Table 5 Summary of included studies

Authors: Adolfsson ET, Walker-EngstrÃm ML, Smide B, Wikblad K [36]

Patient education in type 2 diabetes-A randomized controlled 1-year follow-up study

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Group education

Quality rating: High

Nutrition: N/A

Patient skills: N/A

Description: Group empowerment sessions

Quality score: 2.66

Alcohol: N/A

Self efficacy: No

Intensity: 4–5 sessions over 7 months

Physical activity: N/A

Stage of change: N/A

Intensity score: M

Weight: No

Provider: Multi-disciplinary team (GP, educator)

Patient activation: N/A

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Merrill RM, Ohmine S, et al [37]

Effects of an intensive diet and physical activity modification program on the health risks of adults

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Group education

Quality rating: High

Nutrition: Yes

Patient skills: N/A

Description: Group education with participants following preset dietary goals

Quality score: 3.0

Alcohol: N/A

Self efficacy: N/A

Intensity: 40 h over a 4-week period

Physical activity: Yes

Stage of change: N/A

Intensity score: M

Weight: Yes

Patient activation: N/A

Provider: Multi-disciplinary team (GP, educator)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Brassington GS, Atienza AA, Perczek RE, DiLorenzo TM, King AC [38]

Intervention-Related Cognitive Versus Social

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Mediators of Exercise Adherence in the Elderly

Quality rating: Low

Nutrition: N/A

Patient skills: N/A

Intervention type: Telephone

Alcohol: N/A

Self efficacy: Yes

Description: Telephone Counselling + exercise logs

Physical activity: Yes

Stage of change: N/A

Intensity: exercise prescription, telephone exercise counseling to promote exercise adherence for 12 months, and attended 6- and 12-month assessment visits

Weight: N/A

Patient activation: N/A

Intensity score: H

Quality score: 1.83

Shared decision making: N/A

Provider: Educator

Other health literacy outcome: N/A

Authors: de Vries H, Kremers SP, Smeets T, Brug J, Eijmael K [53]

The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors

Study type: Randomised Controlled Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: 3 iterative tailored feedback letters

Quality score: 2.0

Alcohol: N/A

Self efficacy: Yes

Intensity: 3 iterative feedback letters

Physical activity: Yes

Stage of change: N/A

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Other

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW, Blair SN [39]

Reduction in cardiovascular disease risk factors: 6-month results from Project Active

Study type: Randomised Clinical Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Cognitive & behavioural strategies + Motivational Interviewing - advised to accumulate at least 30 min of moderate intensity physical activity on most days of the week, tailored to their lifestyle

Quality score: 2.33

Alcohol: N/A

Self efficacy: Yes

Intensity: small groups that met for an hour 1 night a week for the first 16 weeks, and then every other week for weeks 17 to 24,

Physical activity: Yes

Stage of change: No

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Educator

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Efraimsson EÃ, Hillervik C, Ehrenberg A [40]

Effects of COPD self-care management education at a nurse-led primary health care clinic

Study type: Randomised Controlled Trial

Smoking: Yes

Patient knowledge: Yes

Intervention type: Motivational interviewing and counseling

Quality rating: Low

Nutrition: N/A

Patient skills: N/A

Description: Disease education (COPD) & counseling on RF

Quality score: 1.83

Alcohol: N/A

Self efficacy: N/A

Intensity: 12–20 weeks

Physical activity: Yes

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Nurse

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Goldstein MG, Pinto BM, Marcus BH, Lynn H, Jette AM, Rakowski W, et al [32]

Physician-based physical activity counseling for middle-aged and older adults: a randomized trial

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Individualised motivational counseling, goal setting + PA prescription + mailed monthly materials

Quality score: 2.33

Alcohol: N/A

Self efficacy: N/A

Intensity: 5 mins brief counseling with mailed monthly materials

Physical activity: No

Stage of change: No

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Hartman TJ, McCarthy PR, Park RJ, Schuster E, Kushi LH [54]

Results of a community-based low-literacy nutrition education program

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: 10 sessions and written information

