vs. 66% vs. 68%). Caution: two work-site samples differed at baseline
793 - 1 Patient
1772 / 1686 / 1686
Additional information not associated with smoking cessation. Nicotine patch associated with
Not adequately described increase in cessation (11% to 19%)
781 - 1 Patient
? / 122 / 115 Systematic sample
Self-management associated with reduction in use of antibiotics, ambulatory care and days taken off work (p < 0.05)
755 - 1 Not recorded 1600 / 1381 / 1053 Systematic sample
Analysis performed control 2 and Group 4: Group 4 associated changes in alcohol and fat consumption, increase fruit and vegetables (p < 0.01) but no change in smoking or exercise
67 - 1 Patient
1581 / 661 / ? Systematic sample
Information intervention not associated with changes in preferences for CPR. Analysis suggested knowledge Alzheimer's disease, age, income and ethnicity were associated with reduced rates of resuscitation
196 - 1 Patient
221 / 131 / 122 Total sample available
Telephone support associated with adherence to more regular meals and use of community resources but no change in smoking cessation
714 - 1 Patient
190 / 190 / 184 Total sample available
Intervention associated with fewer missed appointments and increased adherence to treatment (p < 0.01)
200 - 1 Patient
? / 535 / 520 Total sample available
Intervention associated with increase in physical activity and reductions in CVD risk factors
724 - 1 Patient
1171 / 994 / 814 Total sample available
Intervention associated with increase in smoking cessation (9% vs. 14%; p < 0.01). Cost calculation provided
581 - 1 Patient
? / 363 / 326 Convenience sample
Information intervention not associated with changes in smoking cessation (8% vs. 10%)
542 - 1 Patient
? / 100 / 100 Convenience sample
Positive frame associated with increased consent to study (67% vs. 42%; p < 0.01). Interaction with reasons for choice
120 - 1 Other
3989 / 3704 / 2082 Total sample available
Participants in control group less likely to respond. No association between the intervention and self-report of alcohol use. Note: little description of control group so difficult to interpret findings
301 - 1 Patient
46 / 41 / 28 Total sample available
Increased information on side-effects not associated with changes in adherence to medication. Caution: small sample size
325 - 1 Patient
74 / 54 / 54 Convenience sample
No reliable differential effects between intervention groups on increased uptake of exercise. Both interventions increased uptake over time (p < 0.001)
202 - 1 Patient
80 / 80 / 80 Total sample available
Intervention not associated with increased attendance (68% vs. 53%). However, those failing to attend first appointment more likely to respond to a reminder phone call (84% vs. 52%)
393 - 1 Patient
97 / 90 / 83 Total sample available
Intervention not associated with changes in risky or safe sex
741 - 1 Patient
500 / 256 / 186 Total sample available
Attendance at STD clinic associated with reduction in sexual partners, HIV testing intervention and associated increased use condoms (p = 0.05). Purpose of study to assess impact of offering HIV testing
107 - 1 Other
? / 1213 / 808 Systematic sample
Intentions to engage in safer sex greater in intervention group (p < 0.0001). Operationalising social cognitive framework
585 - 1 Other
383 / 138 / 98 Convenience sample
Authors claim intervention associated with increase in condom use
799 - 1 Patient
? / 128 / 100 Convenience sample
Social skills and culturally appropriate information associated with increase in safer sex (p < 0.05)
299 - 1 Other
8069 / 5242 / ? Total sample available
All reminders associated with increase in attendance for tetanus immunisation (p < 0.0001). Letter reminder produced greater attendance than physician or nurse reminder
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 31 contd Description of the quality of the study and summary results: RCTa
Study Intervention Sample size number level
Summary of results
378 - 1 Patient
1068 / 1068 / 1068 Total sample available
Postcard reminder increased immunisation rates from 9% to 25%
638 - 1 Patient
? / 497 / 434
Telephone intervention associated with less utilisation of primary and hospital care, shorter stays
Not adequately described in hospital, less medication. Cost calculation provided
387 - 1 Patient
163 / 120 / 120 Total sample available
Intervention associated with greater question-asking by patient. Results presented with socio-economic status interaction
333 - 1 Patient
5132 / 254 / 254 Systematic sample
Intervention associated with increase in immunisation and need for physician, decrease in use of medication (p < 0.01)
425 - 1 Patient
3252 / 2794 / ? Total sample available
Intervention associated with fewer scans, day admissions and decreased satisfaction with service
778 - 1 Patient
3368 / 1691 / 1691 Total sample available
Individual information increased attendance for serum screening. General information reduced attendance for CF carrier testing. Note: low attendance at classes (52%)
678 - 1 Patient
854 / 814 / 814 Total sample available
Team care intervention associated with increased attendance to ante-natal clinic and perception of more informed choice for patient decision making
606 - 1 Patient
516 / 516 / 516 Total sample available
Nurse intervention associated with greater attendance at follow-up (51% vs. 40%) and reduced number of attempted suicides (11% vs. 17%)
427 - 1 Patient
68 / 47 / ? Total sample available
Adherence to medication more likely to be achieved in medication group
127
Appendix 8
128
TABLE 32 Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
352 - 1 Patient
187 / 187 / 187 Total sample available
Small incentive not associated with increased uptake of mammography
352 - 2 Patient
184 / 184 / 184 Total sample available
No differential effect of telephone and postcard reminder with uptake of mammography
352 - 3 Patient
63 / 63 / 63 Total sample available
Signed physician letter associated with increased attendance for mammography and breast screening clinic (p < 0.05)
353 - 1 Other
? / 769 / 594 Convenience sample
Phone call reminders by acquaintances associated with increased uptake of mammography (49% vs. 34%; p < 0.001)
420 - 1 Patient
? / 2201 / 2201 Systematic sample
Intervention associated with increased uptake of colorectal screening (Group 3 significantly greater than other groups: 48% vs. 27%, 37%, 37%). Gain/loss framing of messages not associated with uptake of colorectal screening
482 - 1 Patient
? / 2201 / 1565 Systematic sample
Interventions not associated with increase adherence to colorectal screening
653 - 1 Patient
? / 3726 / 3726 Systematic sample
Informing women about research project not associated with uptake of breast cancer screening (53% vs. 53%)
675 - 1 Patient
153 / 153 / 153 Total sample available
Completion colorectal screening not associated with length of time to take samples (3 or 6 days). Adherence associated with dietary restrictions (28% vs. 53%)
683 - 1 Patient
? / 966 / 966 Total sample available
Differential effects in uptake rate (Group 1: 48%; Group 2: 55%; Group 3: 46%; Group 4: 31%: Group 523%). Cost­benefit analysis carried out
491 - 1 Patient
? / 614 / 439 Convenience sample
Interventions not associated with differential effect self-report BSE. Increase in self-report over time. Inappropriate statistics and erroneous exclusion of subjects
533 - 1 Patient
? / 614 / 479 Convenience sample
Differential effects associated with intervention, individual feedback on own breast associated with better BSE technique (p < 0.01)
566 - 1 Patient
? / 325 / 325 Convenience sample
Stamped addressed envelope increased return rate from 61% to 74%. Interaction reported with whether insured or not
705 - 1 Other
? / 543 / 262 Total sample available
Interventions not associated with changes in safe-sun behaviour
728 - 1 Patient
1143 / 834 / 834 Systematic sample
Differential effects in increasing uptake of cervical smear (5%; 11%; 30%; 26%). Personal visit associated with increased attendance rather than video
630 - 1 Patient
799 / 799 / 782 Total sample available
No differential effect interventions on women's attendance for breast screening (11% vs. 8% vs. 13%)
285 - 1 Not recorded ? / ? / ?
Poor explanation study, results reported only for refund vs. free test. Free test increased
Not adequately described screening (42% vs. 56%)
727 - 1 Patient
437771 / 2266 / 2266 Systematic sample
Fixed appointment associated with increase in attendance (27% vs. 40%). Second intervention study not reported as unclear explanation
543 - 1 Patient
2131 / 1912 / 1912 Total sample available
Intervention associated increase cervical smear attendance (28% vs. 13%). Higher in those attending breast screening (42% vs. 20%)
587 - 1 Patient
669 / 205 / 205 Total sample available
Increased information associated with decreased interest in prostrate screening (p < 0.05)
713 - 1 Patient
? / 125 / 108 Systematic sample
Intervention associated with increased attendance at follow-up clinic (75% vs. 46%). Note: little information on attrition
48 - 1 Other
995 / 553 / ? Total sample available
Women already in hospital had greater uptake of cervical smears (72%). No difference in uptake of smears between information only and control group (24% vs 20%)
488 - 1 Patient
169 / 102 / 100 Total sample available
Interactive computer screen associated with increased intention to take part in clinical trial compared with audio-taped information. Concerned with informed patient decision making
86 - 1 Other
?/?/?
