TY - JOUR
T1 - Asking questions changes health-related behavior
T2 - an updated systematic review and meta-analysis
AU - Miles, Lisa M.
AU - Rodrigues, Angela M.
AU - Sniehotta, Falko F.
AU - French, David P.
N1 - Funding Information:
Funding: 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.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - Behavior
KW - Bias
KW - Measurement reactivity
KW - Question-behavior effect
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=85083442706&partnerID=8YFLogxK
U2 - 10.1016/j.jclinepi.2020.03.014
DO - 10.1016/j.jclinepi.2020.03.014
M3 - Review article
C2 - 32229251
AN - SCOPUS:85083442706
SN - 0895-4356
VL - 123
SP - 59
EP - 68
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
ER -