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Effectiveness of multiple health behavior change interventions in reducing symptoms of anxiety in the adult population: A systematic review and meta-analysis of randomized controlled trials.

Authors

Gómez-Gómez, Irene , Barquero-Jiménez, Carlos , Johnson, Emma , Conejo-Cerón, Sonia , Moreno-Peral, Patricia , Bellón, Juan Ángel , MOTRICO MARTINEZ, EMMA

External publication

No

Means

Prev. Med.

Scope

Article

Nature

Científica

JCR Quartile

SJR Quartile

Publication date

08/01/2024

ISI

001169817500001

Scopus Id

2-s2.0-85183203706

Abstract

There is limited evidence regarding the effectiveness of preventive interventions for anxiety disorders. We aim to test the effectiveness of multiple health behavior change (MHBC) interventions in the reduction of symptoms of anxiety in the adult population. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching the most relevant databases and registry platforms in the area. Reference lists of included articles and relevant systematic reviews and meta-analyses of MHBC interventions that examined anxiety or depression as outcomes were also manually searched. To identify RCTs that evaluated preventive interventions, we excluded studies in which the target population included only patients meeting the diagnostic criteria for anxiety disorders. To pool results, the standardized mean difference (SMD) was calculated using the random effects model. Sensitivity, subgroup and meta-regression analyses were performed. Forty-six RCTs were included in the qualitative synthesis, and 34 RCTs were included in the meta-analysis. Thirty RCTs were focused on promoting healthy diet and physical activity, whereas the other 16 studies also focused on smoking cessation. The pooled SMD was small (-0.183; 95% CI -0.276 to -0.091) but significant (p < 0.001). The effect became non-significant when only studies with a low risk of bias were included. There was substantial and significant heterogeneity between the studies. There is currently insufficient evidence regarding the effectiveness of MHBC interventions to reduce symptoms of anxiety in the adult population.

Keywords

Anxiety disorders; Lifestyle; Meta-analysis; Multiple health behavior change; Prevention; Randomized controlled trial