Quality score: 2.5

Alcohol: N/A

Self efficacy: No

Intensity: 10 sessions

Physical activity: N/A

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Lay worker

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Kloek GC, van Lenthe FJ, van Nierop PWM, Koelen MA, Mackenbach JP [55]

Impact evaluation of a Dutch community intervention to improve health-related behaviour in deprived neighbourhoods

Study type: Quasi experimental

Smoking: No

Patient knowledge: Yes

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Group education + community development (one off special events)

Quality score: 2.16

Alcohol: No

Self efficacy: Yes

Intensity: 2 year intervention

Physical activity: No

Stage of change: Yes

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Other

Shared decision making: N/A

Other health literacy outcome: No

Authors: Lorig KR, Ritter PL, Jacquez A [56]

Outcomes of border health Spanish/English Chronic Disease Self-management Programs

Study type: Before and After Study

Smoking: N/A

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: CDSMP

Quality score: 2.16

Alcohol: N/A

Self efficacy: Yes

Intensity: 2.5 h sessions over 6 weeks - total 14 h

Physical activity: Yes

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Lay worker

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Nies MA, Artinian NT, Schim SM, Vander Wal JS, Sherrick-Escamilla S [57]

Effects of lay health educator interventions on activity, diet, and health risks in an urban Mexican American community

Study type: Before and After Study

Smoking: N/A

Patient knowledge: No

Intervention type: Group education

Quality rating: Low

Nutrition: No

Patient skills: N/A

Description: Health promotion train the trainer sessions in the community

Quality score: 1.66

Alcohol: N/A

Self efficacy: N/A

Intensity: 2–6 h train the trainer sessions and 3x1h sessions for community

Physical activity: No

Stage of change: N/A

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Lay worker

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Norris SL, Grothaus LC, Buchner DM, Pratt M [33]

Effectiveness of physician-based assessment and counseling for exercise in a staff model HMO

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: High

Nutrition: N/A

Patient skills: N/A

Description: One counselling session, written PA prescription and one follow up call. A subset received booster telephone calls at 2, 3 and 4 months and postcard reminders at 2, 3, 4, and 5 months. (no significant difference between groups in PA levels)

Quality score: 2.66

Alcohol: N/A

Self efficacy: No

Intensity: One counselling session, written PA prescription and one follow up call

Physical activity: Yes

Stage of change: N/A

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: No

Authors: Ridgeway NA, Harvill DR, Harvill LM, Falin TM, Forester GM, Gose OD [41]

Improved control of type 2 diabetes mellitus: A practical education/behavior modification program in a primary care clinic

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Group education mixed with individual education sessions

Quality score: 2.16

Alcohol: N/A

Self efficacy: N/A

Intensity: 12 weekly group sessions, 1 individual session and 6 bi-weekly sessions

Physical activity: N/A

Stage of change: N/A

Intensity score: H

Weight: Yes

Patient activation: N/A

Provider: Multi-disciplinary team (Nurse, dietician, GP)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Sadur CN, Moline N, Costa M, Michalik D, Mendlowitz D, Roller S, et al [42]

Diabetes management in a health maintenance organization: Efficacy of care management using cluster visits

Study type: Clustered Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Group education + 1 additional individual session

Quality score: 2.33

Alcohol: N/A

Self efficacy: Yes

Intensity: 10–18 patients/month for 6 months

Physical activity: N/A

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Multi-disciplinary team (Psychologist, educator, dietician, pharmacist)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Van Sluijs EMF, Van Poppel MNM, Twisk JWR, Van Mechelen W [43]

Physical activity measurements affected participants’ behavior in a randomized controlled trial

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: No

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Individual physician tailored counseling + 2 phone calls (5–10mins) + follow up consultation

Quality score: 2.0

Alcohol: N/A

Self efficacy: No

Intensity: 10 min initial consult, 5–10 min phone call at 2 weeks, 10 min consult at 4 weeks and phone call 8 weeks after 2nd consult

Physical activity: Yes

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Multi-disciplinary team (GP, nurse, counselor)