Intervention associated with increase in cervical and mammography uptake
Not adequately described
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
114 - 1 Patient
? / 1104 / 405 Systematic sample
Patients belief interventions were twice as effective as routine information
232 - 1 Patient
? / 802 / 626 Systematic sample
Intensive education intervention not associated with a differential effect uptake of mammography. Operationalised HBM
438 - 1 Patient
? / 181 / 133 Convenience sample
Intervention associated with a trend towards significance (gain 52%, loss 66%; p = 0.07). Operationalised prospect theory
784 - 1 Patient
3291 / 3291 / 3290 Total sample available
Authors claim attendance increased to 70% if woman interviewed (42% overall). Actual uptake by group unclear as analysis to assess predictors of uptake
700 - 1 Patient
? / 142 / 92
Question-based intervention increased question asking (35% vs. 16%). Assessed preference of
Not adequately described consultation style
789 - 1 Patient
? / 250 / 197 Convenience sample
Information framed using internal responsibility associated with increased uptake of mammography (55% vs. 66% vs. 57%; p < 0.01)
207 - 1 Other
? / ? / 117 Convenience sample
Smoking and smoking/diet group associated with reduction in smoking; diet and smoking/diet intervention associated with changes in diet
288 - 1 Patient
1927 / 647 / 390 Convenience sample
No differential effect of interventions on number kits ordered or intention to test. Assessed changes in perceptions of risk
690 - 1 Patient
2822 / 1404 / 511 Systematic sample
Belief and information group associated with greater increase in BSE than other groups (p < 0.05)
458 - 1 Other
1703 / 1703 / 1270 Total sample available
Intervention associated with trend towards intention to change behaviour (p < 0.01)
307 - 1 Patient
875 / 175 / 157 Convenience sample
No differential effect in interventions. BSE improved over time
140 - 1 Patient
? / 186 / 114 Convenience sample
Intervention not associated with changes in smoking cessation
757 - 1 Patient
535 / 535 / 446 Total sample available
No differential effects from framing information but additional information associated with increased uptake of mammography (66% vs. 53%; p < 0.01)
434 - 1 Patient
264 / 96 / 90 Convenience sample
Framing information not associated with willingness to enter trial
816 - 1 Patient
218 / 180 / 180 Total sample available
Intervention not associated with increase or decrease in participation (13% control vs. 24% intervention). Analysis looked at predictors of attendance
667 - 1 Patient
64 / 60 / 60 Total sample available
Intervention not associated with changes in participation consultation or final decision
671 - 1 Patient
? / 100 / 81
Additional information not associated with cancellation of procedure. Note: small sample size and
Not adequately described non-validated measures
1-1
Patient
? / 681 / 626
No change in exercise behaviour, though reduction in anxiety
Not adequately described
10 - 1 Patient
200 / 160 / 140
No association between care plan group and hospital attendance. Main results between intervention,
Not adequately described patient satisfaction and mortality
28 - 1 Patient
50 / 46 / 46
Intervention not associated with change in use of healthcare services
Not adequately described
63 - 1 Patient
430 / 391 / 294 Total sample available
Nurse intervention associated with increased uptake of exercise. Exercise uptake not associated with routine and routine plus information group
47 - 1 Patient
? / 2441 / ? Convenience sample
Physician group more likely to eat more healthily and be immunised than hospital-based group. No association with smoking behaviour
55 - 1 Other
? / 267 / 267
Intervention not associated with intention to stop smoking
Not adequately described
continued
129
Appendix 8
130
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
55 - 2 Other
? / 450 / 220
Intervention not associated with intention to stop smoking
Not adequately described
57 - 1
Not recorded 427 / 320 / 213 Total sample available
Adherence decreased if medication taken twice a day (95% vs. 82%)
88 - 1 Patient
71 / 60 / 60 Total sample available
Intervention not associated with changes in adherence. Presented results of demographic associations with adherence
102 - 1 Other
1425 / 1097 / 770 Convenience sample
Intervention not associated with cessation of smoking. Interaction between level education and treatment condition
105 - 1 Patient
74 / 36 / 31 Total sample available
Modified information associated with increase in adherence to medication (79%, 83%, 93%). Small sample size
110 - 1 Other
4712 / 4712 / 1452 Systematic sample
Intervention associated with decrease in self-report alcohol use, increase in healthy eating but no change in smoking or exercise. Caution in interpreting the results as inappropriate use of statistics and potential confounders between randomised groups
147 - 1 Patient
? / 70 / 61 Convenience sample
Intervention group associated with reduction in fatty food intake
155 - 1 Patient
? / 128 / 128 Systematic sample
Patients less likely to sign consent form if given information about videotaping consultation
183 - 1 Patient
? / 453 / 290
No association with information group and cessation of alcohol
Not adequately described
216 - 1 Patient
6000 / 3257 / 140 Systematic sample
One-stage intervention had a higher uptake rate than the two-stage approach 3% vs. 2% (p < 0.05)
217 - 1 Other
7351 / 2577 / ? Total sample available
No changes in smoking behaviour either before/after intervention or between varying amounts and types of information groups
249 - 1 Patient
? / 179 / 155
No association between counselling and cessation of smoking
Not adequately described
259 - 1 Patient
? / 338 / 336 Convenience sample
Control group drinking twice as much as either intervention group (p < 0.001). No difference between intervention groups
279 - 1 Other
1005 / 1005 / 766 Total sample available
Intervention associated with reduced uptake of smoking (17% vs. 26%). No baseline measure of smoking in intervention group
356 - 1 Other
2002 / 1001 / 1001 Systematic sample
Blood pressure and diet monitoring by nurse not associated with change in salt intake/diet change
574 - 1 Patient
? / 44 / 22
No differences in cessation between groups (68% vs. 71% vs. 60%). High cessation rates indicate
Not adequately described that sample not representative
652 - 1 Patient
? / 1975 / 1948 Convenience sample
Authors suggest intervention associated with increase in attendance (46%, 61%, 58%)
679 - 1 Other
? / 1274 / 1274 Systematic sample
Intervention not associated with changes in exercise behaviour
489 - 1 Patient
? / 36 / 36 Convenience sample
Interventions not associated with any changes to lifestyle behaviours
772 - 1 Patient
? / 44 / 42 Convenience sample
No differential effect of patient-centred and directive style with cessation of drinking. Counselling better than no counselling (p < 0.02)
807 - 1 Patient
? / 204 / ? Convenience sample
Intervention associated with increase in self-management of diabetes
447 - 1 Patient
? / 224 / 209
Intervention associated with increased clinic attendance (p < 0.001). Note: interaction analysis
Not adequately described performed between `new' hypertensives and known infrequent attendees
783 - 1 Patient
2021 / 2021 / 1877 Convenience sample
Telephone support counselling increased cessation rates (16% vs. 15% vs. 14% vs. 23%)
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
336 - 1 Other
2753 / 2202 / 1652 Total sample available
Interventions not associated with changes in diet and smoking. Curriculum plus screening associated with increase in aerobic exercise (p < 0.05)
530 - 1 Patient
192 / 116 / 116 Convenience sample
Intervention associated with increase adherence at follow-up (p < 0.05)
564 - 1 Not recorded 371 / 227 / 227 Total sample available
No differences in treatment adherence by group (14%, 12%, 10%). Differential effects of groups on other drinking outcomes: hospitalisation > choice > AA
702 - 1 Patient
70 / 70 / 70 Total sample available
Information plus phone call associated with greater increase in adherence behaviour (p < 0.01)
213 - 1 Other
? / ? / 659 Convenience sample
Intervention associated with increased rates of cessation (18% vs. 9%)
327 - 1 Patient
? / 52 / 52 Convenience sample
No association between computer group and increase in house-mite reduction activities. Both groups increased house-mite reduction activities over time
328 - 1 Patient
? / 102 / 102 Convenience sample
Intervention associated with increase in healthy diet and self-monitoring of glucose. No association between exercise and medication adherence
612 - 1 Patient
? / 27 / 25 Convenience sample
Type of device not associated with adherence therapy
629 - 1 Patient
200 / 190 / 190 Total sample available
Intervention associated with increase in completion healthcare proxy (48% vs. 6%, p < 0.001)
268 - 1 Patient
? / 5354 / 3122 Total sample available
Presentation results by men, wives and children. Intervention associated with changes in diet (p < 0.01). No change in smoking cessation
395 - 1 Other
7397 / 7397 / 7397 Total sample available
Differential effects by group. Authors claim greatest increase associated with physician and patient reminder group (p < 0.01)
396 - 1 Patient
? / 105 / 105
Computer group associated changes in fat and calorie intake (p < 0.05)
Not adequately described
398 - 1 Patient
? / 93 / 75 Convenience sample
Results not reported for exercise/diet adherence by group.Analysis reporting differences between black/white participants. Exercise uptake but not diet intake improved over time
402 - 1 Patient
? / 211 / 211
Randomisation of patients resulted in lower uptake treatment (71% vs. 56%; p < 0.05)
Not adequately described
439 - 1 Patient
5281 / 4195 / 3097 Total sample available
No data provided for uptake of screening in control group. Intervention a predictor for better health at 2-year follow-up
527 - 1 Patient
? / 241 / 231 Convenience sample
Feedback intervention associated with increased adherence with inhaler (p < 0.01)
168 - 1 Patient
122 / 102 / 102 Total sample available
Telephone intervention not associated with adherence to medication (34% vs. 29%)
265 - 1 Patient
? / 229 / 169 Total sample available
Interventions not associated with exercise or smoking behaviours. Control group increased intake of cholesterol, early intervention associated with greater decrease in cholesterol intake than late group (p < 0.05)
365 - 1 Patient
321 / 253 / 231 Convenience sample
Intervention aimed at women associated with change in diet in men (p < 0.05). Note: excluded men no longer living in marital home
372 - 1 Patient
? / 207 / 173 Convenience sample
Intervention not associated with consultation attendance or changes to lifestyle
263 - 1 Patient
? / 303 / 264 Convenience sample
Intervention associated with reduction of fat in diet (17% vs. 36%)
693 - 1 Patient
? / 52 / 42 Total sample available
Authors claim that medication schedule associated with increased compliance but sample size small
137 - 1 Patient
? / 181 / 138 Convenience sample
Intervention not associated with adherence to medication
continued
131
Appendix 8
132
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
139 - 1 Patient
307 / 275 / 275 Total sample available
Analysis performed by risk group: intervention, obese patients more likely to make appointment with dietician; intervention, smoking group more likely to report quitting (though not confirmed by cotinine level)
143 - 1 Patient
? / 1745 / 1745 Convenience sample
No differential effects of intervention on smoking cessation (16% vs. 17%)
668 - 1 Patient
? / 870 / 602 Convenience sample
Differential effects of intervention over time. Personalised feedback plus stage of change leaflet associated with greater cessation. Applied transtheoretical model
332 - 1 Patient
? / 201 / 201 Convenience sample
Differential effects for way medical interventions described: 31% cases positively described, 12% negatively described and 19% medical guideline accepted treatment
20 - 1 Patient
85 / 64 / 43 Convenience sample
Intervention not associated with change in use of healthcare service
27 - 1 Patient
500 / 329 / 303 Convenience sample
Association between groups and use of services by disease: osteoporosis, counselling group fewer clinic visits than other groups; rheumatoid arthritis no association by groups
104 - 1 Patient
? / 156 / 156 Convenience sample
Different associations by different behaviours: behavioural strategy group more likely to monitor glucose level; attention group lower adherence to smoking cessation and medication but better diet and weight behaviours
220 - 1 Other
8565 / 7795 / ? Systematic sample
Adherence to healthy diet associated with intervention (p < 0.001)
233 - 1 Patient
? / 1800 / 1381
Significant group by time interactions for adherence exercise and cessation fat and caffeine intake
Not adequately described
241 - 1 Patient
? / 125 / 114 Convenience sample
Intervention associated with increased duration and frequency of exercise. Path analysis assessed relationship self-efficacy and exercise adherence
276 - 1 Other
1013 / 570 / 570 Total sample available
Intervention not associated with changes in smoking cessation
295 - 1 Patient
? / 66 / 56
Interventions not associated with self-reported changes in diet at 3 months
Not adequately described
305 - 1 Patient
? / 293 / 177 Convenience sample
Both theory-based groups associated with cessation of fatty diet and adherence to exercise. No changes for smoking, use of health professional, and adherence to medication
321 - 1 Patient
? / 26 / 22 Convenience sample
Intervention not associated with differences in adherence (no figures provided)
157 - 1 Other
2332 / 933 / 583 Convenience sample
Information group not associated with infant smoke exposure reduction. Both control and intervention groups increased smoking over time (53% vs. 46%)
376 - 1 Patient
1387 / 1378 / 1378 Total sample available
Intervention associated with increased attendance at smoking cessation programme (after GP advice, 1%; after recruitment 9%)
469 - 1 Patient
? / 453 / 453
Intervention associated with increased adherence to medication in both new and existing patients
Not adequately described
502 - 1 Patient
? / 84 / 58
Intervention not associated with changes in self-management of illness
Not adequately described
503 - 1 Patient
? / 66 / 48
Intervention associated with changes in lifestyle behaviours (p = 0.04). Behaviours not noted and
Not adequately described percentages not stated. Regression analyses performed looking at knowledge
707 - 1 Patient
? / 585 / 585
No difference in adherence to therapies (11% vs. 9%). Biochemical assessment smoking, diet
Not adequately described and exercise suggest changes by group
158 - 1 Patient
72 / 51 / 51 Total sample available
Intervention associated with increased cessation in moderate smokers (31% vs. 7%)
158 - 2 Patient
410 / 296 / 197 Convenience sample
Intervention associated with smoking cessation in moderate smokers (p < 0.05 adjusted for non-responders)
210 - 1 Patient
686 / 507 / 347
Tailored intervention associated with self-reported changes in diet (p < 0.01)
Not adequately described
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
211 - 1 Other
? / 340 / 292 Convenience sample
No differential effects of interventions on smoking cessation (27% vs. 22%). Operationalised stages of change model
644 - 1 Other
488 / 431 / 364
Analysis reported by group and collapsed groups: behavioural counselling associated with higher
Not adequately described cigarette cessation rate than information-feedback groups (18% vs. 3%, p < 0.01)
269 - 1 Patient
? / 345 / 139 Convenience sample
Differential effect of intervention on fibre consumption (29% vs. 88% vs. 66%, p < 0.01). Cost­benefit analysis
291 - 1 Patient
? / 290 / 225 Convenience sample
Education intervention associated with increase in self-management for parents and children
541 - 1 Patient
524 / 290 / 196 Total sample available
Intervention associated with reduction in fat intake (p < 0.001)
255 - 2 Other
8992 / 8992 / 7180 Systematic sample
No differential effects of interventions on smoking behaviour
145 - 1 Other
? / 5589 / 3884 Convenience sample
Intervention not associated with cessation of smoking. Analysis assessed rebelliousness, norms and smoking status
264 - 1 Patient
? / 208 / 169
Intervention associated with increased exercise uptake for control and Group 3, a decrease in fat
Not adequately described consumption for Group 2
659 - 1 Patient
? / 550 / 304
Women's intervention associated with reduction in men's consumption of fat (p < 0.01) but no
Not adequately described increase in eating healthy foods
622 - 1 Patient
? / ? / 842
No differential effects of intervention groups, both increased adherence over control group (p < 0.01).
