Asking questions changes health-related behavior: an updated systematic review and meta-analysis

Miles, Lisa M., Rodrigues, Angela, Sniehotta, Falko F. and French, David P. (2020) Asking questions changes health-related behavior: an updated systematic review and meta-analysis. Journal of Clinical Epidemiology, 123. pp. 59-68. ISSN 0895-4356

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Objectives: The question-behavior effect (QBE) refers to whether asking people questions can result in changes in behavior. Such changes in behavior can lead to bias in trials. This study aims to update a systematic review of randomized controlled trials investigating the QBE, in light of several large preregistered studies being published. Study Design and Setting: A systematic search for newly published trials covered 2012 to July 2018. Eligible trials randomly allocated participants to measurement vs. non-measurement control conditions or to different forms of measurement. Studies that reported health-related behavior as outcomes were included. Results: Forty-three studies (33 studies from the original systematic review and 10 new studies) compared measurement vs. no measurement. An overall small effect was found using a random effect model: standardized mean difference = 0.06 (95% CI: 0.02–0.09), n = 104,388. Statistical heterogeneity was substantial (I2 = 54%). In an analysis restricted to studies with a low risk of bias, the QBE remained small but significant. There was positive evidence of publication bias. Conclusion: This update shows a small but significant QBE in trials with health-related outcomes but with considerable unexplained heterogeneity. Future trials with lower risk of bias are needed, with preregistered protocols and greater attention to blinding.

Item Type: Article
Additional Information: Funding Information: This work has been completed as part of the MERIT study, which is funded by MRC / NIHR Methodology Research Programme, United Kingdom (reference MC_PC_17229); funders have had no role in the design of the study or the writing of this manuscript.
Uncontrolled Keywords: Behavior, Bias, Measurement reactivity, Question-behavior effect, Randomized controlled trial
Subjects: C800 Psychology
Department: Faculties > Health and Life Sciences > Psychology
Depositing User: Elena Carlaw
Date Deposited: 17 Feb 2021 16:28
Last Modified: 31 Jul 2021 15:02

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