Shared decision making: N/A

Other health literacy outcome: No

Authors: Yajima S, Takano T, Nakamura K, Watanabe M [58]

Effectiveness of a community leaders’ programme to promote healthy lifestyles in Tokyo, Japan

Study type: Quasi experimental

Smoking: No

Patient knowledge: N/R

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Range of activities by lay community members to be health promotion leaders

Quality score: 2.0

Alcohol: N/A

Self efficacy: N/A

Intensity: 2 year program

Physical activity: Yes

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/R

Provider: Lay worker

Shared decision making: N/A

Other health literacy outcome: Yes

Authors: Boylan MJ, Renier CM, Knuths JS, Haller IV [44]

Preventing cardiovascular disease in women: an intervention-control randomized study

Study type: Randomised Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Lifestyle intervention program including individualized review, information, classes and follow up phone calls

Quality score: 2.0

Alcohol: N/A

Self efficacy: Yes

Intensity: 12 months

Physical activity: N/A

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Educator

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Jimmy G, Martin BW [59]

Implementation and effectiveness of a primary care based physical activity counselling scheme

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Individual counseling & feedback on stage of change + take home leaflets + offer of referral to PA specialist (at ¼ of cost) + follow up session computer assisted tool (PA & motivation assessment) + telephone reminders (3)

Quality score: 2.33

Alcohol: N/A

Self efficacy: N/A

Intensity: Feedback, information 45 min counselling session

Physical activity: No

Stage of change: No

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Kreuter MW, Strecher VJ [60]

Do tailored behavior change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial

Study type: Randomised Controlled Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Written material

Quality rating: High

Nutrition: No

Patient skills: N/A

Description: individually-tailored behavior change information with health risk assessment mailed

Quality score: 2.66

Alcohol: N/A

Self efficacy: N/A

Intensity: 1 off risk information sheet and 1 individually tailored behavior change info

Physical activity: No

Stage of change: No

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Computer

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Miller CK, Edwards L, Kissling G, Sanville L [45]

Evaluation of a theory-based nutrition intervention for older adults with diabetes mellitus

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Group education

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: 10 group education sessions

Quality score: 2.33

Alcohol: N/A

Self efficacy: Yes

Intensity: 10 weekly group sessions

Physical activity: N/A

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Dietician

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Oenema A, Brug J, Dijkstra A, de Weerdt I, de Vries H [61]

Efficacy and use of an internet-delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation: a randomized controlled trial

Study type: Randomised Controlled Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Computer

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Internet-delivered, computer-tailored lifestyle intervention

Quality score: 2.5

Alcohol: N/A

Self efficacy: N/A

Intensity: 1 month

Physical activity: Yes

Stage of change: No

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider:

Shared decision making: N/A

Computer

Other health literacy outcome: N/A

Authors: Ogden J, Hoppe R [62]

The relative effectiveness of two styles of educational package to change practice nurses’ management of obesity

Study type: Before and After Study

Smoking: N/A

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: Yes

Description: Individual consultation + advice by nurse

Quality score: 2.0

Alcohol: N/A

Self efficacy: N/A

Intensity: One consultation

Physical activity: N/A

Stage of change: N/A

Intensity score: L

Weight: No

Patient activation: N/A

Provider: Nurse

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Simmons D, Voyle JA, Fout F, Feot S, Leakehe L [63]

Tale of two churches: Differential impact of a church-based diabetes control programme among Pacific Islands people in New Zealand

Study type: Non-Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Group education

Quality rating: High

Nutrition: N/A

Patient skills: N/A

Description: Tailored activities by language & culture relevance & cooking classes

Quality score: 2.66

Alcohol: N/A

Self efficacy: N/A

Intensity: NR

Physical activity: No

Stage of change: Yes

Intensity score: NR

Weight: Yes

Patient activation: N/A

Provider: Lay worker

Shared decision making: N/A

Other health literacy outcome: No

Authors: Ryan A, Smith C [64]

Change for Life/Cambia tu vida: a health promotion program based on the stages of change model for African descendent and Latino adults in New Hampshire

