Table 3 Intervention characteristics and effectiveness

Alegria (2014) [61^a

Mental health

Outpatient health clinics

Education only

Moderate dose

Short term f/u

DECIDE Intervention: 3 x (30–45 min) didactic presentations sessions with opportunities for participation, role-play & reflection. Delivered in person or (rarely) by telephone over 3 months

Self-management

β(SE) = 2.42 (SE 0.90), d = 0.22

1

1

Fox (1999) [88]

Mental health

Home- based

Education ± PS

Low dose

Short term f/u

Single education session delivered with or without a significant other present. Involved a 1-h interview of 90 min duration (including a video) and a follow up phone call. Provided resource list of local mental health services

Rates of help seeking behaviour

(n = 566) Yates corrected χ² (1) = 0.977, p = 0.32; favours intervention

1

NS

Xu (2019) [127]

Mental health

Home- based

Education + rewards

High dose

Medium f/u

LEAN intervention: 2 text messages (at 9am and 7 pm) per day for 6 months, send by an e-platform to the patient and to the lay health supporter, Lay health worker reviewed the patient on a 1:1 basis to ensure medication adherence and monitoring

Medication adherence

Mean difference 0.12 (95% CI 0.03 to 0.22)

1

1

Annan (2017) [65]^a

Parenting skills

Home- based

Education only

High dose

Short term f/u

Instruction of parenting skills & social skills (children), practice of positive family interactions. 14 × weekly (in-person) education sessions, 2-h duration each, culturally adapted for non-literate participants. Integrated social learning theory

Child attention problems

Intervention 0.50 (SD 0.18); Control 0.52 (SD 0.26), ES = -0.23

1

1

Bagner (2016) [66]

Parenting skills

Home- based

Education only

Moderate dose

Long term f/u

Parenting intervention program with education and problem-solving skills training. Up to 7 × weekly one-on-one sessions delivered to caregiver (until caregiver meets mastery), 1 to 1.5 h duration

Observed parent 'don't' skills

Intervention (n = 20) 0.19 (SD 0.18), Control (n = 26) 0.48 (SD 0.29); OR 5.29, p = 0.05

1

1

Barry

(2022) [68]

Parenting skills

Community centre

Education + PS

High dose

Long term f/u

Group-based educational intervention providing blocks of weekly group sessions (90–150 min duration) over a period spanning 3 to 5 years

Externalising behaviours

Intervention (Los Angeles) OR 0.38 (95% CI 0.17 to 0.84), p ≤ 0.05

1

1

Dawson-McClure (2014) [79]^a

Parenting skills

School + home-based

Education + PS

High dose

Long term f/u

13 × weekly (2 h) sessions for parents and concurrent sessions for children. Education included flyers and brief information sessions at school events. Delivered in person and by phone to parents. Designed to serve culturally diverse communities

Parent involvement (parent rated)

Intervention Estimate 0.78 (SE 1.55), d = 0.38

1

1

El-Mohandes (2003) [81]

Parenting skills

Home- based + community centres

Education + PS

High dose

Long term f/u

32 home visits and 16 play group sessions; weekly visits for first 5 months, followed by biweekly group sessions of developmental play groups and parent support groups (45 min). Monthly support calls, total duration 1 year

Number of well infant visits at 12 months

(Total n = 167) Intervention 3.51; Control 2.68, p = 0.0098

1

1

Fiks (2017) [86]

Parenting skills

Home- based

Education + PS

High dose

Long term f/u

2 educational sessions delivered in-person (1 prenatal and 1 at age 4 months), total duration 11 months (2 months prenatal and 9 months postnatal). Peer to peer Facebook group during intervention. Based on social cognitive theory

Infant feeding behaviours: Total score

Intervention 40.7; Control 38.2, ES = 0.45 (95% CI 0.01 to 0.92)

1

1

Hesselink (2012) [90]

Parenting skills

Community centres & home-based

Education + PS

High dose

Long term f/u

Antenatal education and parenting program involving 8 group classes (2 h each)—seven before and 1 after delivery, and 2 home visits (1 h each) after delivery. Quasi-experimental study

SIDS prevention behaviour

β = -0.024 (95% CI -2.9 to 2.4); favours control

0

NS

Jensen (2021) [95]

Parenting skills

Home-based

Education only

High dose

Long term f/u

Approximately 14 × 1 h home visits over a 9-month period. Followed an educational curriculum, included active play sessions with live feedback and linkage to government support service

Harsh discipline

‘Difference in difference’ 0.74 (95% CI 0.66 to 0.84), p < 0.001; favours intervention

1

1

Kasari (2014) [96]

Parenting skills

Home- based

Education only

High dose

Medium f/u

Individualized caregiver-mediated intervention with caregivers coached in the treatment model with their child. 2 x (1 h session) weekly sessions; duration 12 weeks (24 sessions, 24 h). Written material in participants native language

Parent–child interaction: Total time in joint engagement

Cohen’s f = 0.21 (“moderate treatment effect”)

1

1

Luten-bacher (2018) [101]

Parenting skills

Community centre + home-based

Education + PS

Moderate dose

Long term f/u

The Maternal Infant Health Outreach Worker program. Monthly individual home visits (1 h) and periodic group gatherings. Bilingual

Breast-feeding duration (weeks)

Intervention (n = 76) median 28.0 (IQR 12–28); control (n = 70) median 28.0 (IQR 12–28); p = 0.76

 <  > 

NS

Mc Gilloway (2014) [107]a

Parenting skills

Community centre

Education + PS

High dose

Long term f/u

Incredible Years Basic parent program. 14 (2 h) sessions delivered over 12–14 week period, Education provided in groups using role plays and video material. Intervention culturally tailored, based on social cognitive theory