Not adequately described Operationalised HBM
814 - 1 Patient
? / 136 / 120 Convenience sample
Intervention associated with greater adherence to exercise programme (p < 0.01)
490 - 1 Patient
133 / 88 / 80 Total sample available
Intervention leaflet associated with increase in rehabilitation exercises (p < 0.001). Main analysis assessed gender differences and anxiety
22 - 1 Other
? / 2271 / ? Systematic sample
Results presented by gender. Males and females in intervention group showed increase in intention to use condoms
732 - 1 Other
14749 / 12537 / 8845 Systematic sample
Intervention not associated with changes in risky sex behaviour. Purpose of study to look at prevalence of HIV
736 - 1 Patient
? / 313 / 218 Convenience sample
Authors claim intervention not associated with change in behaviours but sample group highly selective and attrition
341 - 1 Patient
313 / 313 / 218 Total sample available
Intervention not associated with changes in drug use or sexual behaviour. Sub-group analysis between used vs. not used alcohol
156 - 1 Patient
? / 99 / 61
High reward associated with increase in attendance, decrease `drug' behaviours. No difference in low
Not adequately described reward intervention over time
212 - 1 Other
?/?/?
Intervention not associated with any changes in cigarette, alcohol or marijuana over 5-year period
Not adequately described
639 - 1 Patient
243 / 217 / 217 Total sample available
Video group associated with greater intention to reduce risk behaviour immediately after information. No effect at 2 months
289 - 1 Patient
? / 107 / 77 Convenience sample
Acquisition of condoms associated with intervention (38% vs. 77% vs. 75%). No differential effects between intervention groups
465 - 1 Patient
? / 214 / 97 Convenience sample
Results on behaviour not clearly reported, no reported change in behaviour
733 - 1 Patient
? / 70 / 60 Convenience sample
Intervention associated with trend towards drug cessation and attendance for health appointments (p = 0.06, 0.07)
4-1
Patient
184 / 184 / 184 Convenience sample
Contact therapy not associated with greater decrease in cocaine use. Authors looked at predictors of cocaine use
continued
133
Appendix 8
134
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
24 - 1 Patient
? / 20 / ? Convenience sample
Alcohol was associated with reduced discussion of condoms. No change in intention to use condoms
223 - 1 Patient
? / ? / 296 Convenience sample
Social skills intervention no more effective than routine information in increasing cessation of drug use
226 - 1 Other
3011 / 2416 / 2416 Total sample available
Groups confronting beliefs and normative behaviours associated with reduced drug use. Control and resistance training alone not useful in reducing drug use behaviour
247 - 1 Other
5070 / 3549 / ? Total sample available
Authors claim psycho-social interventions associated with changes in alcohol, smoking and marijuana use. Analysis performed by gender
277 - 1 Other
?/?/? Total sample available
No association of theory-based interventions and changes in alcohol, smoking and marijuana use, 2 years after intervention. Analysis performed on process measures
424 - 1 Other
?/?/? Convenience sample
Authors claim intervention associated with increased safer sex practices. Note: analysis only on sexually active sub-group
478 - 1 Other
? / 1033 / 758 Total sample available
Intervention associated with greater contraceptive discussions with parents. In female, first-time sexual encounters intervention associated with safer sex practices
600 - 1 Other
387 / 220 / 208 Total sample available
Directive intervention associated with lower recruitment rates (65% vs. 52%). No association between intervention and attendance at counselling sessions. No demographic results presented although reported
685 - 1 Patient
? / 291 / 291
Theory-based information associated with increase in attainment of free condoms (p < 0.01).
Not adequately described Assessed relationship experience and attitude formation (Fazio)
742 - 1 Patient
? / ? / 206
Analysis suggests AIDS information group more likely to use condoms
Not adequately described
492 - 1 Patient
? / 89 / 81 Convenience sample
Intervention not associated with changes in risky behaviour
766 - 1 Patient
246 / 246 / 225 Total sample available
Intervention associated with increased use of condoms over time (p < 0.01), reduction in the initiation of sexual activity (31% vs. 12%)
776 - 1 Patient
? / 187 / 93 Convenience sample
Intervention associated with increased use of condoms (p < 0.001)
165 - 1 Patient
? / 1770 / 994 Convenience sample
Intervention not associated with cessation of risky drug behaviours although a time effect
632 - 1 Patient
55 / 50 / 47 Convenience sample
Analysis of safe sex/drug use not reported. Intervention associated with skill acquisition for condom and needle sterilisation use
632 - 2 Patient
? / 98 / 60
Intervention not associated with behaviour change
Not adequately described
635 - 1 Patient
176 / 152 / 106 Total sample available
Risky sex/drug behaviour decreased over time (p < 0.001). No reliable differential effects by intervention but for sex/ drugs more in information group increased risk behaviour (11% vs. 4%)
636 - 1 Patient
? / 497 / 407
Enhanced intervention associated with cessation of cocaine use and risky drug use
Not adequately described
525 - 1 Patient
? / 200 / 88 Convenience sample
No differential effect between groups on drug use, risky sex and study attrition. Over time, reduction in risky drug use but not sex
660 - 1 Other
1315 / 1201 / 867 Systematic sample
Intervention associated with adherence to safer sex (p < 0.01)
454 - 1 Patient
? / 916 / 858 Convenience sample
Decreased risky behaviours for both groups over time, traditional group associated with greater cessation of behaviours than intensive group
706 - 1 Patient
465 / 419 / 419 Total sample available
Intervention associated with mixed findings: reduction in home visits for coughs, colds, fevers but increase for diarrhoea and vomiting
6-1
Patient
10 / 10 / ? Convenience sample
Adherence to medication not associated with taste of medication
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
6-2
Not recorded 15 / 12 / ?
Adherence to medication not associated with taste of medication
Not adequately described
6-3
Patient
10 / 10 / ? Convenience sample
Adherence to medication not associated with taste of medication
32 - 1 Patient
201 / 194 / 174 Total sample available
Intervention associated with differences in attendance and adherence. Stimulus group had lower attendance than regular class; weight-dependence group had better adherence than time-dependent group
51 - 1 Patient
? / 400 / 385
Medication provided with precise unit of measurement in liquid form associated with increase in
Not adequately described adherence to medication
174 - 1 Patient
? / 44 / 39 Convenience sample
Intervention associated with adherence to exercise programme but not with diet
302 - 1 Other
? / 100 / 98
Leaflet associated with fewer home visits and physician appointments and more self-treatments of
Not adequately described children's symptoms (p > 0.01)
589 - 1 Patient
? / 325 / 159 Systematic sample
No difference between two methods of invitation (72% vs. 66%)
572 - 1 Patient
239 / 239 / 103 Total sample available
Intervention associated with increased uptake of immunisation (p < 0.001)
747 - 1 Patient
? / 1200 / 1200 Systematic sample
Differential effect of interventions on uptake (75% vs. 69% vs. 54%)
769 - 1 Not recorded 4641 / 855 / 567 Systematic sample
No differential effects of interventions on attendance at general practice. Article reports costs of each alternative
520 - 1 Patient
3913 / 3404 / 3404 Total sample available
Leaflet associated with lower utilisation of services. Interaction with perception of health risk
234 - 1 Patient
? / 3884 / 1989
Free vaccination increased uptake of flu immunisation more than the control group.
Not adequately described Uptake of immunisation increased over time. Note: less than a 40% response rate
337 - 1 Other
2624 / 2624 / 2624 Total sample available
Attendance increased in intervention group, particularly for `alarming' coughs
796 - 1 Other
548 / 548 / 548 Total sample available
Intervention associated with adherence to cough care treatment (30% vs. 56%; p < 0.01)
414 - 1 Patient
? / 43 / 32 Convenience sample
No association of intervention and therapy adherence, diet or exercise changes
553 - 1 Patient
? / 120 / 86
No association between groups and changes in exercise behaviour. Predictors of behaviour analysis
Not adequately described only reported
408 - 1 Patient
229 / 229 / 222 Total sample available
Telephone reminder not associated with increase in immunisation
19 - 1 Patient
? / 236 / 236
Choice of treatments associated with presentation data: fewer patients chose immediate survival
Not adequately described when data presented as a curve rather than point estimates
167 - 1 Patient
? / 288 / 288
Interventions associated with increased attendance at well-baby clinic (p < 0.05). No differential effects
Not adequately described interventions (68%, 75%, 74%)
357 - 1 Patient
? / 66 / 62
Illustrated leaflet not associated with increased adherence to medication (p = 0.07)
Not adequately described
426 - 1 Patient
299 / 299 / 299 Total sample available
Fixed appointment increased uptake from 27%­ 59%. Operationalised HBM
506 - 1 Patient
141 / 67 / 67 Total sample available
Intervention not associated with increase in patient participation consultation
633 - 1 Patient
422 / 422 / 359 Total sample available
Intervention not associated with uptake of vaccination
continued
135
Appendix 8
136
TABLE 32 contd Description of the quality of the study and summary results: RCTb
Study Intervention Sample size number level
Summary of results
369 - 1 Patient
587 / 439 / 439 Total sample available
Intervention not associated with adherence to medication
620 - 1 Patient
299 / 254 / 121
No differential effect in uptake of health check by group. Fewer people in opportunistic group
Not adequately described approached, resulting in differences in uptake (79% vs. 33%; p < 0.01)
135 - 1 Patient
68 / 68 / 55 Convenience sample
Authors suggest intervention group associated with increase in exclusively breast feeding for 3 months (p < 0.02). (published again Journal of The American Dietetic Association 1995;95:323­8.)
698 - 1 Patient
300 / 210 / 210
Adherence trial associated with effectiveness of HRT in controlling menopausal symptoms
Not adequately described (47% vs. 49% vs. 73%)
634 - 1 Patient
? / 800 / 800
Fixed appointment letter associated with increased attendance (75% vs. 54%)
Not adequately described
768 - 1 Patient
270 / 216 / 87 Total sample available
Breast pump rather than formula associated with increased breast feeding only if women perceived bottle to make night-time feed easier (p < 0.05)
616 - 1 Patient
? / 194 / 175 Convenience sample
Intervention associated with increased breast-feeding (38% vs. 70%; p < 0.001)
403 - 1 Patient
? / ? / 180 Total sample available
No association between interventions and uptake or duration of breast feeding
562 - 1 Patient
232 / 232 / 186 Total sample available
Feedback and information group associated with increase in dental hygiene (76% vs. 67% vs. 90%; p < 0.01)
576 - 1 Patient
? / 20 / 20
Interventions associated with increase in dental hygiene (additional feedback plus checklist)
Not adequately described
758 - 1 Patient
700 / 167 / 91 Convenience sample
Intervention not associated with changes in dental hygiene behaviour. Operationalised the theory of reasoned action
371 - 1 Other
? / 119 / 98
Intervention not associated with changes in self-reported dental behaviour, but changes in plaque level
Not adequately described
457 - 1 Patient
? / 84 / 84
Group 2 associated increase in dental hygiene activities (36% vs. 41% vs. 100%; p < 0.01)
Not adequately described
304 - 1 Patient
392 / 318 / ? Convenience sample
Differential attendance rates for final visit (65% vs. 94% vs. 95% vs. 78%). Despite inappropriate statistics, nurse home-based interventions associated with increased attendance (p < 0.05)
308 - 1 Other
? / 200 / 179 Systematic sample
Intervention group more likely to clear mosquito breeding sites (82% vs. 25%)
96 - 1 Patient
? / 191 / 172
Intervention not associated with adherence to medication
Not adequately described
479 - 1 Patient
? / 77 / 77
Family intervention associated with increased adherence to treatment. Results indicate patient's
Not adequately described clinical state improved
511 - 1 Patient
400 / 322 / 290 Total sample available
Intervention associated with exercise uptake (p < 0.001) and trend towards decreased physician visits (p = 0.06)
494 - 1 Not recorded ? / 206 / 199 Convenience sample
Intervention associated with fewer referrals to Nursing Homes (p < 0.05). Main analysis between social support, health and behaviour
554 - 1 Patient
? / 816 / 783 Systematic sample
Pre-paid plans not associated with Medicaid beneficiaries utilisation services
794 - 1 Patient
281 / 217 / 177 Total sample available
Authors claim intervention associated with increased adherence to medication (76% vs. 50%; p < 0.01)
493 - 1 Patient
? / 102 / 91 Convenience sample
Computer associated with increased confidence in decision making but not decision skill. Computer used for information and not as a decision aid
176 - 1 Patient
511 / 492 / 470 Total sample available
57% patients chose medication phrased in relative-risk terms, 15% when phrased in absolute-risk terms. Good experimental design but no control over order effects
150 - 1 Patient
400 / 234 / 205 Total sample available
Use of cartoons plus leaflet increased adherence to wound care
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 33 Description of the quality of the study and summary results: RCTc
Study Intervention Sample size number level
Summary of results
37 - 1 Patient
? / 1744 / ? Total sample available
Video intervention associated with increased uptake of rate cervical smear
154 - 1 Patient
511 / 369 / 369 Total sample available
Intervention associated with increased mammography screening. Note: women `dropped out' perceived themselves to be less susceptible to breast cancer and perceived mammography to be less effective than those who took part
296 - 1 Patient
527 / 395 / 179
Free test by physician increased adherence to screening (p < 0.05). Addition of reminder letter not
Not adequately described associated with increase in adherence
377 - 1 Patient
621 / 204 / 202 Total sample available
No differential effect in uptake of either intervention (55% vs. 67%)
412 - 1 Patient
? / 146 / 146
Stamped addressed envelope associated with higher return rate for hemoccult cards (37% vs. 57% vs.
