Social determinants as moderators of the effectiveness of health behavior change interventions: scientific gaps and opportunities

Carmela Alcántara, Sarah Valentina Diaz, Luciana Giorgio Cosenzo, Eric B. Loucks, Frank J. Penedo, Natasha J. Williams

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Social determinants of health (SDOH) refer to the broad range of social, economic, political, and psychosocial factors that directly or indirectly shape health outcomes and contribute to health disparities. There is a growing and concerted effort to address SDOH worldwide. However, the application of SDOH to health behavior change intervention research is unknown. We reviewed the synthesis literature on health behavior change interventions targeting self-regulation to (a) describe the sociodemographic characteristics, (b) determine which types of social determinants were tested as moderators of health behavior change interventions, (c) evaluate the methodological quality of the meta-analytic evidence, and (d) discuss scientific gaps and opportunities. Thirty (45.4%) of 66 articles examined heterogeneity of treatment effects by SDOH. There was a lack of racial/ethnic, immigrant, sexual/gender minority, and lifecourse sample diversity. Overall, 73.5% of SDOH moderator analyses tested heterogeneity of treatment effects by gender, race/ethnicity, and intervention setting; none examined neighborhood factors. Methodological quality was negatively correlated with number of SDOH analyses. Most SDOH moderator analyses were atheoretical and indicated statistically non-significant differences. We provide an integrated SDOH and science of behavior change framework and discuss scientific opportunities for intervention research on health behavior change to improve health equity.

Original languageEnglish (US)
Pages (from-to)132-144
Number of pages13
JournalHealth Psychology Review
Volume14
Issue number1
DOIs
StatePublished - Jan 2 2020

Keywords

  • behavioral interventions
  • Health disparities
  • health risk behaviors
  • heterogeneity of treatment effects
  • psychosocial
  • social determinants

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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