Child problem behavior

Mean difference 2.0 (95% CI 1.1 to 3.0), ES = 1.07

1

1

Pitchik

(2021) [112]

Parenting skills

Community centre + home based

Education + PS

High dose

Long term f/u

2 intervention arms: 18 × 45–60 min Group sessions (with 3–6 women/caregivers); or 9 × group sessions alternated with 9 × 20–25 min home visits. The material covered was equivalent across the delivery mechanisms, duration 9 months

Stimulating caregiving practices

Group 4.22 (95% CI 3.97 to 4.47); combined 4.77 (4.60 to 4.96); control 3.24 (3.05 to 3.39); in favour of intervention

1

1

Segal-Isaacson (2006) [121]

Diet

Community centres

Education + skills training

High dose

Long term f/u

Nutrition education and coping skills/stress management sessions. Phase 1- high intensity received group sessions of therapist guided exercises. Phase 2—high intensity received behavioural exercises led by therapist plus expert advice from relevant professionals (nutritionist, exercise trainer or pharmacist). 10 group sessions and 6 behavioural exercises

Triglycerides

Group 1 (n = 97) 188 (SD = 103), group 3 (n = 79) 178 (SD = 96); d = 0.10 (95% CI -0.20 to 0.40)

1

NS

Steptoe (2003) [125]^a

Diet

Health clinics (primary care)

Education only

Moderate dose

Long term f/u

Individualised behavioural dietary counselling intervention targeted increasing intake of fruit and vegetables. 15-min consultation followed by another 15-min consultation after 2 weeks. Delivered individually face-to-face. Time matched with nutrition education counselling. Behavioral counselling integrated social learning theory and the stage of change model

N^o of portions of fruit/vegetables per day

Plasma β-carotene

Adjusted difference in change 0.89 (95% CI 0.25 to 1.54)

Adjusted difference in change 0.18 (95% CI 0.02 to 0.37)

1

1

1

1

Zoellner (2016) [26]^a

Diet

Community centre & home-based

Education + skills in self-monitoring

High dose

Medium f/u

SIPsmartER intervention: 3 small-group classes (90-120 min) (delivered in week 1, week 6 and week 17) + 1 live teach back call (avg of 18.6 min duration) + 11 interactive voice response calls (weekly for the first 3 weeks and then bi-weekly for the rest of the intervention) (avg 6.9 min duration of each call). Group classes delivered face-to-face. Culturally sensitive, integrated Theory of Planned Behaviour

Sugar sweetened beverage consumption

Blood Glucose

Relative effect between cond-itions -14 (95% CI = -23 to -6)

Relative effect between cond-itions -0.8 (95% CI -3.6 to 2.0)

1

1

1

NS

Avila (1994) [37]

Diet & exercise

Community health clinics

Education + exercise

Moderate dose

Medium f/u

Weight reduction/exercise classes including 25-min exercise (stretching and walking) component with nutritional education, self-change behavioural modification strategies, buddy system and an exercise component. 1 h per week for 8 weeks. Bilingually delivered

Exercise fre-quency (days/wk)

BMI

Intervention (n = 21) 3 (SD 2.6), control (n = 18) 1 (SD 2)

Intervention 28.7 (SD 2.2) Control 32.0 (SD 2.27)

1

1

1

1

Baranowski (1990) [67]

Diet & exercise

Community centre or school

Education + counselling + exercise

High dose

Short term f/u

Program to improve diet and increase aerobic activity. Sessions involved education, behavioural counselling, food/activity records, goal setting, problem solving and aerobic activity. Intervention involved 1 × 90-min education and 2 fitness sessions per week for 14 weeks

Per week energy expenditure

Resting pulse rate

Intervention (n = 50) 247 (SD 46.6); Control (n = 48) 248 (SD 29.4); d = -0.03 (95% CI -0.42 to 0.37)

NS

0

-

NS

NS

Befort (2016) [69]

Diet & exercise

Community cancer centres

Education + PS

High dose

Long term f/u

Education program for breast cancer survivors Phase 2 (maintenance intervention) involving 25 biweekly conference call sessions. (Phase 1 included 25 weekly 60-min conference call sessions)

Weight change

Phone counselling (n = 85) 3.3 (SD 4.8); newsletter (n = 83) 4.9 (SD 4.9) d = -0.33 (95% CI -0.63 to -0.03); favours phone counselling intervention

1

1

Brooking (2012) [53]

Diet & exercise (diabetes prevention)

Community centre

Education + PS + food

High dose

Long term f/u

Involved group and individual education sessions, written resources, cooking demonstrations and shopping tours. Weekly face to face contact with both group and individual. Three 8-week phases

Weight (kg)

Intervention (n = 20) 100.6 (SD 20.4); Control (n = 21) 97.7 (SD 20.01); d = 0.14 (95% CI -0.47 to 0.76); favours control

0

0

Staten (2004) [56]

Diet & physical activity

Community centres

Education only

High dose

Long term f/u

Arm 1 – 1:1 counselling to increase fruit and vegetable consumption and physical activity, referral to education classes. Arm 2—counselling and health education plus education classes and a monthly newsletter. Arm 3—counselling, health education and community health worker support. Bilingual, based on social cognitive theory

Physical activity levels > / = 150 min/week

High blood pressure

Intervention (arm 2, n = 70) % difference 2.6%, control (n = 73) % difference 0%

Intervention (arm 2): 11.4% difference, control 11%

1

1

NS

NS

King (2013) [38]