Study type: Before and After Study

Smoking: N/A

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Group education targeting participants stage of change + culturally appropriate written resources + decision tree

Quality score: 2.33

Alcohol: N/A

Self efficacy: N/A

Intensity: six 2-h classes held weekly, followed by periodic group support meetings after the series of classes is completed

Physical activity: N/A

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Multi-disciplinary team (Researcher, lay worker)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Steptoe A, Rink E, Kerry S [65]

Psychosocial predictors of changes in physical activity in overweight sedentary adults following counseling in primary care

Study type: Randomised Controlled Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Individual brief counseling by a nurse (1–3 sessions)

Quality score: 2.33

Alcohol: N/A

Self efficacy: Yes

Intensity: 1–3 sessions

Physical activity: Yes

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Nurse

Shared decision making: N/A

Other health literacy outcome: No

Authors: Toobert DJ, Glasgow RE, Strycker LA, Barrera M, Ritzwoller DP, Weidner G [46]

Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes (Provisional abstract)

Study type: Randomised Controlled Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: 2.5 day non residential education + weekly meetings for 6 months with small group support

Quality score: 2.33

Alcohol: N/A

Self efficacy: Yes

Intensity: 2.5 day non residential education + weekly meetings for 6 months with small group support

Physical activity: Yes

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Multi-disciplinary team (Dietician, exercise physiologist, educator, lay worker)

Shared decision making: N/A

Other health literacy outcome: Yes

Authors: Hoffman AM, Redding CA, Goldberg D, Añel D, Prochaska JO, Meyer PM, et al [66]

Computer expert systems for African-American smokers in physicians offices: A feasibility study

Study type: Randomised Trial

Smoking: Yes

Patient knowledge: N/A

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Computer feedback with nurse + stage based RF manual + 3–6 min audio-tapes + stress management exercise instructions

Quality score: 2.0

Alcohol: N/A

Self efficacy: N/A

Intensity: Interactive computer sessions (number uncertain) and brief audiotapes

Physical activity: N/A

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Computer

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Wolf RL, Lepore SJ, Vandergrift JL, Basch CE, Yaroch AL [67]

Tailored telephone education to promote awareness and adoption of fruit and vegetable recommendations among urban and mostly

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Telephone

Quality rating: High

Nutrition: N/A

Patient skills: N/A

Description: Telephone individual education & mailed brochure

Quality score: 2.66

Alcohol: N/A

Self efficacy: N/A

Intensity: 2 calls and mailed brochure

Physical activity: N/A

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Other

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Swerissen H, Belfrage J, Weeks A, Jordan L, Walker C, Furler J, et al [68]

A Randomized Controlled Trial of Financial Incentives for Smoking Cessation

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Language specific SM Program + audiocassette + program booklet

Quality score: 2.0

Alcohol: N/A

Self efficacy: Yes

Intensity: 6 weekly 2.5 h sessions. 20 h training for peer leaders

Physical activity: Yes

Stage of change: N/A

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Lay worker

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Campbell J, Aday RH [69]

Improving dietary behavior: the effectiveness of tailored messages in primary care settings

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Written material

Quality rating: High

Nutrition: Yes

Patient skills: N/A

Description: Computer generated tailored nutrition newsletters & profile feedback related to stage of change

Quality score: 3.0

Alcohol: N/A

Self efficacy: N/A

Intensity: one-time, mailed nutrition information packet

Physical activity: N/A

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Computer

Shared decision making: N/A

Other health literacy outcome: Yes

Authors: Collins R, Lee RE, Albright CL, King AC [47]

Ready to be Physically Active? The Effects of a Course Preparing Low-Income Multiethnic Women to be more Physically Active

Study type: Before and After Study

Smoking: N/A

Patient knowledge: Yes

Intervention type: Group education

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Group Education + culturally sensitive curriculum

Quality score: 2.16

Alcohol: N/A

Self efficacy: No

Intensity: 10 mth intervention

Physical activity: Yes

Stage of change: Yes

Intensity score: H

Weight: N/A

Patient activation: N/A

Provider: Educator

Shared decision making: N/A

Other health literacy outcome: Yes

Authors: Gladys Block PW, Rochelle Mandel, Diane Metz, Mary L Fujii, Nancy Feldman, and Barbara Sutherland [70]

