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 Margaret Dall, Ukachukwu Abaraogu, Sebastien Chastin, Ijeoma Blessing Anieto, Giuliana Raffaella Longworth, Israel Ikechukwu Adandom, Ogochukwu Kelechi Onyeso, Anthony Obinna Iwuagwu, Niamh Smith, Kolawole Francis, Miracle Ndubuaku, Mark Chigozie Odom, Chris Seenan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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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.
Original languageEnglish
Article number105929
Number of pages8
JournalPublic Health
Volume248
Early online date21 Aug 2025
DOIs
Publication statusE-pub ahead of print - 21 Aug 2025

Keywords

  • co-creation
  • NCDs
  • health behaviour
  • mental health
  • physical health
  • systematic review

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