Systematic review and meta-analysis of the effectiveness of volitional help sheet interventions for health behaviour change

Citation

Stewart RJ, Presseau J & Dombrowski SU (2026) Systematic review and meta-analysis of the effectiveness of volitional help sheet interventions for health behaviour change. Health Psychology Review. https://doi.org/10.1080/17437199.2025.2530574

Abstract
This systematic review aimed to synthesise studies evaluating the effectiveness of volitional help sheet (VHS) interventions in changing health behaviours, behavioural outcomes and behaviour-related cognitions. Controlled or uncontrolled VHS-based intervention studies targeting health behaviour change were included. Effect sizes were estimated using random effects meta-analyses as standardised mean differences (SMD), mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI). Twenty-seven studies met inclusion criteria; including 25 randomised trials. Interventions targeted health risk behaviours (e.g., alcohol consumption), health promoting behaviours (e.g., physical activity), and behaviour-related outcomes (i.e., weight). Overall, VHS interventions led to significant changes in health behaviours (SMD 0.22, 95% CI, 0.13, 0.30), and non-significant effects on cancer screening OR 0.93 (95% CI, 0.81, 1.07) and weight change (MD – 1.20 kg, 95% CI, – 2.79–0.38). The VHS led to significant changes in intentions (SMD 0.29, 95% CI, 0.08, 0.49; 6 comparisons, n = 770); self-efficacy (SMD 0.31, 95% CI, 0.15, 0.46) and self-regulatory effort (SMD 0.27, 95% CI, 0.03–0.51). Subgroup analysis found no difference for in-person vs remote delivery (P = 0.06) or behavioural categories (P = 0.23). The VHS is a scalable intervention for behaviour change with the potential to support small changes in some health-related behaviours.

Keywords
Volitional help sheet; health behaviours; behavioural intention; self-efficacy; self-regulatory effort

Journal
Health Psychology Review