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 .
A randomized trial of sequential and simultaneous multiple behavior change interventions for physical activity and fat intake.
BACKGROUND Major questions remain unanswered about how best to accomplish multiple behavior change . The purpose of this study was to evaluate whether there are differences in successfully changing multiple behaviors in computer-tailored sequential and simultaneous interventions for physical activity ( PA ) promotion and fat intake ( FI ) reduction . METHODS Participants ( N=567 ) were r and omly assigned to receive an intervention for PA and FI simultaneously ; PA at baseline and FI at 3 months ; or FI at baseline and PA at 3 months .  Successful behavior change at 6 months was defined as : > 60 min PA increase and /or 5 % FI reduction . Using multinomial logistic regression the odds ratios of successful behaviors change ( none , PA only , FI only , or both ) were determined for intervention mode , gender , age , BMI and education . RESULTS Overall drop-out was 26 % . There was no behavior change for 20.2 % of participants ; 30.5 % successfully decreased FI ; 15.8 % successfully increased PA ; 33.5 % successfully changed both behaviors . Intervention mode , gender and age were not associated with successful behavior change . Compared to those that did not change any behaviors : participants that successfully changed FI were more likely to be overweight/obese ( OR=1.85 ) ; and participants that successfully changed both behaviors were more likely to be overweight/obese ( OR=2.13 ) and have lower education ( OR=2.46 ) . CONCLUSIONS Success in changing multiple behaviors was not associated with intervention mode ; both simultaneous and sequential interventions can be applied . Being overweight might be an extra motivator to change health behaviors
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 .