Physical activity

Community centres

Education + pedometer

Moderate dose

Medium f/u

4 × monthly virtual advisor sessions accessed on a computer, average 7 min each. Individually tailored walking program, physical activity education, personalised feedback, problem solving & goal setting. Culturally and linguistically tailored, bilingual intervention

Increase in walking

Between group difference 226.7 (95% CI 107.0 to 346.4), F(1,38) = 13.6, p = 0.0008, ES = 1.2

1

1

Reijneveld (2003) [114]

Physical activity

Community-based

Education + exercise

High dose

Short term f/u

8 × 2-h health education sessions offered by a peer educator. Each session ended with a group exercise session

Physical activity (low score = better)

Intervention (n = 54) 9.87; control (n = 38) 9.26; Difference -0.12 (95%CI -0.67 to 0.29) ES 0.04

0

NS

Alias

(2021) [62]

Healthy lifestyle

Primary care clinics, community

Education + PS High dose,

Long term f/u

12 × 2-h weekly sessions for groups of 15 people. 9 delivered in primary care centre; 3 involved local outings to public spaces (for physical activity/shopping/social activities)

Social participation

Between group data not reported. Raw data show results in favour of control group

0

NS

Fernandez-Jimenez (2020) [85]

Healthy lifestyle

Community or home- based

Education ± activity monitor

High dose

Long term f/u

Individual intervention 1: 8–12 counselling sessions with a lifestyle coach. Held every 3–4 weeks, lasting 45 min for first 8 months, 4 complimentary sessions offered over the following 4 months. Also provided with activity monitoring device. Group intervention 2: monthly group meetings for 12 months, 45 min each

Change in a composite health score

Group intervention: mean difference 0.00 (95% CI -0.50 to 0.49)

 <  > 

NS

Hovell (2008) [29]

Healthy lifestyle

Community centre

Education + exercise

High dose

Aerobic dance intervention (vigorous low impact aerobic dance sessions) plus 30 min exercise/diet education. 3 sessions per week (each 90 min) over 6 months. Culturally tailored and bilingual, developed for low literacy

Moderate exer-cise (min/2 wk)

Relative VO_2max

B = -0.184 (95% CI -0.87 to 0.497) p = 0.596; favours control

B = 2.533 (95% CI 1.10 to 3.97), p < 0.001

0

1

NS

1

Keyserling (2008) [30]

Healthy lifestyle

Community health centre & home-based

Education + PS

High dose

Long term f/u

Lifestyle intervention to improve physical activity and diet. 2 individual counselling sessions, 3 × 90-min group sessions and 3 phone calls from a peer counsellor over 6 months, followed by a 6-month maintenance phase with 1 individual counselling session and 7 monthly peer counsellor calls. Reinforcement mailings of pamphlet & 2 postcards

Moderate intensity physical activity (mins/day)

Difference between means 1.5 (95% CI -1.6 to 4.6)

1

NS

Khare (2012) [27]

Healthy lifestyle

Community centre & home-based

Education only

High dose

Long term f/u

Minimum intervention—received CVD risk factor screening and educational materials. Enhanced intervention—also received a 12-week lifestyle change (nutrition and physical activity) intervention: 90-min weekly sessions for 12 weeks. Bilingual, based on social Cognitive Theory and Transtheoretical Model

All intensity physical activity (hours/week)

BMI

MI (n = 280) 9.2 (SD 6.0); EI (n = 225) 9.7 (SD 6.6), d = 0.08 (95% CI -0.10 to 0.26)

MI (n = 280) 31.5 (SD 7.6); EI (n = 225) 31.8 (SD 7.7), d = 0.04 (95% CI -0.14 to 0.21)

1

1

NS

NS

Khare (2014) [28]

Healthy lifestyle

Community centre & home-based

Education only

High dose

Long term f/u

Minimum intervention—received CVD risk factor screening and educational materials. Enhanced intervention—also received a 12-week lifestyle change (nutrition and physical activity) intervention: 90-min weekly sessions for 12 weeks. Bilingual, based on social Cognitive Theory and Transtheoretical Model

All intensity physical activity

BMI

MI (n = 37) 10.0 (SD 5.61); EI (n = 30) 8.48 (SD 5.73), d = 0.27 (96% CI -0.22 to 0.75)

MI (n = 37) 32.03 (SD 8.06); EI (n = 30) 30.22 (SD 5.57), d = 0.26 (95% CI -0.23 to 0.74)

1

1

NS

NS

Kim

(2021) [98]

Healthy lifestyle

Community centre

Education + exercise

Moderate dose

Short term f/u

8 week group-based intervention addressing nutrition, exercise, stress management psychological wellbeing and cognitive health. Involved education and physical activity components plus recommended daily exercise (> 10,000 steps or > 30 min mod exercise per day)

Health promot-ing behaviour

% body fat

d = 1.27, p < 0.001; results favour intervention

d = 0.53, p = 0.62; results equivocal for both groups

1

(< >)

1

(NS)

Parra-Medina (2011) [31]

Healthy lifestyle

Home- based

Education only

High dose

Long term f/u

Standard care plus 12 motivational, ethnically tailored newsletters over 1 year, an in-depth introductory telephone call, & up to 14 brief, motivationally tailored telephone counselling calls from research staff over 1 year. Print materials for less than 8^th grade reading level, based on transtheoretical model and social cognitive theory

Improvement in moderate-to-vigorous physical activity

(n = 142) Intervention 30.7%, control 44.8%; OR 0.63 (95% CI 0.24 to 1.68); favours control

0

0

Polomoff

(2022) [113]

Healthy lifestyle

Community centres

Education + PS + medication management

High dose

Long term f/u

A bilingual, trauma-informed, cardiometabolic education intervention to decrease diabetes risk. 2 intervention arms: Eat,walk sleep (EWS) (or EWS + 3 or more MTM (medication therapy management) sessions. EWS involved 3 individual sessions and 24 group sessions over a 12-month period