Not adequately described 71%; p < 0.01). Calculated cost intervention
695 - 1 Not recorded 527 / 498 / 147 Systematic sample
Uptake of mammography not associated intervention
712 - 1 Patient
220 / 220 / 178 Total sample available
Differential effects of interventions by experimental group (73% vs. 72% vs. 44% vs. 36%; p < 0.01)
310 - 1 Other
? / 1618 / 603 Convenience sample
No differential effects associated with any interventions on smoking cessation. Analysis carried out for number of quit attempts and differences in participants/non-participants
752 - 1 Other
1588 / 1588 / 1588 Total sample available
Sending hemoccult by post associated with greater uptake (26% vs. 32% vs. 21%; P < 0.01). Hemoccult screening not associated with invitation to attend health check
691 - 1 Other
89 / 82 / 82 Total sample available
No differential effect in uptake irradiation therapy by group (95%: 96%: 93%). Differences with decision-making process: consultation less directive and more involved in decision process
248 - 1 Patient
170 / 161 / 161 Total sample available
Leaflet not associated with increased attendance at appointment (P = 0.097). No evidence leaflet readable
354 - 1 Other
752 / 616 / 412 Systematic sample
Theory-based intervention associated with increased uptake of mammography (45% vs. 12%; p < 0.001). Operationalised HBM
380 - 1 Patient
90 / 90 / 90 Total sample available
Telephone counselling confronting barriers to attendance increased attendance at clinic (67% vs. 43%, p < 0.05)
484 - 1 Other
2044 / 2044 / 2044 Total sample available
Free transportation associated with highest attendance at clinic, letter only with lowest. Logistic regression analysis, so no percentages
507 - 1 Patient
3035 / 3035 / 963 Total sample available
Interventions not associated with increased uptake rates (89%, 90%, 90%). Note all uptake rates very high
508 - 1 Other
541 / 541 / 541 Total sample available
Intervention associated with increased cervical screening. Logistic regression presented, interaction with type of cervical abnormality
303 - 1 Other
268 / 219 / 219 Total sample available
Information intervention not associated increased with adherence. Interactions showed least compliant patients improved following intervention (55% vs. 32%)
320 - 1 Patient
379 / 287 / 287 Total sample available
Information intervention associated with decreased attendance at clinic p < 0.05), no change in diet, smoking and alcohol behaviour
381 - 1 Patient
? / 313 / 238 Convenience sample
Additional information and letter prompt not associated with increased referral to physician (25% vs. 24%) or self-reported changes in diet, exercise or smoking
471 - 1 Patient
? / 139 / 96 Convenience sample
No results reported evaluating impact interventions alone. Results analysed by gender group interaction
473 - 1 Patient
? / 921 / 570 Convenience sample
Interventions not associated with any changes in smoking cessation
475 - 1 Patient
? / 36 / 27 Convenience sample
Intervention associated with increase in checking blood glucose, diet, exercise, service utilisation
485 - 1 Patient
371 / 227 / 200 Total sample available
Hospitalisation associated with greatest cessation of drinking after 2 years (37% vs. 17% vs. 16%)
763 - 1 Other
? / 88 / 79
Intervention associated with increase adherence (95% vs. 83%; p = 0.02)
Not adequately described
continued
137
Appendix 8
138
TABLE 33 contd Description of the quality of the study and summary results: RCTc
Study Intervention Sample size number level
Summary of results
459 - 1 Other
? / 873 / 630 Convenience sample
No differential effects of cessation smoking by group (10% vs. 9% vs. 10%)
754 - 1 Patient
924 / 342 / 305 Convenience sample
Both intervention groups associated with changes in diet (p < 0.05). Assessed knowledge
708 - 1 Other
? / 580 / 510
Intervention not associated with changes in smoking
Not adequately described
711 - 1 Other
? / 309 / 309
Follow-up phone call decreased drop-out rate for 6 months only after treatment (p < 0.01)
Not adequately described
170 - 1 Patient
1142 / 1015 / 747
Information intervention associated with small change in preventive behaviour in better educated
Not adequately described parents. Likely some group contamination and no evidence leaflet readable
343 - 1 Other
309 / 149 / 137 Total sample available
Information intervention not associated with increase in advance directives. Note: questionnaire only offered to intervention group, no self-report data for controls
56 - 1 Other
2452 / 1272 / 1260 Systematic sample
Attendance twice as high when free service provision (66% vs. 37%)
472 - 1 Other
67 / 61 / 61 Total sample available
Intervention patients asked more questions at discharge (7.8 vs. 3.1; p < 0.01).An association between perception of physical and psychological functioning and intervention
72 - 1 Other
? / 446 / 218 Convenience sample
Results for both groups at all time points not reported. No differences in smoking cessation by group across all time points. Operationalised stages of change model
242 - 1 Patient
482 / 375 / 268 Convenience sample
Stages of change intervention associated with increased smoking cessation and more quitting attempts. Note: only two groups reported although three randomised
254 - 1 Patient
3161 / 2707 / 2707 Total sample available
Prompts plus skill acquisition group increased cessation smoking twice as much as advice only or group session (from 6% to 12%)
375 - 1 Patient
? / 28 / 28 Convenience sample
Intervention not associated with greater attendance at exercise classes. Purpose of study to assess increase in knowledge
792 - 1 Other
? / 5458 / 2540 Total sample available
Theory-based intervention associated with increase in smoking cessation (p < 0.01)
640 - 1 Other
3655 / 3655 / 2688 Total sample available
Intervention not associated with changes in tobacco use
287 - 1 Patient
1119 / 1119 / 996 Total sample available
Intervention associated with increased smoking cessation (11% vs. 16%; p < 0.009)
169 - 1 Patient
1383 / 719 / 706 Total sample available
Intervention associated with increased adherence (p < 0.001)
405 - 1 Other
? / 146 / 146
Intervention not associated with changes in tobacco use
Not adequately described
442 - 1 Other
? / 2791 / 1222 Convenience sample
Intervention not associated with changes in CVD risk factors
360 - 1 Other
? / 511 / 434
Intervention not associated with changes in children's intention to change drug use behaviour.
Not adequately described Reports changes in process measures
115 - 1 Patient
328 / 328 / 225 Total sample available
Study operationalised the theory of planned behaviour and results analysed accordingly. Interventions not associated with differential adherence to diet. No control group
329 - 1 Patient
193 / 193 / 109 Total sample available
No differential effect on cessation of smoking (42% vs. 38% vs. 48% quit)
80 - 1 Patient
131 / 91 / 86 Total sample available
No association between intervention and changes in self-report smoking cessation (too few smokers), dietary change or uptake of exercise. Both groups changed diet and uptake of exercise
649 - 1 Other
337 / 337 / 240 Total sample available
Intervention not associated with changes in safer sex practices
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 33 contd Description of the quality of the study and summary results: RCTc
Study Intervention Sample size number level
Summary of results
684 - 1 Patient
? / 407 / 301 Convenience sample
No differential effects of interventions on condom use
720 - 1 Other
? / 385 / 243 Total sample available
Analysis assessed relationship between social network and behaviour. Unclear relationship between intervention and behaviour
407 - 1 Other
? / 2144 / 1866 Convenience sample
Intervention associated with decreased in risky drug use (p < 0.05)
181 - 1 Patient
60 / 51 / 39 Total sample available
Authors suggest intervention associated with greater adherence (p < 0.05). Unclear sample size in final analysis, large attrition
762 - 1 Patient
? / 106 / 76 Convenience sample
Interventions associated with increased acquisition of condoms and initiation of HIV conversations (p < 0.01). Interventions not associated with self-reported behaviour change safer sex
528 - 1 Patient
907 / 693 / 381 Convenience sample
Authors claim intensive information associated with safer drug practices
646 - 1 Other
? / 233 / 213 Convenience sample
Intervention not associated with cessation of drug/ sex behaviours
696 - 1 Other
3348 / 3226 / 1665 Total sample available
Interventions associated with differential effect on uptake of free condoms (21% vs. 27% vs. 41%)
817 - 1 Other
567 / 411 / 339 Total sample available
No differential effect of interventions and risky behaviour. Both interventions associated with decreased risky behaviours
749 - 1 Patient
? / 157 / 157 Convenience sample
HIV risk intervention associated with appropriate change in sex behaviours (p < 0.01)
777 - 1 Other
? / 1417 / 1417 Total sample available
Intervention associated with increase in facewashing (p < 0.05)
172 - 1 Other
? / 1303 / 1303 Total sample available
Postcard reminders not associated with increased attendance. Predictors of non-attendance analysis carried out
363 - 1 Patient
? / 238 / 238
Intervention not associated with change in immunisation uptake (31% vs. 33%)
Not adequately described
470 - 1 Patient
207 / 177 / 157 Total sample available
Intervention associated with fewer problems but more health supervision surgery visits. No change in late and emergency visits
512 - 1 Other
8002 / 8002 / 6623 Total sample available
Odds ratios reported: intervention associated with increased immunisation of children; specific message more impact than general; invitation call greater impact than reminder
98 - 1 Patient
140 / 75 / 57 Convenience sample
Intervention associated with changes in self-management of arthritis but not exercise
601 - 1 Patient
? / 129 / 129 Convenience sample
Intervention increased request for information from 10% to 27%. No change in self-report of behaviour
601 - 2 Patient
? / 163 / 163 Convenience sample
Nurse intervention associated with increased question asking 8% to 54%
83 - 1 Patient
1566 / 549 / 401 Total sample available
Intervention group associated with fewer prenatal visits and ultrasounds. No differences in uptake serum screening or perinatal outcomes
106 - 1 Patient
? / 240 / 240
Provision of toy associated with greater attendance post-partum. It is likely that the `toy' group had
Not adequately described more contact with health professional
788 - 1 Other
251 / 251 / 226 Total sample available
Additional information not associated with postpartum healthcare utilisation
481 - 1 Other
2008 / 2008 / 2008 Total sample available
Interventions not associated with differential effect attendance. Before/after analysis suggest reminder call increased attendance from 53% to 62%
411 - 1 Patient
? / 40 / 40
Intervention associated with greater adherence TB medication (64% vs. 11%; p < 0.001)
Not adequately described
continued
139
Appendix 8
TABLE 33 contd Description of the quality of the study and summary results: RCTc
Study Intervention Sample size number level
Summary of results
743 - 1 Patient
? / 2002 / 1908
Uptake of CF carrier screening not associated with type of screening technique. Purpose of study
Not adequately described to assess impact testing
790 - 1 Patient
5529 / 5529 / 5529
Differential effects of interventions on uptake CF carrier testing (12% vs. 9% vs. 17% vs. 70% vs. 25%
Not adequately described vs. 4%)
293 - 1 Other
210 / 93 / 93 Total sample available
No differential effects between groups on use of car seats. Note: majority of sample using car seats
349 - 1 Patient
202 / 93 / 61 Total sample available
Questionnaire plus leaflet reduced number of missed initial appointments and increased attendance for therapy at 6 months (p < 0.05)
58 - 1 Other
5600 / ? / ? Systematic sample
No baseline figures, statistical tests or indication sample size.Twice as likely to sign donor card if `intensive package' than information only or control group (5%, 5%, 12%, 13%)
324 - 1 Patient
? / 149 / 98 Convenience sample
Illustrated leaflet associated with increased intention to check heat of water (p < 0.0001)
717 - 1 Patient
74 / 74 / 74 Total sample available
Intervention associated with increased attendance (57% vs. 82%; p < 0.05)
140
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 34 Description of the quality of the study and summary results: concurrent
Study Intervention Sample size number level
Summary of results
44 - 1 Other
1750 / ? / ? Systematic sample
No significant difference between sampled women's uptake of breast screening. Difficult to interpret results as an additional intervention conducted within the communities at the same time
61 - 1 Other
?/?/? Total sample available
Results from medical records by age. Difficult to assess significance association intervention with uptake rates (71% vs. 65%)
203 - 1 Other
1937 / 1697 / 1697 Total sample available
Intervention not associated with differential effects on uptake by group. Interaction between age and uptake of screening
243 - 1 Other
?/?/? Systematic sample
Community and physician intervention associated with increased attendance for mammography
246 - 1 Other
? / 1405 / 875 Systematic sample
Both intervention groups associated with increase in BSE
385 - 1 Other
? / 1200 / ?
