Adherence Trajectories Across Behaviors and Associated Impact on Quality of Life

This study is designed to pool adherence data across eight funded maintenance of behavior change studies in order to answer the following:

1. What degree of variability occurs across behaviors in the way that adherence is assessed? We will review current survey data and summarize the ways that studies have conceptualized adherence and measured adherence processes and will write a descriptive paper based on the findings.
2. What degree of variability occurs in adherence across behaviors with respect to various aspects of adherence, including level and frequency of adherence over time, i.e. time trajectories, and patterns of dropout, relapse, reactivation and other time-related transitions. To what extent does the environmental context within which each intervention takes place (e.g. communities with greater vs. lesser amounts of social deprivation) affect adherence, relapse and reactivation?
3. What level of adherence is necessary across behaviors to impact a common outcome such as healthy days and other related quality of life constructs? We will work with the outcome group to assess the relationship of adherence to this outcome and we will work with the modality group to assess the comparative impact of three different attributes of the interventions: the impact of degree of tailoring within the intervention; the impact of intervention intensity, and the impact an environmental component within the intervention on degree of adherence achieved and likelihood of impacting quality of life.

The result of these analyses will be heretofore unavailable information about predictors of adherence across behaviors, knowledge about adherence transitions across behaviors, and a more complete understanding of the complexity and opportunities inherent in achieving multiple risk factor reduction in populations.