Medication forgetting

Results in favour of intervention but between-group differences not significant

1

NS

Seguin-Fowler (2020) [122]

Healthy lifestyle

Community-based

Education + PS + exercise,

High dose

Medium term f/u

24 weeks of hour-long, twice weekly classes held in community-based locations. Sessions included strength training, aerobic exercise and health related education, civic engagement activities and out of class assignments

Moderate and vigorous physical activity

Total cholesterol

Intervention: 41.5% improved, control: 21.5% improved (p = 0.008)

2.8% difference, p = 0.66); favours intervention

1

1

1

NS

Saleh (2018) [119]

Healthy lifestyle

Community centre & home-based

Education only

High dose

Long term f/u

Weekly short message service over 2 years. Messages included medical information & reminders of appointments. Information included hypertension and diabetes guidelines for management, dietary habits, body weight, smoking

Blood pressure controlled at post-test

Intervention (n = 426) 63.6%; control (n = 362) 58.4%; OR = 0.80 (95% CI 0.60 to 1.07)

1

NS

Hayashi (2010) [40]

Healthy lifestyle

Community health centres

Education only

Moderate dose

Long term f/u

WISEWOMAN Program: 3 sessions (at 1, 2, 6 months post enrolment). Initial session of 40–70 min, 3 lifestyle intervention sessions lasted 30–45 min. Delivered face-to-face. Bilingual and bicultural Intervention, outcome measures selected based on transtheoretical model

Improvement in eating habits

Total cholesterol > 240 mg/dL

Intervention (n = 433) 71%; Control (n = 466) 48%; RR 3.3, p < 0.001; favours intervention

Intervention 200.3; control 199.3, p = 0.906; favours control

1

0

1

NS

Suhadi (2018) [57]

Healthy lifestyle

Community centres

Education only

Moderate dose

Long term f/u

Oral presentations and discussion of topics such as hypertension, hyperlipidaemia and diabetes. Participants were handed posters, activity manuals and 4 booklets with education material. 4 sessions of 90-min each done consecutively every 1–2 months

BMI

Intervention (n = 82) 24.1 (SD 4.5); control (n = 108) 24.0 (SD 4.4); d = 0.02 (95% CI -0.26 to 0.31)

0

NS

Fitzgibbon

(1996) [87]

Healthy lifestyle (diet/breast health)

Community centre

Education only

High dose

Short term f/u

12 weeks × 1-h classes. Culture specific family-based dietary intervention to reduce cancer risk among low-literacy, low-income Hispanics by reducing fat intake, increasing fibre intake, increasing nutrition knowledge and increasing parental support for healthy eating

Saturated fat intake

Blood pressure

Intervention (n = 18) 11.2 (SD 4.0), control (n = 18) 13.6 (3.1)

NS

1

-

NS

NS

Bray (2013) [71]^a

Diabetes self-man-agement

Health clinics

Education only

High dose

Long term f/u

Point of care diabetes care management involved education, self-management coaching and medication adjustment. 1:1 face to face sessions. Patients seen an average of 4 times over 12 months by a nurse, pharmacist, or dietitian care manager for 30–60 min, seen every 3–6 months by a care manager for an additional 2 years. Quasi-experimental study

Haemoglobin A1C

Intervention (n = 368) 7.4 (SD 1.9); Control (n = 359) 7.8 (SD 2.0), d = -0.21

1

1

Brown (2013) [73]

Diabetes self-man-agement

Community centre

Education + PS

High dose

Long term f/u

Culturally tailored diabetes self-management education including educational videos and group activities. Conducted near participants home, required to partner with a relative/friend. 1 year duration with 52 contact hours. 26 educational and group support sessions (each 2 h)

Haemoglobin A1C

Females (n = 70): Intervention 10.8 (SD 2.5), Control 11.5 (SD 3.0); NS

1

NS

Andrews (2016) [64] + a

Smoking cessation

Community centres + home-based

Education + PS + Nicotine replacement

Moderate dose

Long term f/u

6 × weekly group sessions. Community health workers provided 1:1 contact (× 16) to reinforce educational content and behavioural strategies from the group sessions & provide social/psychological support. 24-weeks duration

7-day point prevalence abstinence

OR = 0.44 (95% CI 0.18 to 1.07), favours intervention

1

NS

Berman (1995) [70]

Smoking cessation

School- based

Education + PS

High dose

Long term f/u

Smoking cessation group class – seven sessions, 1.5 h each. Received tailored support letters and brief tailored smoking cessation booster messages at end of 3- and 6-month interviews. Quasi-experimental study

Continuous abstinence

(Total n = 132), Intervention 6.4%; Control 7.3%; χ²⁼0.042; RR = 0.88; favours control

0

NS

Brooks (2018) [72]

Smoking cessation

Home- based

Education + MI

Moderate dose

Long term f/u

Up to 9 education sessions from a Tobacco Treatment Advocate over 6 months, Delivered in person (at home). Involved motivational interviewing and cognitive behavioural strategies and cessation counselling. Also offered community resources + educational materials. Considered racial and linguistic diversity

30-day point prevalence abstinence

Adjusted OR 2.98 (95% CI 1.56 to 3.94)

1

1

Curry (2003) [77]^a

Smoking cessation

Outpatient paediatric health clinics

Education + MI

Moderate dose

Long term f/u

Pediatric setting-based smoking cessation intervention where women received a motivational message from the child's clinician, a guide to quitting smoking and a 10-min motivational interview with a nurse or study interventionist followed by up to 3 outreach telephone counselling calls over 3 months