No significant differences in tobacco use between intervention groups (18% vs. 20% vs. 15%)
Not adequately described
686 - 1 Other
? / 970 / 970 Systematic sample
Intervention associated with increased mammography (from 35% to 55% vs. 30% to 40%)
171 - 1 Other
? / 1500 / 966 Systematic sample
Information intervention not associated with changes in smoking, sun-tanning or breast examination behaviours
205 - 1 Other
1346 / 1346 / 559 Total sample available
Community-based intervention associated with greater uptake than media intervention (50% vs. 32%)
205 - 2 Other
1013 / 1013 / 1013 Total sample available
GP intervention associated with greater attendance at breast cancer screening than community intervention (64% vs. 49%)
397 - 1 Other
?/?/? Convenience sample
Results not reported for uptake cervical and mammography screening by group. Note: awareness programme increased in both groups so contamination groups
546 - 1 Other
1616 / 1332 / 1332 Total sample available
Personalised invitation associated with greater attendance at cervical screening than national rate (55% vs. 41%)
448 - 1 Other
225 / 135 / 135 Total sample available
Skills group associated with increased uptake of colorectal cancer (65% vs. 41% vs. 94%); p < 0.05)
418 - 1 Other
? / 294 / 294
Intervention not associated with change in uptake of sigmoidoscopy examinations, immunisations,
Not adequately described cholesterol screening or installation of smoke detectors
386 - 1 Other
? / 189 / 179
Uptake and maintenance of BSE improved in both intervention groups (p < 0.001). No differential
Not adequately described effect between intervention groups
760 - 1 Other
? / 615 / 295 Convenience sample
Differential effects of interventions on attendance for mammography (10% vs. 30% vs. 34%; p < 0.01). Operationalised HBM
608 - 1 Other
1194 / 628 / 628 Convenience sample
Media-based intervention associated with increase in mammography uptake (15% vs. 24%; p < 0.05)
404 - 1 Other
? / 1857 / 1857 Total sample available
Women within the intervention community more likely to report having a mammogram (30% vs. 19% increase; p < 0.05). Analysis carried out to assess predictors attendance
446 - 1 Other
? / 2724 / 2724 Systematic sample
Intervention associated with changes in mammography uptake (10% vs. 27%; p < 0.01)
136 - 1 Other
648 / 648 / 612 Systematic sample
Group 2 associated with increased sun protection behaviours over time (p < 0.01)
237 - 1 Other
2000 / 1506 / 1231 Systematic sample
Intervention associated with a decreased fat intake over time (p < 0.01). No change in smoking habits
180 - 1 Other
?/?/?
Self-report hat wearing and sunscreen increased, no change in covering up after intervention.
Not adequately described Less change in men's behaviour
45 - 1 Other
?/?/? Systematic sample
Self-report attending cholesterol checks higher in white intervention than control population. No increase amongst black respondents. Sample randomly selected by phone
continued
141
Appendix 8
142
TABLE 34 contd Description of the quality of the study and summary results: concurrent
Study Intervention Sample size number level
Summary of results
82 - 1 Patient
? / 84 / 84 Convenience sample
Patients within intervention group fewer emergency visits and days off work than matched controls. No differences between number hospitalisations. Note: data suggest non-parametric analysis more appropriate
218 - 1 Other
2812 / 1506 / 1093 Total sample available
Intervention not associated with reliable differences in smoking cessation
222 - 1 Other
286 / 209 / 125 Total sample available
Screening teachers associated with uptake of exercise but no change in smoking behaviour
235 - 1 Other
1052 / 966 / 931
Prevalence of smoking not associated with type of work policy; daily rate cigarette consumption
Not adequately described associated with type of work policy
245 - 1 Patient
? / 62 / ? Convenience sample
Intervention groups not associated with smoking cessation at 6 months follow-up. Caution: hospital had a no-smoking policy
256 - 1 Patient
1946 / 1286 / 997 Total sample available
Cessation rates: advice only (13%), counselling only (24%), counselling and gum (30%). Logistic regression analysis modelling demographic variables and cessation
258 - 1 Other
3558 / 708 / 708 Convenience sample
Authors suggest intervention associated with changes in CVD risk factors. Caution: low response rate over large period of time
260 - 1 Patient
? / 8184 / 8184
Special care intervention reported greater change in smoking cessation than usual care (43% vs. 14%).
Not adequately described Little information about intervention or process measures of change
280 - 1 Other
16089 / 3382 / 2972 Convenience sample
Participation in survey greater in North Karelia (0.6% vs. 0.3%, 0.3%). Reported change cessation smoking higher in North Karelia (25% vs. 20%, 19%)
283 - 1 Other
5445 / 56 / 56 Convenience sample
Competition intervention associated with greater interest in programme (2% vs. 0.6%). Maintenance abstinence greater in competition intervention (p < 0.05)
284 - 1 Other
? / 2147 / 1220 Convenience sample
Cessation of smoking greater within intervention group (32% vs. 17%; p < 0.05)
315 - 1 Other
96 / 84 / 55 Total sample available
Packaging pills in foil holders with `date to take' increased compliance up to 3 months after discharge (49% vs. 23%)
390 - 1 Other
? / ? / 1880 Convenience sample
Authors claim counselling and exercise compatible with daily life is effective in increasing exercise uptake. Note: results not clearly reported and unclear
504 - 1 Other
? / 46 / 46 Total sample available
Intervention associated with fewer GP contacts and emergency visits (p < 0.01) but no change in referrals to specialists
657 - 1 Patient
? / 4487 / 2767 Systematic sample
Intervention group three times more likely to quit smoking (6% vs. 2%)
731 - 1 Other
? / 5078 / 4538 Systematic sample
Interventions not associated with changes in smoking behaviour
740 - 1 Other
?/?/?
Authors claim that smoking cessation greater within intervention community but analysis not
Not adequately described carried out to illustrate this
779 - 1 Other
1087 / 1036 / 1036 Total sample available
Intervention village greater long-term smoking cessation rate (p = 0.01) but no difference in short-term cessation rates
206 - 1 Other
?/?/?
Intervention associated with increased smoking cessation in men only (8% vs. 3%). Results presented
Not adequately described for physiological estimates CVD risk
215 - 1 Other
? / 1500 / ? Systematic sample
Authors claim Group 1 associated diet change. However, small sub-section of sample. Group 2 and 3 not associated with changes
409 - 1 Other
? / ? / 1863 Convenience sample
No differential effect of information on children's report of diet. Note: differences between trained/not trained teachers, e.g. funding schools; inappropriate statistics
312 - 1 Other
?/?/? Systematic sample
Intervention associated with reduction in fatty diet (p < 0.05)
273 - 1 Other
? / 4270 / 2605 Systematic sample
Intervention not associated with cessation of smoking, though there was a time effect (p < 0.01)
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 34 contd Description of the quality of the study and summary results: concurrent
Study Intervention Sample size number level
Summary of results
394 - 1 Patient
? / 1024 / 860 Convenience sample
Intervention not associated with change in ophthalmic specialist use
194 - 1 Other
203 / 184 / ? Total sample available
Authors present changes in intention to behave more safely for: seat-belt use as a driver and passenger, speeding and drink-driving. Intervention associated with increased intention of passenger seat-belt use
89 - 1 Patient
738 / 227 / 227 Convenience sample
Authors suggest post-intervention group had greater intention to change exercise behaviour than pre-intervention group (p < 0.05). Operationalise the theory planned behaviour
184 - 1 Other
276 / 232 / 146 Total sample available
Interventions not associated with differential effect of smoking cessation but reduction in overall pre-/post-intervention
253 - 1 Other
? / 465 / 346 Convenience sample
Parent information associated with greater increase of intention and actual food buying than child/control groups. Operationalised SLT
345 - 1 Other
252 / 252 / 187 Total sample available
Intervention not associated with increased smoking cessation rates. Operationalised stages of change theory
416 - 1 Patient
? / 48 / 48 Convenience sample
Interventions not associated with changes in self-report behaviour
440 - 1 Other
? / 2500 / ? Systematic sample
Behavioural-based intervention assessed mainly by physiological changes.There was no association with smoking cessation
209 - 1 Other
407 / 255 / 212 Convenience sample
Stages of change intervention associated with increased exercise uptake (p < 0.01)
631 - 1 Other
? / ? / 6814 Systematic sample
Intervention not associated with reliable changes in self-report of diet change at 5 years
464 - 1 Other
? / 907 / 907 Systematic sample
Intervention not associated with exercise adherence but effects reported for subsidiary analysis
658 - 1 Other
? / 2136 / 1674 Systematic sample
Intervention increased attendance at lifestyle change activities
726 - 1 Other
?/?/? Systematic sample
Little association between intervention and self-reports of smoking or exercise behaviour
255 - 1 Other
?/?/? Systematic sample
Intervention not associated with changes in tobacco use
313 - 1 Other
625 / 558 / 516 Total sample available
Both interventions associated with increased medication adherence and self-monitoring (p < 0.05). Neither intervention associated with changes in diet and exercise
367 - 2 Patient
? / 341 / 119 Convenience sample
Differential attrition (56% vs. 48%) and smoking cessation rates (14% vs. 57%). Difficult to draw any conclusions as poor design
370 - 1 Other
? / 5356 / 3833 Total sample available
Intervention associated with decreased self-report of alcohol use (p < 0.01)
238 - 1 Other
?/?/? Systematic sample
Intervention not associated with changes in smoking behaviour
261 - 1 Other
171 / 171 / 157 Total sample available
Intervention associated with favourable changes in smoking, diet and dental health (p < 0.01)
456 - 1 Other
405 / 155 / 55
Intervention associated with changes in diet (p < 0.05) but not smoking or uptake exercise
Not adequately described
709 - 1 Other
?/?/? Systematic sample
Intervention not associated with changes in diet, smoking, exercise. Interaction between social support and intervention
311 - 1 Other
? / ? / 2863
Authors claim social intervention associated with lower onset substance use than control, whereas
Not adequately described the affective intervention group was associated with increased substance use
125 - 1 Patient
? / 117 / 77 Convenience sample
Intervention associated with intention to practice safer sex. No association with drug or alcohol use
continued
143
Appendix 8
144
TABLE 34 contd Description of the quality of the study and summary results: concurrent
Study Intervention Sample size number level
Summary of results
161 - 1 Other
? / 600 / 600 Convenience sample
Intervention associated with increased condom use and reduced number of sexual partners (p < 0.001)
177 - 1 Patient
? / 2624 / 1616 Convenience sample
Results not reported for comparison interventions but as before/ after design, predictors of behaviour change. Cessation of risky needle use and adherence to safer sex in males after intervention
392 - 1 Other
? / 7946 / 7946 Systematic sample
Uptake of contraception use in intervention area over time greater than control community (57% vs. 27%)
791 - 1 Patient
? / 541 / 524 Convenience sample
Intervention associated with increased use of condoms and raising issue of condom use with clients (p < 0.01)
555 - 1 Other
? / 1398 / 1398 Convenience sample
Authors claim intervention not associated with use of condoms but increase in intention to use condoms
665 - 1 Other
? / 1267 / 1267 Convenience sample
Authors claim reduction in self-report of risky sex practices within intervention city only
579 - 1 Other
1226 / 442 / 442 Convenience sample
Information intervention not associated with changes in condom use
748 - 1 Patient
? / 209 / 20 Convenience sample
Group 1 associated with reduced length of hospital stay and fewer outpatient visits (p < 0.01) but increased GP visits for Groups 1 and 4
455 - 1 Other
? / 1261 / 1256
Control group associated with increased utilisation of care (p < 0.01), intervention group less likely
Not adequately described to change method of contraception (85% vs. 92%, p < 0.01)
