Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change .
Follow-up period and intervention characteristics impacted effectiveness for some outcomes .
Interventions comprising education ( e.g. , providing information about behaviors associated with health risks ) and skills training ( e.g. , teaching skills that equip participants to engage in less risky behavior ) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity .
Although on average smoking was reduced , it appeared changes in smoking were negatively associated with changes in other behaviors , suggesting it may not be optimal to target smoking simultaneously with other risk behaviors
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease , cancer , or Type 2 diabetes .
Systematic reviews of health effects of social interventions: 2. Best available evidence: how low should you go?
Study objective : There is little guidance on how to select the best available evidence of health effects of social interventions . The aim of this paper was to assess the implication s of setting particular inclusion criteria for evidence synthesis . Design : Analysis of all relevant studies for one systematic review , followed by sensitivity analysis of the effects of selecting studies based on a two dimensional hierarchy of study design and study population . Setting : Case study of a systematic review of the effectiveness of interventions in promoting a population shift from using cars towards walking and cycling .  Main results : The distribution of available evidence was skewed . Population level interventions were less likely than individual level interventions to have been studied using the most rigorous study design s ; nearly all of the population level evidence would have been missed if only r and omised controlled trials had been included . Examining the studies that were excluded did not change the overall conclusions about effectiveness , but did identify additional categories of intervention such as health walks and parking charges that merit further research , and provided evidence to challenge assumptions about the actual effects of progressive urban transport policies . Conclusions : Unthinking adherence to a hierarchy of study design as a means of selecting studies may reduce the value of evidence synthesis and reinforce an “ inverse evidence law ” whereby the least is known about the effects of interventions most likely to influence whole population s. Producing generalisable estimates of effect sizes is only one possible objective of evidence synthesis . Mapping the available evidence and uncertainty about effects may also be important
Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change .
Follow-up period and intervention characteristics impacted effectiveness for some outcomes .
Interventions comprising education ( e.g. , providing information about behaviors associated with health risks ) and skills training ( e.g. , teaching skills that equip participants to engage in less risky behavior ) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity .
Although on average smoking was reduced , it appeared changes in smoking were negatively associated with changes in other behaviors , suggesting it may not be optimal to target smoking simultaneously with other risk behaviors
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease , cancer , or Type 2 diabetes .