7-day point prevalence abstinence

OR = 2.12 (95% CI 0.96 to 4.66)

0

NS

Gielen (1997) [89]

Smoking cessation

Health clinic

Education + PS

Low dose

Long term f/u

Individual skills instruction and counselling by a peer health counsellor. 1:1 (15 min) counselling session, clinic reinforcement and support including two letters of encouragement mailed 1–2 weeks after first visit

Smoking status: quit rate (self-report & saliva cotinine test)

Intervention (n = 193) 6.2%; control (n = 198) 5.6%; OR = 0.89 (95% CI 0.38 to 2.06)

1

NS

Hooper (2017) [91]

Smoking cessation

Research clinic

Education + CBT + Nicotine patches

High dose

Long term f/u

Group based cognitive behavioural therapy for smoking and health, self-motivation and goal setting with culturally specific education. 8 sessions: 4 during week 1, 2 during week 2 and 2 booster sessions weeks 3 and 4. Session duration 90–120 min

7-day point prevalence abstinence (biochemically verified)

Intervention (n = 168) 23.2; control (n = 174) 22.0; OR 1.21 (95% CI 0.71 to 2.04)

1

NS

McClure

(2020) [105]

Smoking cessation

Home-based (telephone)

Education only

Moderate dose

Medium f/u

4–5 sessions of telephone counselling plus scripted educational content, mailed oral health promotion brochure, access to online (educational) information and oral health messaging in 16 text messages

Meet brushing and flossing

recommendation

Adjusted OR 1.16 (0.96,1.41), p = 0.13; raw data in favour of intervention

1

NS

Simmons (2022) [123]

Smoking cessation

Home-based (via mail)

Education only

High dose

Long term f/u

Participants received a series of 11 booklets and 9 pamphlets over a 18 month period, and a 10 min phone call one week after randomisation

7-day point prevalence smoking abstinence

Abstinence rates: intervention 33.1%, control 24.3%; OR 1.54 (95% CI 1.18 to 2.02), p = 0.002

1

1

El-Mohandes (2010) [82]

Tobacco smoke exposure

Health clinics

Education + CBT/safety plan

High dose

Medium f/u

10 × behavioural counselling intervention sessions occurred in conjunction with prenatal and post-partum health checks. Based on behaviour change literature

Environmental tobacco smoke exposure

Intervention (n = 335) 53.9; control (n = 356) 68.2, Adjusted OR 0.50 (95% CI 0.35 to 0.71)

1

1

Emmons (2001) [83]^a

Tobacco smoke exposure

Home- based

Education + MI

Moderate dose

Long term f/u

Motivational interview at client's home and 4 follow up telephone counselling calls over 6 months, quit magazines. Tailored for men and women and in English and Spanish, theory driven approach

Nicotine level: TV room (mg/m³)

Intervention (n = 150) 2.3; control (n = 141) 3.5, F(1235) = 5.04, p < 0.05

1

1

Byrd

(2013) [32]^a

Cancer screening

Community centres

Education only

Low dose

Medium f/u

Bilingual program delivered by a lay health worker: (i) full program included video and flip chart (educational information, games, and activities); (ii) program without video; (iii) program without flip chart. All received educational handouts, cards and 1 × face-to-face session

Validated pap smear

Intervention (full program: n = 151) 17.9%, Control (n = 152) 7.2%, OR = 0.35 (95% CI 0.17 to 0.75)

1

1

Calderon-Mora (2020) [44]

Cancer screening

Community centre

Education + PS

Low dose

Medium f/u

Group program comprised of outreach, educational session, navigation services, and no cost cervical cancer testing. Used flipchart, message cards, action plan worksheet, resource sheet and informational handouts. Mean duration 90 min with 3–6 participants. Bilingual

Self-reported cervical cancer screening

Intervention (n = 150) 68.9%; control (n = 125) 77.6%

ITT RR (adjusted) 0.95 (95% CI 0.80 to 1.13), p = 0.59

0

NS

Dooren-bos (2011) [43]^a

Cancer screening

Home- based

Education only

Low dose

Long term f/u

Participants were mailed a calendar with cancer screening messages and screening service information

Breast cancer screening mammogram

Intervention 14.0%; control 13.6%; no effect, OR = 0.96 (95% CI 0.83 to 1.13)

1

NS

Fitzgibbon (2004) [41]

Cancer screening

Community centre

Education only

High dose

Long term f/u

16 (90 min) sessions: once per week for 8 weeks, biweekly for 2 months and once monthly for 4 months; Education provided in groups led by a research nutritionist and a trained breast health educator; duration 8 months. Bilingual Intervention

Breast self-examination frequency

Intervention (n = 92) 45.7%; Control (n = 103) 22.3%; OR = 0.34 (0.18 to 0.63)

1

1

Gathirua-Mwangi (2016) [33]

Cancer screening

Home- based

Education only

Low dose

Long term f/u

Two interventions compared with control group: mailed interactive DVD (10 min duration) and a tailored telephone counselling intervention (approximately 11 min duration). Both delivered similar messages related to importance of mammograms

Mammography adherence rates

DVD: OR = 1.64 (95% CI 0.80 to 3.39); Telephone: OR = 1.24 (95% CI 0.61 to 2.50)

1

NS

Kalichman (2000) [42]

Cancer screening

Community centre

Education only

Low dose

Medium f/u

Single session; 2.5 h duration; small group workshop; delivered in person. Intervention culturally tailored, based on social cognitive theory

Performance of monthly breast self-examination

Intervention (n = 15) 52%; control (n = 6) 25%; OR = 4.68 (95% CI 1.3–18.4)

1

1

Katz

(2007) [34]