71 - 1
Not recorded 29 / 22 / 22 Convenience sample
Those with lower addiction (baseline group 1) were more likely to attend antenatal classes.Those with a higher addiction (intensive Group 2) expressed more intention to quit. Design of study unable to evaluate intervention
486 - 1 Patient
? / 248 / 113
Intervention associated with greater number of children adopted (43% vs. 0%), less sexually active
Not adequately described (57% vs. 75%) at 24 months. Low response rate and samples significantly different at beginning of study
17 - 1 Other
738 / 734 / 520 Total sample available
Authors suggest intention to use condoms and practice safer sex increased after role play. Carried out attitude-behaviour analysis
18 - 1 Other
173 / 120 / 80 Systematic sample
Intervention associated with less intention to use steroids. Operationalised model
240 - 1 Other
? / 2844 / 1477
Theory-based (skills) intervention associated with increased use of condoms, reduction in number of
Not adequately described partners and behavioural intentions. Operationalised theory of reasoned action
251 - 1 Other
? / 5378 / 3875
Authors claim programme associated with increased smoking cessation in intervention school
Not adequately described
391 - 1 Patient
? / 763 / 763 Systematic sample
Authors suggest intervention associated with increased condom use (42% vs. 30%). Unclear description of design either before/after or concurrent
515 - 1 Other
? / 2026 / 1785 Systematic sample
Intervention associated with greater intention to practice safer sex. Operationalisation theory planned behaviour
759 - 1 Other
? / 6573 / 6573
Intervention not associated with changes in behaviour, though control schools increased sexual activity and
Not adequately described intervention group remained the same. Analysis looked at predictors of sexual activity
628 - 1 Other
? / 197 / 145 Convenience sample
Authors claim intervention associated with increased consistent condom use (p < 0.01)
780 - 1 Other
? / 2239 / 2239 Systematic sample
Intervention not associated with changes in risky sex
463 - 1 Other
? / 298 / 191 Convenience sample
Intervention community decreased number of risky sex behaviours, not changed in comparison community
663 - 1 Other
880 / 845 / 804 Systematic sample
Intervention not associated with intention to change behaviour (p = 0.07)
373 - 1 Other
? / 1444 / 888 Convenience sample
Intervention not associated with sexual activity. Analysis operationalised HBM
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 34 contd Description of the quality of the study and summary results: concurrent
Study Intervention Sample size number level
Summary of results
453 - 1 Other
? / 377 / 161 Convenience sample
Both intervention groups associated with changes in alcohol use but not cigarette or marijuana use (p < 0.05)
822 - 1 Other
?/?/? Convenience sample
Differential effects between groups and in comparison with intervention groups for safer sex
823 - 1 Other
? / ? / 4806
Intervention associated with changes in smoking and drug use (p < 0.05)
Not adequately described
813 - 1 Other
5686 / 3779 / 1786 Total sample available
Intervention associated with changes in seat belt use and diet (p < 0.01). No changes for smoking, exercise or alcohol
146 - 1 Other
2978 / 2978 / 2978 Total sample available
Authors suggest intervention associated with increased uptake of influenza vaccination (40% to 56%). Main analysis was predictors uptake
257 - 1 Other
? / ? / 3884 Total sample available
More aggressive recruitment associated with greater attendance for health check (14%, 21%, 32%, 37%)
775 - 1 Other
3616 / 3616 / 3616 Total sample available
Children more likely to be immunised in general practice than in health centre (80% vs. 68%).Analysis assessed differences between rural and inner city locations
331 - 1 Patient
? / 80 / 80
Adherence to routine health/immunisation screenings was not associated with immunisation in A&E
Not adequately described
95 - 1 Patient
? / 175 / ?
No improvement in self-management behaviours by intervention group. Main outcomes were
Not adequately described knowledge and satisfaction
3-1
Other
? / 256 / 206
Intervention associated with an increase in breast feeding
Not adequately described
529 - 1 Other
? / 2610 / 2508 Systematic sample
Intervention associated with increased chewing of xylitol (p < 0.05)
618 - 1 Other
?/?/? Convenience sample
Intervention not associated with increased use of reimbursed dental service
430 - 1 Patient
? / ? / 230
Differences in reproductive choices found between counselled/not counselled. Note: not a
Not adequately described controlled sample
516 - 1 Patient
? / 1607 / 1607 Total sample available
Health centre intervention higher uptake than letter invitation (24% vs. 4%). Assessed process variables
323 - 1 Other
9150 / 1265 / 551 Total sample available
Both information interventions associated with higher recruitment to study and adherence at 6 months, no differential effect between intervention groups
586 - 1 Patient
161 / 127 / 127 Convenience sample
Observation of medication taking associated with greater adherence (88% vs. 50%)
452 - 1 Other
1300 / 1300 / 1300 Total sample available
Intervention associated with increased completion treatment (65% vs. 78%; p < 0.05)
124 - 1 Patient
? / 93 / 93 Convenience sample
Whether drug was taken orally or injected had no impact on medication adherence post-discharge
825 - 1 Not recorded ? / ? / ?
Authors claim intervention associated with increased adherence
Not adequately described
335 - 1 Other
? / ? / 334 Convenience sample
Intervention women more likely to assemble rehydration solution accurately
570 - 1 Other
? / 106 / 106
Intervention not associated with any changes in risk taking behaviours
Not adequately described
773 - 1 Other
1620 / 1168 / 1043 Total sample available
No association between intensive intervention and increased adherence to helmet use
40 - 1
Not recorded ? / 72 / ? Convenience sample
More symptoms noted when using computer also preferred method
75 - 1 Patient
? / 108 / 108 Convenience sample
Insured patients more likely to keep appointments, less likely to make appointments and willing to pay more for insurance
145
Appendix 8
146
TABLE 35 Description of the quality of the study and summary results: before/after different samples
Study Intervention Sample size number level
Summary of results
34 - 1 Other
?/?/?
Mammography uptake improved over 5 years
Not adequately described
100 - 1 Patient
?/?/? Convenience sample
Uptake rate for mammography increased from 47% to 72% a year
192 - 1 Other
410 / 316 / ? Total sample available
Cervical screening increased from 51% to 78%
383 - 1 Other
? / 516 / 516 Systematic sample
Intervention not associated with uptake of mammography (47% vs. 41%: aware intervention vs. not aware)
421 - 1 Other
?/?/?
Actual results not reported but authors claim intervention associated with increased BSE
Not adequately described
575 - 1 Patient
? / 2972 / 2972 Systematic sample
Intervention associated with increased smear uptake (20% to 58%)
401 - 1 Other
985 / 656 / 656 Total sample available
Trained health professionals and provision prompts increased referral and attendance in women for mammography (55% to 88%)
765 - 1 Patient
618 / 109 / 109 Convenience sample
Authors claim intervention associated increase sun protective behaviours (6.5% to 27%)
495 - 1 Patient
? / 533 / 533 Systematic sample
Intervention not associated with increase in making living wills. Analysis looked at predictors of living will completion
340 - 1 Other
? / 7667 / 7667 Systematic sample
Authors claim smoking decreased over a 4-year period. Actual percentages not reported and likely self-selecting sample bias
423 - 1 Patient
912 / 706 / 706 Total sample available
Authors claim media interventions associated with increase testing for HIV but no increase in number of positives
550 - 1 Other
344 / 314 / 314 Total sample available
No-smoking policy not associated changes marijuana and alcohol use.Associated with cessation of cigarette use (p = 0.02)
514 - 1 Not recorded ? / 1232 / 1232 Systematic sample
Intervention not associated cessation smoking
461 - 1 Other
? / 15188 / 15188 Systematic sample
Self report increase seat belt use (17% more) and reduction drunk driving (40% less) greater in intervention city
462 - 1 Other
? / 2016 / 2016 Systematic sample
Intervention community associated increase physical activity and cholesterol checks (p < 0.05), no change smoking cessation or fruit consumption
670 - 1 Patient
?/?/? Convenience sample
Analysis suggests greatest change in testing after television campaigns
680 - 1 Patient
?/?/? Convenience sample
Authors claim interventions associated with decreased risky sexual behaviours. Interactions with ethnicity and sexual orientation
662 - 1 Patient
? / 276 / 266 Convenience sample
Announcement associated with greater intention to test for HIV (p < 0.01)
142 - 1 Other
?/?/? Convenience sample
Authors claim changes in risky sex and safe drug taking practices
619 - 1 Other
? / 1515 / 1515 Convenience sample
Surveys demonstrated no change in behaviour over the two time points. Behaviour change probably made before first survey
647 - 1 Other
? / 1469 / 1469
Intervention associated reduction high risk behaviours in all three cities
Not adequately described
193 - 1 Patient
?/?/? Systematic sample
Intervention not associated with an increase in childhood immunisations
767 - 1 Other
?/?/? Total sample available
Intervention associated increase immunisation (53% to 78%). Analysis assessed uptake by deprivation indices
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 35 contd Description of the quality of the study and summary results: before/after different samples
Study Intervention Sample size number level
Summary of results
413 - 1 Other
? / 299 / 299 Total sample available
Intervention associated increase vaccination from 50% to 73%
623 - 1 Other
? / 652 / 524
Intervention not associated changes in breast feeding behaviour
Not adequately described
26 - 1 Other
167 / 167 / 167 Total sample available
Intervention associated increase breast feeding in hospital, not maintained at home
97 - 1 Other
?/?/? Convenience sample
More people reported brushing teeth and buying toothbrushes /fluorinated toothpaste. No reduction in those that do not attend a health professional
737 - 1 Patient
? / 604 / 604
Adherence to treatment increased between two time points
Not adequately described
563 - 1 Patient
? / 928 / 928
Use of mobile clinic increased completion of examination forms and adherence to treatment
Not adequately described (from 9% to 91%)
239 - 1 Other
6168 / 5925 / 5385 Total sample available
Risky child sleep position decreased from 30% to 5%
294 - 1 Other
?/?/? Convenience sample
Authors claim 523 people requested fragile X information, no increase uptake diagnostic tests. Note: no baseline, post intervention or population figures given to support authors claims
674 - 1 Patient
? / 1339 / 1339 Total sample available
Introduction clinic associated with fewer non-attendees (0.3% vs. 4.3%)
149 - 1 Other
? / 783 / 783 Convenience sample
Authors claim helmet use increased
147
Appendix 8
148
TABLE 36 Description of the quality of the study and summary results: before/after same sample
Study Intervention Sample size number level
Summary of results
99 - 1 Patient
1087 / 727 / 526 Convenience sample
Intention to attend for mammography increased (60% vs. 51%; p < 0.01). Analysis performed by intention to have vs. not to have
266 - 1 Patient
1592 / 1592 / 1022 Total sample available
Increased sun protective behaviours were observed over 6 years. Unable to attribute to clinic intervention alone
746 - 1 Patient
1628 / 1000 / 100 Systematic sample
Intervention associated with increased uptake of cervical and mammography screening. However, less than target rates
815 - 1 Patient
? / 127 / 127
Authors claim increased uptake of testicular cancer screening over three years (p < 0.01)
Not adequately described
795 - 1 Other
9650 / 9650 / 9650 Total sample available
Cervical smear uptake increased from 78% to 85% (80% target rate)
809 - 1 Other
? / 268 / 268 Systematic sample
Intervention associated with increased mammography uptake. Results presented by age group
133 - 1 Other
? / 11600 / ? Systematic sample
Intervention not associated with changes in health behaviours over time
466 - 1 Other
?/?/? Total sample available
Prompt on notes associated with increased attendance for screening and immunisations
46 - 1 Patient
? / 10 / ?
