Pooled net change in systolic blood pressure ( 16 trials ) was -1.86 ( 95 % CI -3.17 to -0.55 ; p=0.01 ) mm Hg ; diastolic blood pressure ( 15 trials ) , -1.53 ( -2.43 to -0.62 ; p=0.001 ) mm Hg ; body mass index ( 14 trials ) , -0.13 ( -0.26 to -0.01 ; p=0.04 ) kg/m2 ; serum total cholesterol ( 14 trials ) , -0.13 ( -0.19 to -0.07 ; p<0.001 ) mmol/L. There was no significant association between interventions with a reported theoretical basis and improved intervention outcomes .
No association was observed between intervention intensity ( number of sessions and intervention duration ) and intervention outcomes .
MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors .
BACKGROUND It is uncertain whether multiple health behaviour change ( MHBC ) interventions are effective for the primary prevention of cardiovascular disease ( CVD ) in primary care .
Motivational interviewing and problem solving treatment to reduce type 2 diabetes and cardiovascular disease risk in real life: a randomized controlled trial
Background Intensive lifestyle interventions in well-controlled setting s are effective in lowering the risk of chronic diseases such as type 2 diabetes ( T2DM ) and cardiovascular diseases ( CVD ) , but there are still no effective lifestyle interventions for everyday practice . In the Hoorn Prevention Study we aim ed to assess the effectiveness of a primary care based lifestyle intervention to reduce the estimated risk of developing T2DM and for CVD mortality , and to motivate changes in lifestyle behaviors . Methods The Hoorn Prevention Study is a parallel group r and omized controlled trial , implemented in the region of West-Friesl and , the Netherl and s. 622 adults with ≥10 % estimated risk of T2DM and /or CVD mortality were r and omly assigned and monitored over a period of 12 months . The intervention group ( n=314 ) received a theory-based lifestyle intervention based on an innovative combination of motivational interviewing and problem solving treatment , provided by trained practice nurses in 12 general practice s. The control group ( n=308 ) received existing health brochures . Primary outcomes was the estimated diabetes risk according to the formula of the Atherosclerosis Risk In Communities ( ARIC ) Study , and the estimated risk for CVD mortality according to the Systematic COronary Risk Evaluation ( SCORE ) formula . Secondary outcomes included lifestyle behavior ( diet , physical activity and smoking ) . The research assistants , the principal investigator and the general practitioners were blinded to group assignment . Linear and logistic regression analysis was applied to examine the between-group differences in each outcome measure , adjusted for baseline values . Results 536 ( 86.2 % ) of the 622 participants ( age 43.5 years ) completed the 6-month follow-up , and 502 ( 81.2 % ) completed the 12-month follow-up . The mean baseline T2DM risk was 18.9 % ( SD 8.2 ) and the mean CVD mortality risk was 3.8 % ( SD 3.0 ) . The intervention group participated in a median of 2 sessions . Intention-to-treat analyses showed no significant differences in outcomes between the two groups at 6 or 12-months follow-up . Conclusions The lifestyle intervention was not more effective than health brochures in reducing risk scores for T2DM and CVD or improving lifestyle behavior in an at-risk population .Trial registration Current Controlled Trials : IS RCT
Pooled net change in systolic blood pressure ( 16 trials ) was -1.86 ( 95 % CI -3.17 to -0.55 ; p=0.01 ) mm Hg ; diastolic blood pressure ( 15 trials ) , -1.53 ( -2.43 to -0.62 ; p=0.001 ) mm Hg ; body mass index ( 14 trials ) , -0.13 ( -0.26 to -0.01 ; p=0.04 ) kg/m2 ; serum total cholesterol ( 14 trials ) , -0.13 ( -0.19 to -0.07 ; p<0.001 ) mmol/L. There was no significant association between interventions with a reported theoretical basis and improved intervention outcomes .
No association was observed between intervention intensity ( number of sessions and intervention duration ) and intervention outcomes .
MHBC interventions delivered to CVD-free participants in primary care did not appear to have quantitatively important effects on CVD risk factors .
BACKGROUND It is uncertain whether multiple health behaviour change ( MHBC ) interventions are effective for the primary prevention of cardiovascular disease ( CVD ) in primary care .