Cancer screening

Home- based

Education only

Moderate dose

Long term f/u

Lay health advisor education program. 3 home visits, follow up phone calls and tailored mailings after each visit. First visit 45–60 min, 2nd visit 2–3 weeks later 30–45 min, tailored phone calls/mailings in months 3–9, final visit 10–14 months

Cervical cancer screening rates

(n = 792) OR^a = 1.03 (95% CI 0.80 to 1.32)

1

NS

Kreuter

(2005) [35]

Cancer screening & diet

Home based

Education only

Moderate dose

Long term f/u

Home-based

6 women's health magazines promoting use of mammography for ages 40–65 and promoting fruit and vegetable intake for ages 18–39. Three intervention arms: behavioural construct tailoring, culturally relevant tailoring, or both. Culturally tailored

Use of mammography

Intervention (both) (n = 45) 75.6%; control (n = 55) 54.5%, OR = 0.39 (95% CI 0.16 to 0.92)

1

1

Kreuter (2010) [45]

Cancer screening

Neighbour-hood & home-based

Education only

Low dose

Long term f/u

Narrative video comprised of stories from African American breast cancer survivors OR content equivalent information video. Delivered in a mobile research van in participants neighbourhood, follow up questionnaire administered by phone

Use of mammography

Narrative video (n = 107) 48.6%; Informational video (n = 115) 40.0%; OR = 0.71 (95% CI 0.41 to 1.20)

1

NS

Ridgeway

(2022) [116]

Cancer screening

Health clinics

Education only

Low dose

Short/Med f/u

2 intervention arms: The enhanced care group were provided with an educational brochure along with their results letter; the interpersonal group received follow-up telephone interaction and education (along with the educational brochure)

Self-reported provider conversations:

Between group difference in favour of intervention, p < 0.001

1

1

Valdez (2016) [36]

Cancer screening

Community health centre

Education only

Low dose

Medium f/u

One -time, low-literacy, interactive cervical cancer education program

Education was individualised, self-paced via a multimedia kiosk (2 languages and age category options) involved 8 interactive education modules. Average duration 24 min (English) and 28 min (Spanish)

Self-reported cervical cancer screening

Intervention (n = 138) 51%; control (n = 344) 48%, p = 0.35

OR = 0.90 (95% CI 0.60 to 1.33)

1

NS

Jacobson (1999) [93]

Vaccina-tions

Health clinic

Education only

Low dose

Short term f/u

Single session: education provided by a 1-page document given before a doctor’s appointment. Designed for low literacy levels

Discussion of vaccination with physician

Intervention (n = 221) 39.4%; control (n = 212) 9.9%; RR 3.97 (95% CI 2.71 to 5.83)

1

1

Falbe (2015) [84]

Family health

Health clinics & home-based

Education only

High dose

Short term f/u

Family centred; culturally tailored group intervention. Covered topics such as parenting, screen time, healthy beverages, physical activity and stress due to immigration. 10-week, biweekly group sessions lasting 2 h each. Two between-session phone calls

BMI

Adjusted difference in change -0.78 (95%CI -1.28 to -0.27), p = 0.004

1

1

Phillips (2014) [111]^a

Ear health (children)

Home-based

Education

Moderate dose

Long term f/u

Seven ear health multi-media messages (over 6 weeks) in local Indigenous language, accompanied by personalised ear health text messages in English, with prompts to visit the clinic for the children's health check-ups. Included short, caricature animation videos of Indigenous role models

Clinic attendance

Mean difference -0.1 (95% CI -1.1 to 0.9)

0

0

Janicke (2008) [94]

Weight loss (children)

Community centre

Education + Pedometer

High dose

Long term f/u

Behavioural family-based OR parent-only diet and weight loss educational intervention. In both groups families and group leaders set daily dietary goals at end of each group sessions, increased physical activity promoted through pedometer. Weekly group sessions for first 8 weeks, biweekly for the next 8 weeks, sessions lasted 90 min

Change in children's standardized BMI

Intervention (family) (n = 24) mean change -0.115 (SD 0.22); control (n = 21) mean change 0.022 (SD 0.17), p < 0.05

1

1

Smith

(2021) [124]

Weight loss (children)

Health clinic + home based

Education ± community services

High dose

Long term f/u

An individually tailored intervention designed to pre-empt excess weight gain by improving parenting skills. Delivered for 6 months in clinic, at home and in the community with a dose target of 26–50 h of support. Support included face to face and telephone coaching and connection to community-based services

Health routines

BMI

d = 0.33; β = 0.16 (95% CI 0.009 to 0.291), p = 0.037; favours intervention

No between group differences: d =  − 0.01, p = 0.96

1

 <  > 

1

0

Kelly (1994) [97]

Sexual health

Health clinics

Education + PS

Moderate dose

Medium f/u

Group sessions focusing on risk education, skills training in condom use, sexual assertiveness, problem solving, and risk trigger self-management and peer support for change efforts. 5 x (90 min) 4- weekly group sessions and a 1-month group follow up

Frequency of unprotected sexual intercourse

Intervention 11.7 (SD 22.8); control 15.0 (SD 26.4); d = -0.13 (95% CI -0.42 to 0.15)

1

NS

Kulathinal (2019) [100]

Sexual health

Community education + home based

Education + contraceptives

Variable dose

Medium f/u

Involved a mobile helpline, mid-media activities (including street art, theatre), personal contact from village health workers and distribution of contraceptives. Total duration of intervention period 12 months. Questionnaire tailored for low literacy

Uses contraception

Intervention 42.9%; control 40.8%; OR 3.207 (95% CI 3.03–3.39); favours intervention

1

1

Miller (2013) [108]