Study designed to compare a psycho-educational programme and control but no measure of
Not adequately described behaviour. Before/after results associated with increased BSE and mammography
126 - 1 Patient
3686 / 1585 / 948 Total sample available
Authors suggest intervention associated with uptake of mammography. Results analysed using age and income interactions
198 - 1 Patient
320 / 200 / 178 Total sample available
Intervention associated with increased safer sun practices (p < 0.05)
42 - 1
Not recorded ? / 110 / 102
Intervention associated with decreased GP visits, increased use of prevention medication, decreased
Not adequately described use of other medication
74 - 1 Patient
? / 15 / 15
Actual results not reported, authors claim participants more likely to test blood and adjust
Not adequately described insulin level after programme (p = 0.01)
79 - 1 Other
? / 70 / 54 Convenience sample
Claimed to be comparative design but only results of before/after measures intervention group reported. Intervention associated with changes in diet adherence but not exercise
111 - 1 Patient
57 / 43 / 31 Convenience sample
Receipt of information on living wills increased patients completion of wills and discussions with family members and health professionals
244 - 1 Patient
? / 396 / 257 Convenience sample
Intervention associated with increased exercise uptake
270 - 1 Patient
111 / 89 / 89 Total sample available
Intervention associated with 25% smoking cessation rate. Analysis assessed predictors of cessation
355 - 1 Patient
? / 94 / 38 Convenience sample
Intervention associated with increased exercise uptake. Analysis assessed attendees vs. non-attendees
384 - 1 Patient
? / 2244 / 338 Convenience sample
Intervention associated with changes in diet and exercise uptake but not smoking
521 - 1 Patient
208 / 186 / 148 Total sample available
Intervention associated with increased self-management behaviours (p < 0.01)
676 - 1 Patient
223 / 38 / 30 Convenience sample
Intervention associated with fewer emergency visits, improved useof inhalers and appropriate self-administration of steroids
522 - 1 Patient
2500 / 588 / 300 Convenience sample
Intervention not associated with changes in medication use or utilisation of health services
544 - 1 Not recorded 142 / 142 / 132 Total sample available
Authors report adherence to medication increased, reduction in visits by health professionals (p < 0.001)
continued
Health Technology Assessment 1999; Vol. 3: No. 1
TABLE 36 contd Description of the quality of the study and summary results: before/after same sample
Study Intervention Sample size number level
Summary of results
262 - 1 Patient
2215 / 1113 / 1097 Convenience sample
Intervention associated with 13% cessation rate. Only 5% of smokers who did not take part in intervention quit
449 - 1 Patient
? / 78 / 53 Convenience sample
Intervention associated with increased adherence from 73% to 83% (p < 0.01)
798 - 1 Patient
1006 / 526 / 520 Total sample available
Self-reported changes at follow-up: exercise (11%), smoking (15%), alcohol (24%), diet (less fat 46%)
821 - 1 Patient
? / 68 / 45
Authors claim intervention associated with implementation of exercise programme at home and
Not adequately described smoking cessation
621 - 1 Other
? / 937 / 596 Convenience sample
Participants more likely to adopt new diet (16% vs. 1%). Poor design but looked at predictors of uptake
348 - 1 Patient
2324 / 771 / 512 Total sample available
Authors claim intervention associated with changes in osteoporosis prevention activities. Analysis assessed differences in attendees/non-attendees
162 - 1 Patient
160 / 3 / 3
Authors claim intervention associated with increased healthy diet choice
Not adequately described
84 - 1 Patient
? / ? / 274 Convenience sample
Intervention associated with changes in self-report of car safety
594 - 1 Patient
? / 83 / 64 Convenience sample
Interactive video associated with uptake of medication from 0% to 25% of patients. Study assessed several decision-making process measures
179 - 1 Patient
?/7/5 Convenience sample
Sample selection of before/after design too small to draw any conclusions
367 - 1 Patient
? / 112 / 78 Convenience sample
15% sample quit after the programme
91 - 1 Patient
? / 20 / ? Convenience sample
Intervention associated with increased self-report of safe sex behaviours, cessation of risky sex
38 - 1
Not recorded ? / 143 / 56 Convenience sample
Intervention associated with increased use of condoms and decreased risky sex encounters
49 - 1
Not recorded 1180 / 1161 / ? Total sample available
Intervention associated with intentions to engage in safer sex, in one of the two schools. No association in the other school
123 - 1 Patient
? / 239 / 139 Convenience sample
Intervention associated with increased self-report use of condoms and decreased anal intercourse
159 - 1 Patient
202 / 193 / 147 Convenience sample
Intervention not associated with changes in risky sexual behaviours. Assessed predictors of behaviour
480 - 1 Patient
414 / 414 / 241 Total sample available
Intervention associated with reduction in sexual activity (33% to 25%)
651 - 1 Patient
3702 / 1458 / 1385 Systematic sample
Use of condoms increased from 7% to 22% after intervention
655 - 1 Patient
? / 586 / 502 Convenience sample
Intervention associated with increased uptake of hormonal contraception
688 - 1 Patient
? / 195 / 149 Convenience sample
Intervention associated with increased condom use (62% to 82%, p = 0.01)
729 - 1 Patient
? / 659 / 402 Convenience sample
Authors claim intervention associated with some change in drug use behaviours
770 - 1 Patient
? / 1113 / 983 Convenience sample
Authors claim a mixed association between intervention and drug use behaviours
610 - 1 Patient
? / ? / 208 Convenience sample
Authors claim intervention associated with increased intention to use condom (44% vs. 65%) and reduce number of partners (43% vs. 53%)
continued
149
Appendix 8
TABLE 36 contd Description of the quality of the study and summary results: before/after same sample
Study Intervention Sample size number level
Summary of results
467 - 1 Other
? / 2378 / 1688 Total sample available
Intervention associated with greater intention to engage in safe sex
723 - 1 Patient
? / 292 / 134
Intervention associated with increased use condom (64% to 70%)
Not adequately described
545 - 1 Patient
? / 755 / 61
Authors claim association between counselling and reduction risky sex
Not adequately described
650 - 1 Patient
814 / ? / 614 Total sample available
Clinic information not associated with changes in risk behaviours
537 - 1 Patient
? / 700 / 700 Total sample available
Intervention not associated with increased attendance at clinic. No differences in attendance between sexes
35 - 1 Other
97 / 77 / 31 Total sample available
Small sample size and self-selected. Self-report of condom use increased and discussions of safer sex increased after the intervention
364 - 1 Patient
? / 109 / 109 Convenience sample
Intervention associated with increased intention to use condoms. Operationalised social cognitive theory
526 - 1 Patient
141 / 138 / 119 Total sample available
Intervention associated with changes in risky sex behaviours.Analysis assessed predictors behaviour change, operationalised five models
654 - 1 Patient
? / 327 / 327 Convenience sample
Authors claim intervention associated with intention to change sex practices (p < 0.01)
450 - 1 Patient
? / 93 / 69 Convenience sample
Authors claim intervention associated with risk-reducing behaviours
573 - 1 Patient
? / 1915 / 1145 Total sample available
Intervention associated with 20% increased uptake of Hepatitis B vaccination (p < 0.01)
342 - 1 Patient
? / 195 / 195 Total sample available
Uptake of immunisation increased from 8% to 46%
132 - 1 Patient
893 / 893 / 893 Total sample available
Breast feeding increased from 18% to 52%
163 - 1 Patient
? / 11 / 11 Convenience sample
Authors claim intervention associated with increased hygiene activities
361 - 1 Patient
? / 11 / 11
Authors claim intervention associated with increased appropriate behaviour (library visit)
Not adequately described
150
Health Technology Assessment 1999; Vol. 3: No. 1
Health Technology Assessment panel membership
This report was identified as a priority by the Screening Panel.
Current members Chair: Professor Francis H Creed, University of Manchester Professor Clifford Bailey, University of Leeds Ms Tracy Bury, Chartered Society of Physiotherapy Professor Collette Clifford, University of Birmingham Past members Professor John Farndon, University of Bristol* Professor Senga Bond, University of Newcastleupon-Tyne Professor Ian Cameron, Southeast Thames Regional Health Authority Ms Lynne Clemence, Mid-Kent Health Care Trust
Acute Sector Panel
Dr Katherine Darton, M.I.N.D. Mr John Dunning, Papworth Hospital, Cambridge Mr Jonathan Earnshaw, Gloucester Royal Hospital Mr Leonard Fenwick, Freeman Group of Hospitals, Newcastle-upon-Tyne Professor David Field, Leicester Royal Infirmary
Ms Grace Gibbs, West Middlesex University Hospital NHS Trust Dr Neville Goodman, Southmead Hospital Services Trust, Bristol Professor Mark P Haggard, MRC Professor Robert Hawkins, University of Manchester
Dr Duncan Keeley, General Practitioner, Thame Dr Rajan Madhok, East Riding Health Authority Dr John Pounsford, Frenchay Hospital, Bristol Dr Mark Sculpher, University of York Dr Iqbal Sram, NHS Executive, North West Region
Professor Cam Donaldson, University of Aberdeen Professor Richard Ellis, St James's University Hospital, Leeds Mr Ian Hammond, Bedford & Shires Health & Care NHS Trust Professor Adrian Harris, Churchill Hospital, Oxford Dr Gwyneth Lewis, Department of Health
Mrs Wilma MacPherson, St Thomas's & Guy's Hospitals, London Dr Chris McCall, General Practitioner, Dorset Professor Alan McGregor, St Thomas's Hospital, London Professor Jon Nicholl, University of Sheffield Professor John Norman, University of Southampton
Professor Michael Sheppard, Queen Elizabeth Hospital, Birmingham Professor Gordon Stirrat, St Michael's Hospital, Bristol Dr William Tarnow-Mordi, University of Dundee Professor Kenneth Taylor, Hammersmith Hospital, London
Current members
Diagnostics and Imaging Panel
Chair: Professor Mike Smith, University of Leeds Dr Philip J Ayres, Leeds Teaching Hospitals NHS Trust Dr Paul Collinson, Mayday University Hospital, Thornton Heath
Dr Barry Cookson, Public Health Laboratory Service, Colindale Professor David C Cumberland, University of Sheffield Professor Adrian Dixon, University of Cambridge Mr Steve Ebdon-Jackson, Department of Health
Mrs Maggie Fitchett, Association of Cytogeneticists, Oxford Dr Peter Howlett, Portsmouth Hospitals NHS Trust Professor Alistair McGuire, City University, London Dr Andrew Moore, Editor, Bandolier Dr Peter Moore, Science Writer, Ashtead
Professor Chris Price, London Hospital Medical School Dr William Rosenberg, University of Southampton Dr Gillian Vivian, Royal Cornwall Hospitals Trust Dr Greg Warner, General Practitioner, Hampshire
Past members
Professor Michael Maisey, Guy's & St Thomas's Hospitals, London* Professor Andrew Adam, Guy's, King's & St Thomas's School of Medicine & Dentistry, London Dr Pat Cooke, RDRD, Trent Regional Health Authority Ms Julia Davison, St Bartholomew's Hospital, London
Professor MA Ferguson-Smith, University of Cambridge Dr Mansel Hacney, University of Manchester Professor Sean Hilton, St George's Hospital Medical School, London Mr John Hutton, MEDTAP International Inc., London
Professor Donald Jeffries, St Bartholomew's Hospital, London Dr Ian Reynolds, Nottingham Health Authority Professor Colin Roberts, University of Wales College of Medicine Miss Annette Sergeant, Chase Farm Hospital, Enfield
