Background: Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. Purpose: This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provided to participants while aiming to determine whether or not genetic testing facilitates changes in lifestyle habits. This review is timely in light of a recently published “call-to-action” paper, highlighting the need to incorporate the TPB into personalized healthcare behaviour change research. Methods: Three bibliographic databases, one key website, and article reference lists were searched for relevant primary research articles. The PRISMA Flow Diagram and PRISMA Checklist were used to guide the search strategy and manuscript preparation. Out of 32,783 titles retrieved, 26 studies met the inclusion criteria. Three quality assessments were conducted and included: (1) risk of bias, (2) quality of genetic interventions, and (3) consideration of theoretical underpinnings – primarily the TPB. Results: Risk of bias in studies was overall rated to be “fair.” Consideration of the TPB was “poor,” with no study making reference to this validated theory. While some studies (n = 11; 42%) made reference to other behaviour change theories, these theories were generally mentioned briefly, and were not thoroughly incorporated into the study design or analyses. The genetic interventions provided to participants were overall of “poor” quality. However, a separate analysis of studies using controlled intervention research methods demonstrated the use of higher-quality genetic interventions (overall rated to be “fair”). The provision of actionable recommendations informed by genetic testing was more likely to facilitate behaviour change than the provision of genetic information without actionable lifestyle recommendations. Several studies of good quality demonstrated changes in lifestyle habits arising from the provision of genetic interventions. The most promising lifestyle changes were changes in nutrition. Conclusions: It is possible to facilitate behaviour change using genetic testing as the catalyst. Future research should ensure that high-quality genetic interventions are provided to participants, and should consider validated theories such as the TPB in their study design and analyses. Further recommendations for future research are provided.

中文翻译：

---

基因检测和生活方式行为改变的系统回顾：我们是否在使用高质量的基因干预并考虑行为改变理论？

背景：研究基因检测干预对生活方式行为改变的影响已成为近年来的优先研究领域。该文献的结果和结论存在大量异质性，尚未使用经过验证的行为改变理论和对遗传干预质量的评估进行解释。计划行为理论 (TPB) 有助于解释行为改变的关键因素。假设可以将个性化添加到该理论中，以帮助预测健康行为的变化。目的：本系统综述详细、全面地识别、评估和总结与基因检测干预导致的生活方式行为改变（营养、体育活动、睡眠和吸烟）有关的主要研究文章。本综述进一步旨在对迄今为止在 TPB 背景下进行的研究以及向参与者提供的基因干预的质量进行深入分析，同时旨在确定基因检测是否有助于改变生活方式。鉴于最近发表的“号召性用语”论文，这篇评论是及时的，强调了将 TPB 纳入个性化医疗行为改变研究的必要性。方法：在三个书目数据库、一个重点网站和文章参考列表中搜索相关的主要研究文章。PRISMA 流程图和 PRISMA 检查表用于指导搜索策略和手稿准备。在检索到的 32,783 个标题中，26 项研究符合纳入标准。进行了三项质量评估，包括：(1) 偏倚风险，(2) 遗传干预的质量，以及 (3) 考虑理论基础——主要是 TPB。结果：研究中的偏倚风险总体上被评为“公平”。对 TPB 的考虑是“糟糕的”，没有研究参考这个经过验证的理论。虽然一些研究（n = 11；42%）参考了其他行为改变理论，但这些理论通常被简要提及，并没有完全纳入研究设计或分析。提供给参与者的基因干预总体上质量“差”。然而，对使用受控干预研究方法的研究进行的单独分析表明，使用了更高质量的基因干预（总体评价为“公平”）。与不提供可操作的生活方式建议的遗传信息相比，通过基因检测提供可操作的建议更有可能促进行为改变。几项高质量的研究表明，由于提供基因干预，生活习惯发生了变化。最有希望的生活方式改变是营养的改变。结论：有可能使用基因测试作为催化剂来促进行为改变。未来的研究应确保为参与者提供高质量的遗传干预，并应在研究设计和分析中考虑经验证的理论，如 TPB。为未来的研究提供了进一步的建议。几项高质量的研究表明，由于提供基因干预，生活习惯发生了变化。最有希望的生活方式改变是营养的改变。结论：使用基因检测作为催化剂可以促进行为改变。未来的研究应确保为参与者提供高质量的遗传干预，并应在研究设计和分析中考虑经验证的理论，如 TPB。为未来的研究提供了进一步的建议。几项高质量的研究表明，由于提供基因干预，生活习惯发生了变化。最有希望的生活方式改变是营养的改变。结论：有可能使用基因测试作为催化剂来促进行为改变。未来的研究应确保为参与者提供高质量的遗传干预，并应在研究设计和分析中考虑经验证的理论，如 TPB。为未来的研究提供了进一步的建议。未来的研究应确保为参与者提供高质量的遗传干预，并应在研究设计和分析中考虑经验证的理论，如 TPB。为未来的研究提供了进一步的建议。未来的研究应确保为参与者提供高质量的遗传干预，并应在研究设计和分析中考虑经验证的理论，如 TPB。为未来的研究提供了进一步的建议。