A Randomized Trial of the Little by Little CD-ROM: Demonstrated Effectiveness in Increasing Fruit and Vegetable Intake in a Low-income Population

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Computer

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Self Guided interactive computer program + goal setting + handouts

Quality score: 2.33

Alcohol: N/A

Self efficacy: N/A

Intensity: CD ROM and 2 reminder phone calls

Physical activity: N/A

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Computer

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Koffman DM BT, Mosca L, Redberg R, Schmid T, Wattigney WA [71]

An evaluation of Choose to Move 1999: an American Heart Association physical activity program for women.

Study type: Before and After Study

Smoking: N/A

Patient knowledge: Yes

Intervention type: Written material

Quality rating: Low

Nutrition: Yes

Patient skills: N/A

Description: written materials + Postcards + Email + Newsletter

Quality score: 1.5

Alcohol: N/A

Self efficacy: N/A

Intensity: 12-week, mail-mediated lifestyle intervention program

Physical activity: Yes

Stage of change: N/A

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Other

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Marcus BH BB, Pinto BM, Forsyth LH, Roberts MB, Traficante RM [72]

Efficacy of an individualized, motivationally-tailored physical activity intervention

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Tailored counseling messages using “computer expert system” + motivationally matched manuals + feedback on progress were mailed to subjects

Quality score: 2.16

Alcohol: N/A

Self efficacy: Yes

Intensity: NR

Physical activity: Yes

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Other

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Prochaska JO, Velicer WF, Redding C, Rossi JS, Goldstein M, DePue J, et al [73]

Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms

Study type: Randomised Controlled Trial

Smoking: Yes

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Mailed computer generated profile reports (stage of change, use of change processes, pros & cons of changing) + self help manual + strategies on how to progress stages

Quality score: 2.33

Alcohol: N/A

Self efficacy: N/A

Intensity: 3 reports mailed for each risk factor

Physical activity: N/A

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Computer

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Prochaska JO, Velicer WF, Rossi JS, Redding CA, Greene GW, Rossi SR, et al [74]

Multiple Risk Expert Systems Interventions: Impact of Simultaneous Stage-Matched Expert System Interventions for Smoking, High-Fat Diet, and Sun Exposure in a Population of Parents

Study type: Randomised Controlled Trial

Smoking: Yes

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Mailed computer generated profile reports (stage of change, use of change processes, pros & cons of changing) + self help manual + strategies on how to progress stages

Quality score: 2.16

Alcohol: N/A

Self efficacy: N/A

reports for each of their relevant behaviors at 0, 6, and 12 months as well as a multiple behavior manual.

Physical activity: N/A

Stage of change: Yes

Intensity: Received 3 reports per year

Weight: N/A

Patient activation: N/A

Intensity score: L

Shared decision making: N/A

Provider: Computer

Other health literacy outcome: N/A

Authors: Beresford SA SJC, A R Kristal, D Lazovich, Z Feng and E H Wagner [34]

A dietary intervention in primary care practice: the Eating Patterns Study.

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Written material

Quality rating: High

Nutrition: Yes

Patient skills: No

Description: Self help materials

Quality score: 2.66

Alcohol: N/A

Self efficacy: N/A

Intensity: Low intensity – time not stated

Physical activity: N/A

Stage of change: No

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Marcus B H Emmons KM, Simkin-Silverman L R, Linnan L A, Taylor E R, Bock B C, Roberts M B, Rossi J S, Abrams D B [75]

Evaluation of motivationally tailored vs standard self-help physical activity interventions at the workplace

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Repeated mailing (3 times) Self-help manuals + motivational messages related to stage of change

Quality score: 2.0

Alcohol: N/A

Self efficacy: N/A

Intensity: 3 lots of written material

Physical activity: No

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Other

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Graham-Clarke P, Oldenburg B [76]

The effectiveness of a general-practice-based physical activity intervention on patient physical activity status

