Can communicating personalized disease risk promote healthy behaviour change? A systematic review of systematic reviews

Abstract

Background The assessment and communication of disease risk that is personalised to the individual is currently happening on a large scale. Despite this, it is not clear how best to communicate this personalised risk information to bring about behaviour change, despite several systematic reviews of RCTs in this area. The aim of the present research is to systematically identify, evaluate and synthesise the findings of these systematic reviews. Methods This systematic review of systematic reviews followed published guidance. A search of four databases from 2008-2016 yielded 3402 citations. Following a two-stage screening procedure with good reliability, nine systematic reviews were identified. Findings The number of participants included in nine reviews varied from 784 to 6673, but several studies appeared in multiple systematic reviews. Methods of personalising risk feedback included biomedical test results, genetic testing, noninvasive imaging, and estimation from risk algorithms. Most reviews considered several behaviours but four focussed solely on smoking cessation. The reviews were generally high quality: six reviews had AMSTAR scores of at least nine (of 11 criteria). The key finding was the general lack of impact on behaviour of personalised risk communication across reviews. Effects were most promising for visual feedback of images, albeit with inconsistent effects. Discussion Presenting personalised risk information on its own does not produce much change in behaviour. Future research in this area should determine which additional intervention components are likely to facilitate effects of risk communication on behaviour. Alternatively personalised risk information may not usefully add to these additional intervention components.