Sexual health

Home- based

Education only

Low dose

Long term f/u

Arm 1: telephone assessment of barriers to adherence and tailored counselling. Arm 2:as arm 1, plus mailing of a tailored information brochure. Arm 3 – standard care (telephone assessment only)

Adherence rates to initial colposcopy

Intervention 75.4%; control 65.75%, p = 0.23, OR = 0.94 (95% CI 0.47 to 1.87)

1

NS

Robinson (2002) [117]

Sexual health

Community centre

Education + PS

High dose

Long term f/u

Education of HIV and sexually transmitted disease prevention strategies plus comprehensive sexuality education. Sessions were multimedia and multimethod including peer panels, storytelling, exercises, small group support and discussions. 2-day program

Frequency of unprotected intercourse

f = 0.339, df = 1,101; p = 0.562; (direction of effect unclear)

-

NS

Santa Maria

(2021) [120]

Sexual health

Community-based

Education only

Moderate dose

Medium f/u

Parents received a 1:1 individual 45-min information session, were provided with an education manual and received 2 booster phone calls

HPV vaccine completion

Study concluded no difference between the groups. No raw data available

-

NS

Kim

(2014) [54]

Hyper-tension

Community centre & home-based

Education + monitoring device

High dose

Long term f/u

6 × weekly, 2-h education sessions (including overview of high blood pressure management guidelines, complications, healthy diet, exercise, medications, problem solving skills); participants given a blood pressure monitoring machine and asked to take blood pressure twice a day; monthly telephone counselling for 12 months

Blood pressure control rates

Intervention (n = 184) 54.3%; control (n = 185) 53.0%, OR = 0.95 (95% CI 0.628 to 1.42)

1

NS

Kisioglu (2004) [55]

Hyper-tension & obesity

Community centre & home-based

Education only

Low dose

Long term f/u

Group sessions of 5. All women in the intervention group received health training support from an expert and a leaflet. No limit applied to session length. (Daily exercise advised)

Blood pressure (optimum)

Intervention 54%; control 50%, p = 0.31, OR = 0.85 (95% CI 0.58 to 1.26)

1

NS

Martin (2011) [104]

Hyper-tension

Home- based

Education only

Moderate dose

Long term f/u

Medication adherence intervention via computer; a community health advisor; and telephone contact. Involved 4 home visits over a 6-month period with telephone contact at 2 weeks post session after each home visit. Program used 50 videos ranging 10–60 secs

Pill count (adherence to medication)

N = 338, Intervention 51%, control 49%, p = 0.67, RR = 1.04

1

NS

Almabadi (2021) [60]

Dental health

Dental health clinic

Education + oral health care

High dose

Long term f/u

Program provided information regarding oral hygiene procedures, smoking and alcohol cessation, healthy diet

Vegetable consumption

Sites with PPD > 5 mm

Greater improvement in treatment group at 12 months

Equivocal results both groups

1

 <  > 

1

NS

Cibulka (2011) [76]

Dental health

Hospital health clinic

Education + dental supplies

Low dose

Medium f/u

1:1 education session with dental nurse practitioner. Five-minute section of a digital video disc and scheduling of an oral health appointment

Attend dental check up

Intervention 56.9%; Control 32.9%; Pearson’s χ² = 7.544, df = 1, p = 0.006, OR = 0.37 (95% CI 0.19 to 0.73)

1

1

Dela Cruz (2012) [80]

Dental health

Home- based

Education only

Low dose

Long term f/u

Home-based

Post card mailing about benefits of dental health care. 1 postcard for group 1; 3 postcards for group 2 over 1 year

Preventive dental service utilisation rates

No significant between group differences (61% vs 62% vs 61%), RR = 1.02 (group 2 vs control)

1

NS

Krieger (2005) [99]

Asthma

Home- based

Education + household equipment

High dose

Long term f/u

Involved education, social support, resources to reduce exposure (allergy control pillow, mattress encasements, vacuums, cleaning kits, referral to smoking cessation counselling, roach bait, rodent traps), skin prick allergy testing. 7 visits and resources over 12 months. Delivered in English, Spanish & Vietnamese

Behaviour summary score

High intensity (n = 104) 8.0, low intensity (n = 104) 6.4, GEE coefficient (group x time interaction) 0.41 (95% CI -0.13 to 0.95), p = 0.11

1

NS

Damush (2003) [78]

Low back pain

Health clinic & home-based

Education only Moderate dose

Long term f/u

Self-management program involving 3 face-to-face group sessions (once per week), class handouts with written education materials, audio cassettes if missed session, phone follow up, physician letters of support after each session

Total physical activity

Intervention 178.1 (SD 149.3); control 152.5 (SD 159.3); effect estimate 42.0 (95% CI 0.63 to 38.87), d = 0.14 (95% CI -0.19 to 0.48)

1

NS

Cahill (2018) [74]

Healthy pregnancy

Home- based

Education only

High dose

Long term f/u

Home based lifestyle weight management intervention. Included goal setting, regular self-assessment of weight, education about positive eating and physical activity behaviours, observational learning through role play and environmental changes in the home. 10 biweekly home visits lasting 1 h through duration of pregnancy

% Whose gestational weight gain exceeded guidelines

Intervention (n = 133) 36.1%; Control (n = 134) 45.9%, p = 0.11

1

NS

Hillemeier (2008) [39]

Healthy pregnancy

Community centre

Education + PS

Moderate dose

Medium f/u

Strong Healthy Women program: 6 × biweekly group sessions; duration 12 weeks. Designed for low literacy, based on social cognitive model

Physical activity

BMI

OR 1.867, p = 0.019; favours intervention

Intervention effect -0.036, p = 0.809

1

1

1

NS

Hunt (1976) [92]

