The effectiveness of co-created lifestyle interventions in improving health behaviour, physical and mental health in adults with non-communicable diseases: A systematic review with meta-analysis
Ebuka Miracle Anieto, Philippa Dall, Ukachukwu Okoroafor Abaraogu, Sébastien Chastin, Ijeoma Blessing Anieto, Giuliana Raffaella Longworth, Israel I. Adandom, Ogochukwu Kelechi Onyeso, Anthony Obinna Iwuagwu, Niamh Smith, Kolawole Francis, Miracle Ndubuaku, Mark Chigozie Odom, Chris Seenan
Abstract
OBJECTIVES: This systematic review aimed to evaluate the effectiveness of co-created lifestyle interventions in modifying health behaviour, and mental/physical health outcomes in individuals with non-communicable diseases (NCDs). STUDY DESIGN: A systematic review of Randomized Control Trials (RCTs). METHODS: A systematic search of nine databases from inception until March 2023 was performed, plus weekly email alerts of new literature until March 2025. Studies comparing co-created lifestyle interventions with any control were included. Meta-analysis using the random effects model was conducted. Risk of bias was assessed using the Cochrane-RoB-2, and quality of evidence was assessed using GRADE system. RESULTS: Sixteen RCTs (2201 participants; 74.2 % female; mean 53.8 years) were included. Meta-analysis showed that at <6 months, there is moderate quality evidence that co-created lifestyle interventions significantly improve health behaviour (moderate effect; SMD = 0.49, 95 %CI: 0.33-0.65) and physical health (small effect; SMD = 0.21, 95 %CI: 0.09-0.34), and mental health (small effect; SMD = 0.29, 95 %CI: 0.14-0.43), in individuals with NCDs. At ≥6 months, there is moderate quality evidence that co-created interventions improve health behaviour (small effect; SMD = 0.21, 95 %CI: 0.07-0.35), and mental health (small effect; SMD = 0.19, 95 %CI: 0.12-0.26). A small effect with low quality evidence (SMD = 0.11, 95 %CI: 0.09-0.32) was also observed for physical health, however, it was not statistically significant. CONCLUSIONS: There is moderate quality evidence that co-created lifestyle interventions for secondary prevention of NCDs have a significant positive impact on the target health behaviour, and on mental health, and physical health outcomes.