Professor John Stuart, University of Birmingham Dr Ala Szczepura, University of Warwick Mr Stephen Thornton, Cambridge & Huntingdon Health Commission Dr Jo Walsworth-Bell, South Staffordshire Health Authority
* Previous Chair continued
153
Health Technology Assessment panel membership
continued Current members Chair: Professor Martin Buxton, Brunel University Professor Doug Altman, Institute of Health Sciences, Oxford Dr David Armstrong, Guy's, King's & St Thomas's School of Medicine & Dentistry, London Professor Nick Black, London School of Hygiene & Tropical Medicine Past members Professor Anthony Culyer, University of York * Professor Michael Baum, Royal Marsden Hospital Dr Rory Collins, University of Oxford
Methodology Panel
Professor Ann Bowling, University College London Medical School Dr Mike Clarke, University of Oxford Professor Michael Drummond, University of York Dr Vikki Entwistle, University of Aberdeen Professor Ewan Ferlie, Imperial College, London Professor Ray Fitzpatrick, University of Oxford
Professor Jeremy Grimshaw, University of Aberdeen Dr Stephen Harrison, University of Leeds Mr John Henderson, Department of Health Professor Richard Lilford, Regional Director, R&D, West Midlands Professor Theresa Marteau, Guy's, King's & St Thomas's School of Medicine & Dentistry, London Dr Henry McQuay, University of Oxford
Professor George Davey-Smith, University of Bristol Professor Stephen Frankel, University of Bristol Mr Philip Hewitson, Leeds FHSA
Mr Nick Mays, King's Fund, London Professor Ian Russell, University of York Dr Maurice Slevin, St Bartholomew's Hospital, London
Dr Nick Payne, University of Sheffield Professor Margaret Pearson, NHS Executive North West Professor David Sackett, Centre for Evidence Based Medicine, Oxford Dr PAG Sandercock, University of Edinburgh Dr David Spiegelhalter, Institute of Public Health, Cambridge Professor Joy Townsend, University of Hertfordshire Professor Charles Warlow, Western General Hospital, Edinburgh
Current members Chair: Professor Tom Walley, University of Liverpool Dr Felicity Gabbay, Transcrip Ltd Mr Peter Golightly, Leicester Royal Infirmary Dr Alastair Gray, Health Economics Research Unit, University of Oxford Past members Professor Michael Rawlins, University of Newcastleupon-Tyne* Dr Colin Bradley, University of Birmingham Professor Alasdair Breckenridge, RDRD, Northwest Regional Health Authority
Pharmaceutical Panel
Professor Rod Griffiths, NHS Executive West Midlands Mrs Jeanette Howe, Department of Health Professor Trevor Jones, ABPI, London Ms Sally Knight, Lister Hospital, Stevenage
Dr Andrew Mortimore, Southampton & SW Hants Health Authority Mr Nigel Offen, Essex Rivers Healthcare, Colchester Mrs Marianne Rigge, The College of Health, London Mr Simon Robbins, Camden & Islington Health Authority, London
Dr Frances Rotblat, Medicines Control Agency Dr Eamonn Sheridan, St James's University Hospital, Leeds Mrs Katrina Simister, Liverpool Health Authority Dr Ross Taylor, University of Aberdeen
Ms Christine Clark, Hope Hospital, Salford Mrs Julie Dent, Ealing, Hammersmith & Hounslow Health Authority, London Mr Barrie Dowdeswell, Royal Victoria Infirmary, Newcastle-upon-Tyne
Dr Tim Elliott, Department of Health Dr Desmond Fitzgerald, Mere, Bucklow Hill, Cheshire Professor Keith Gull, University of Manchester Dr Keith Jones, Medicines Control Agency
Dr John Posnett, University of York Dr Tim van Zwanenberg, Northern Regional Health Authority Dr Kent Woods, RDRD, Trent RO, Sheffield
154
* Previous Chair
Health Technology Assessment 1999; Vol. 3: No. 1
Current members Chair: Professor Sir John Grimley Evans, Radcliffe Infirmary, Oxford Ms Stella Burnside, Altnagelvin Hospitals Trust, Londonderry Mr John Cairns, University of Aberdeen
Population Screening Panel
Professor Howard Cuckle, University of Leeds Dr Carol Dezateux, Institute of Child Health, London Dr Anne Dixon Brown, NHS Executive, Anglia & Oxford
Professor Dian Donnai, St Mary's Hospital, Manchester Dr Tom Fahey, University of Bristol Mrs Gillian Fletcher, National Childbirth Trust Dr JA Muir Gray, Institute of Health Sciences, Oxford
Professor Alexander Markham, St James's University Hospital, Leeds Dr Ann McPherson, General Practitioner, Oxford Dr Susan Moss, Institute of Cancer Research Dr Sarah Stewart-Brown, University of Oxford
Past members Dr Sheila Adam, Department of Health* Professor George Freeman, Charing Cross & Westminster Medical School, London Dr Mike Gill, Brent & Harrow Health Authority
Dr Anne Ludbrook, University of Aberdeen Professor Theresa Marteau, Guy's, King's & St Thomas's School of Medicine & Dentistry, London
Professor Catherine Peckham, Institute of Child Health, London Dr Connie Smith, Parkside NHS Trust, London Ms Polly Toynbee, Journalist
Professor Nick Wald, University of London Professor Ciaran Woodman, Centre for Cancer Epidemiology, Manchester
Current members Chair: Dr John Tripp, Royal Devon & Exeter Healthcare NHS Trust Mr Kevin Barton, East London & City Health Authority Professor John Bond, University of Newcastleupon-Tyne Dr John Brazier, University of Sheffield
Primary and Community Care Panel
Ms Judith Brodie, Age Concern, London Mr Shaun Brogan, Daventry & South Northants Primary Care Alliance Mr Joe Corkill, National Association for Patient Participation Dr Nicky Cullum, University of York Professor Pam Enderby, University of Sheffield
Mr Andrew Farmer, Institute of Health Sciences, Oxford Professor Richard Hobbs, University of Birmingham Professor Allen Hutchinson, University of Sheffield Dr Phillip Leech, Department of Health Dr Aidan Macfarlane, Oxfordshire Health Authority Professor David Mant, Institute of Health Sciences, Oxford
Dr Chris McCall, General Practitioner, Dorset Dr Robert Peveler, University of Southampton Professor Jennie Popay, University of Salford Ms Hilary Scott, Tower Hamlets Healthcare NHS Trust, London Dr Ken Stein, North & East Devon Health Authority
Past members Professor Angela Coulter, King's Fund, London* Professor Martin Roland, University of Manchester* Dr Simon Allison, University of Nottingham Professor Shah Ebrahim, Royal Free Hospital, London Ms Cathy Gritzner, King's Fund, London
Professor Andrew Haines, RDRD, North Thames Regional Health Authority Dr Nicholas Hicks, Oxfordshire Health Authority Mr Edward Jones, Rochdale FHSA Professor Roger Jones, Guy's, King's & St Thomas's School of Medicine & Dentistry, London
Mr Lionel Joyce, Chief Executive, Newcastle City Health NHS Trust Professor Martin Knapp, London School of Economics & Political Science Professor Karen Luker, University of Liverpool Dr Fiona Moss, Thames Postgraduate Medical & Dental Education
Professor Dianne Newham, King's College London Professor Gillian Parker, University of Leicester Dr Mary Renfrew, University of Oxford
* Previous Chair continued
155
Health Technology Assessment panel membership
National Coordinating Centre for Health Technology Assessment, Advisory Group
Current members Chair: Professor John Gabbay, Wessex Institute for Health Research & Development Professor Mike Drummond, Centre for Health Economics, University of York
Ms Lynn Kerridge, Wessex Institute for Health Research & Development Dr Ruairidh Milne, Wessex Institute for Health Research & Development Ms Kay Pattison, Research & Development Directorate, NHS Executive
Past member Dr Paul Roderick, Wessex Institute for Health Research & Development
Professor James Raftery, Health Economics Unit, University of Birmingham Professor Ian Russell, Department of Health Sciences & Clinical Evaluation, University of York
Professor Andrew Stevens, Department of Public Health & Epidemiology, University of Birmingham
Dr Ken Stein, North & East Devon Health Authority
156
HTA Commissioning Board
Current members Chair: Professor Charles Florey, Department of Epidemiology & Public Health, Ninewells Hospital & Medical School, University of Dundee Professor Doug Altman, Director of ICRF/NHS Centre for Statistics in Medicine, Oxford Professor John Bond, Professor of Health Services Research, University of Newcastle-upon-Tyne Mr Peter Bower, Independent Health Advisor, Newcastle-upon-Tyne Ms Christine Clark, Honorary Research Pharmacist, Hope Hospital, Salford Professor Shah Ebrahim, Professor of Epidemiology of Ageing, University of Bristol
Professor Martin Eccles, Professor of Clinical Effectiveness, University of Newcastleupon-Tyne Dr Mike Gill, Director of Public Health & Health Policy, Brent & Harrow Health Authority Dr Alastair Gray, Director, Health Economics Research Centre, University of Oxford Professor Mark Haggard, MRC Institute of Hearing Research Dr Jenny Hewison, Senior Lecturer, Department of Psychology, University of Leeds Professor Sir Miles Irving (Programme Director), Professor of Surgery, University of Manchester, Hope Hospital, Salford
Professor Alison Kitson, Director, Royal College of Nursing Institute Dr Donna Lamping, Senior Lecturer, Department of Public Health, London School of Hygiene & Tropical Medicine Professor Alan Maynard, Professor of Economics, University of York Professor Jon Nicholl, Director, Medical Care Research Unit, University of Sheffield Professor Gillian Parker, Nuffield Professor of Community Care, University of Leicester Dr Tim Peters, Reader in Medical Statistics, Department of Social Medicine, University of Bristol Professor Martin Severs, Professor in Elderly Health Care, Portsmouth University
Dr Sarah Stewart-Brown, Director, Institute of Health Sciences, University of Oxford Professor Ala Szczepura, Director, Centre for Health Services Studies, University of Warwick Dr Gillian Vivian, Consultant, Royal Cornwall Hospitals Trust Professor Graham Watt, Department of General Practice, Woodside Health Centre, Glasgow Professor Kent Woods, Regional Director of R&D NHS Executive Trent Dr Jeremy Wyatt, Senior Fellow, Health & Public Policy, School of Public Policy, University College, London
Past members Professor Ian Russell, Department of Health Sciences & Clinical Evaluation, University of York* Professor David Cohen, Professor of Health Economics, University of Glamorgan Mr Barrie Dowdeswell, Chief Executive, Royal Victoria Infirmary, Newcastle-upon-Tyne
Dr Michael Horlington, Head of Corporate Licensing, Smith & Nephew Group Research Centre Professor Martin Knapp, Director, Personal Social Services Research Unit, London School of Economics & Political Science Professor Theresa Marteau, Director, Psychology & Genetics Research Group, Guy's, King's & St Thomas's School of Medicine & Dentistry, London
Professor Sally McIntyre, MRC Medical Sociology Unit, Glasgow Professor David Sackett, Centre for Evidence Based Medicine, Oxford Dr David Spiegelhalter, MRC Biostatistics Unit, Institute of Public Health, Cambridge Professor David Williams, Department of Clinical Engineering, University of Liverpool
Dr Mark Williams, Public Health Physician, Bristol * Previous Chair
Copies of this report can be obtained from: The National Coordinating Centre for Health Technology Assessment, Mailpoint 728, Boldrewood, University of Southampton, Southampton, SO16 7PX, UK. Fax: +44 (0) 1703 595 639 Email: [email protected] http://www.soton.ac.uk/~hta
ISSN 1366-5278
Health Technology Assessment 1999; Vol. 3: No. 1

File: informed-decision-making-an-annotated-bibliography-and-systematic.pdf
Title: Informed Decision Making
Author: Bekker et al.
Subject: HTA Methodology. Bekker et al. Volume 3, number 1. Published March 1999.
Published: Fri Feb 19 10:19:01 1999
Pages: 168
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