Healthy pregnancy

Health clinics

Education + vitamins

Moderate dose

Medium f/u

5 nutrition education sessions. Women taught how to plan nutritious meals, and buy, store and prepare these foods. Also given vitamin and mineral capsules. Delivered in native tongue

Dietary iron (% of recommended daily intake)

Serum folic acid deficiency

Intervention 58%, control 51%

Intervention group 10% deficient, control group 15%, p < 0.05

1

1

NS

1

Reisine (2012) [115]

Healthy pregnancy

Community health centre

Education only

Moderate dose

Long term f/up

Arm 1—education alone, Arm 2—education and a 1-h nutrition group session at 9 months and 6 weeks postpartum. Nutrition sessions were small group based educational materials at 9-month prenatal visit

Mutans levels

Decrease in mutans over time did not differ by group F(3,110) = 2.6, p > 0.05; favours educational alone

1

NS

Acharya (2015) [59]^a

Pregnancy & newborn health

Community education ± group meetings

Education only

Variable dose

Long term f/u

Large scale, 3-year intervention via district-level campaigns. Included advocacy (delivery of health messages during community events) & mass media messaging (posters, vehicle branding, street theatre & newsletters). High intensity intervention also involved community field workers in village health & sanitation committees, home visits to pregnant women & encouragement to attend monthly group meetings

Healthy delivery behaviours

(Composite score)

OR = 1.507 (95% CI 1.248 to 1.818); favours intervention

1

1

Hoodbhoy

(2021) [128]

Pregnancy & newborn health

Community + home based

Education only

Low dose

Long term f/u

The community engagement strategy had 2 components—a 45-min community-based; and 2 × interactive sessions were delivered to pregnant women and their families in their own homes

Birth preparedness

Intervention 43.87%, Control 29.72%, OR 1.74 (95% CI 0.64 to 4.73), p = 0.278

1

NS

Manandhar (2004) [103]

Pregnancy & newborn health

Community centre

Education + PS

Variable dose

Long term f/u

Community-based participatory intervention to improve childbirth and care behaviours. A female facilitator convened nine women’s group meetings every month to identify and prioritise peri-natal problems and formulate strategies to address them. 12-month duration

Any iron and folic acid supplements

Intervention 49%; control 30%; adjusted OR 1.99 (95%CI 1.14 to 3.46)

1

1

Pandey (2007) [110]

Pregnancy & newborn health

Community education ± group meetings

Education only

Variable dose

Long term f/u

Two to 3 public meetings were held in each village cluster to disseminate information on entitled health & education services. Education provided in groups using role plays and video material and distribution of posters and leaflets

Visit by nurse/midwife

Intervention 63%; control 61%, p = 0.15, RR = 1.03

1

NS

Abiyu

(2020) [58]

Newborn health

Community centre + home based

Education only

High dose

Long term f/u

Community based leaders delivered intervention involving 9 group sessions and 9 home visits over a 9-month period. Involved talks, group discussions, group work exercises, demonstrations, role plays, story- telling, simulation, case studies and problem-solving

Minimum dietary adversity

RR 3 (95% CI 1.34 to 7.39); favours intervention

1

1

Alvarenga

(2020) [63]

Newborn health

Health centres

Education only

High dose

Long term f/u

Each of the 8 visits had 2 parts: part 1- the mother was video-recorded playing with the baby, part 2—the mother and intervener watch selected scenes and discuss ways to facilitate development

Describes toy/activity

Intervention 8.31 (95% CI 7 to 94) vs Control 4.81 (95% CI 4 to 84); favours intervention, not significant

1

0

Childs (1997) [75]

Newborn health

Home- based

Education only

High dose

Long term f/u

Dietary health education program—sessions delivered face to face plus educational resources (video and leaflets). Multiple sessions over a period of 18 months

Breast feeding at 9 months

Haemoglobin (% with anaemia)

Intervention 6% (SD = 3); control 6% (SD = 2)

Intervention 28%; control 27%; no significant difference

 <  > 

0

NS

NS

McConnell (2016) [106]

Newborn health

Home– based

Education only

Low dose

Short term f/u

Arm 1—Early postnatal care three days after delivery provided in person with a community health worker using a checklist. Arm 2—Care provided by phone with a community health worker checklist. 1 session for each plus follow up phone call

Postnatal health practices (composite score)

Intervention arm 2: mean 7.2, control mean 6.6, p = 0.06

1

NS

Murthy (2019) [109]

Newborn health

Home based

Education only

High dose

Long term f/u

Voice messages delivered 2 × per week throughout pregnancy and until infant turned 1 year of age with a cluster of one message per day immediately postpartum for 7 days for a total of 145 voice messages

Infant immunization status

OR 1.51 (95%CI 1.14 to 2.06), p = 0.005

1

1

Ryser (2004) [118]

Newborn health

Health clinics

Education + counselling

Moderate dose

Medium f/u

4 sessions provided in conjunction with pre-natal visits. Involved educational videotapes, reading material and provision of counselling. Designed to address common breastfeeding barriers. Bilingual availability

Initiation of breastfeeding

Intervention 60.9%, control 14.8%; χ²(1, n = 50) = 9.52, p < 0.01, OR = 0.38 (95% CI 0.10 to 1.44)

1

1

Wiggins (2005) [126]

Newborn health

Community centre & home-based

Education only

High dose

Long term f/u

Community group support intervention for mothers with children less than 5 years. Standard package included drop-in sessions, home visiting (monthly visits for 1 year) and/or telephone support

Maternal smoking

RR 0.86 (95% CI 0.62 to 1.19); favours intervention

1

NS