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: High

Nutrition: N/A

Patient skills: N/A

Description: Lifestyle counseling - Fresh Start Program by Heart Foundation

Quality score: 2.66

Alcohol: N/A

Self efficacy: N/A

Intensity: NR

Physical activity: No

Stage of change: Yes

Intensity score: NR

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: No

Authors: O’Loughlin, Jennifer Paradis, Gilles Meshefedjian, Garbis Kishchuk, Natalie [77]

Evaluation of an 8-Week Mailed Healthy-Weight Intervention

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Unsure

Intervention type: Written material

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: 8-Week Mailed Healthy-Weight Intervention

Quality score: 2.33

Alcohol: N/A

Self efficacy: No

Intensity: 18 pamphlets mailed over 8 weeks

Physical activity: Unsure

Stage of change: No

Intensity score: M

Weight: No

Patient activation: No

Provider: Other

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Winkleby MA, Howard-Pitney B, Albright CA, Bruce B, Kraemer HC, Fortmann SP [48]

Predicting achievement of a low-fat diet: a nutrition intervention for adults with low literacy skills

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Yes

Intervention type: Mixed intervention

Quality rating: High

Nutrition: Yes

Patient skills: N/A

Description: Group education (Stanford Nutrition Action Program) + multiple mail/telephone follow up calls

Quality score: 2.66

Alcohol: N/A

Self efficacy: Yes

Intensity: six or seven 60-min sessions classes

Physical activity: N/A

Stage of change: N/A

Intensity score: H

Weight: No

Patient activation: N/A

Provider: Educator

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Agurs-Collins, TD, Kumanyika, SK, Ten Have, TR, Adams-Campbell, LL [49]

A randomised controlled trial of weight reduction and exercise for diabetes management in older African-American subjects.

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: Unsure

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: No

Patient skills: N/A

Description: 6 group sessions, 1 individualised counseling + diary

Quality score: 2.16

Alcohol: N/A

Self efficacy: N/A

Intensity: 12 weekly group sessions, 1 individual session and 6 bi-weekly group sessions

Physical activity: No

Stage of change: Unsure Not reported

Intensity score: H

Weight: Yes

Patient activation: N/A

Provider: Multi-disciplinary team (Dietician, exercise physiologist)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Butler, CC, Rollnick, S, Cohen, D et al, [78]

Motivational consulting versus brief advice for smokers in general practice: a randomized trial

Study type: Randomised Trial

Smoking: Yes

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Motivational Counselling + patient setting targets

Quality score: 2.0

Alcohol: N/A

Self efficacy: N/A

Intensity: NR

Physical activity: N/A

Stage of change: Yes

Intensity score: NR

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Calfas, KJ, Sallis, JF, Oldenburg, B et al, [35]

Mediators of change in physical activity following an intervention in primary care: PACE

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Motivational counseling + patient setting goals + activity log + examples of activities

Quality score: 2.33

Alcohol: N/A

Self efficacy: No

Intensity: Brief intervention

Physical activity: Yes

Stage of change: Yes

\Intensity score: L

Weight: N/A

Patient activation: N/A

Provider:

Shared decision making: N/A

Doctor

Other health literacy outcome: No

Authors: Delichatsios, HK, Hunt, MK, Lobb, R et al, [50]

EatSmart: efficacy of a multifaceted preventive nutrition intervention in clinical practice

Study type: Clustered

Smoking: N/A

Patient knowledge: N/A

Intervention type: Mixed intervention

Randomised Controlled Trial

Nutrition: Yes

Patient skills: N/A

Description: Tailored recommendations & stage matched booklets by mail + Motivational Counseling + personalized letter + physician endorsement + option of referral to counselor

Quality rating: Medium

Alcohol: N/A

Self efficacy: N/A

Intensity: 1 mailed information, verbal endorsement by provider and 2 motivational sessions with phone counsellor. Dietitian consult offered

Quality score: 2.33

Physical activity: N/A

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Multi-disciplinary team (GP, counselor)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Fries,E, Edinboro, P, McClish, D, Manion, L, Bowen, D, Beresford, SAA, Ripley, J [79]

Randomized trial of a low-intensity dietary intervention in rural residents: the Rural Physician Cancer Prevention Project.

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: No

Intervention type: Mixed intervention

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: A series of tailored feedback, brief telephone counseling + booklets

Quality score: 2.16

Alcohol: N/A

Self efficacy: No

Intensity: Feedback, 1 phone call and 4 booklets mailed weekly

Physical activity: N/A

Stage of change: N/A

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: No

Authors: Lancaster, T, Dobbie, W, Vos, K et al [51]

Randomized trial of nurse-assisted strategies for smoking cessation in primary care

Study type: Randomised Trial

Smoking: No

Patient knowledge: N/A

Intervention type: Motivational interviewing and counseling

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Brief advice by a doctor followed by extended counseling from a nurse

Quality score: 2.16

Alcohol: N/A

Self efficacy: N/A

Intensity: 6 weeks

Physical activity: N/A

Stage of change: No

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Nurse

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Little, P, Dorward, M, Gralton, S, Hammerton, L, Pillinger, J, White, P et al. [80]

A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease.

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Mixed intervention

Quality rating: High

Nutrition: N/A

Patient skills: N/A

Description: Exercise Prescription provide by GP + counseling by practice nurses and booklet

Quality score: 2.83

Alcohol: N/A

Self efficacy: N/A

Intensity: Brief intervention with GP, 1 counseling session with nurse and material

Physical activity: Yes

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Multi-disciplinary team (GP, nurse)

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Naylor, PJ, Simmonds, G, Riddoch, C et al. [81]

Comparison of stage-matched and unmatched interventions to promote exercise behaviour in the primary care setting

Study type: Randomised Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Mixed intervention

Quality rating: Low

Nutrition: N/A

Patient skills: N/A

Description: General advice and written materials or counseling and 4 staged booklets or 4 staged booklets and action planner for all groups

Quality score: 1.66

Alcohol: N/A

Self efficacy: No

Intensity: Single contact interventions

Physical activity: No

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Nurse

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Siero, FW, Broer, J, Bemelmans, WJ, Meyboom-de Jong, BM [52]

Impact of group nutrition education and surplus value of Prochaska-based stage-matched information on health-related cognitions and on Mediterranean nutrition behavior.

Study type: Randomised Controlled Trial

Smoking: N/A

Patient knowledge: N/A

Intervention type: Group education

Quality rating: Medium

Nutrition: Yes

Patient skills: N/A

Description: Group education + booklets (core information)

Quality score: 2.16

Alcohol: N/A

Self efficacy: No

Intensity: 3 sessions of 2 h each

Physical activity: N/A

Stage of change: Yes

Intensity score: M

Weight: N/A

Patient activation: N/A

Provider: Educator

Shared decision making: N/A

Other health literacy outcome: Yes

Authors: Slama K, Redman S, Perkins J et al [82]

The effectiveness of two smoking cessation programmes for use in general practice: a randomised controlled trial.

Study type: Randomised Controlled Trial

Smoking: Yes

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Asked if a smoker and given a brochure

Quality score: 2.0

Alcohol: N/A

Self efficacy: N/A

Intensity: Brief

Physical activity: N/A

Stage of change: N/A

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Doctor

Shared decision making: N/A

Other health literacy outcome: N/A

Authors: Lennox AS, Osman LM, Reiter E, Robertson R, Friend J, McCann I, Skatun D, Donnan PT [83]

Cost effectiveness of computer tailored and non-tailored smoking cessation letters in general practice: randomised controlled.

Study type: Randomised Controlled Trial

Smoking: Yes

Patient knowledge: N/A

Intervention type: Written material

Quality rating: Medium

Nutrition: N/A

Patient skills: N/A

Description: Tailored letter

Quality score: 2.16

Alcohol: N/A

Self efficacy: N/A

Intensity: Brief

Physical activity: N/A

Stage of change: Yes

Intensity score: L

Weight: N/A

Patient activation: N/A

Provider: Computer

Shared decision making: N/A

Other health literacy outcome: N/A