Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change .
Follow-up period and intervention characteristics impacted effectiveness for some outcomes .
Interventions comprising education ( e.g. , providing information about behaviors associated with health risks ) and skills training ( e.g. , teaching skills that equip participants to engage in less risky behavior ) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity .
Although on average smoking was reduced , it appeared changes in smoking were negatively associated with changes in other behaviors , suggesting it may not be optimal to target smoking simultaneously with other risk behaviors
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease , cancer , or Type 2 diabetes .
Randomized trial of a clinic-based, community-supported, lifestyle intervention to improve physical activity and diet: the North Carolina enhanced WISEWOMAN project.
OBJECTIVE To determine if a clinic-based behavioral intervention program for low-income mid-life women that emphasizes use of community re sources will increase moderate intensity physical activity ( PA ) and improve dietary intake . METHODS R and omized trial conducted from May 2003 to December 2004 at one community health center in Wilmington , NC . A total of 236 women , ages 40 - 64 , were r and omized to receive an Enhanced Intervention ( EI ) or Minimal Intervention ( MI ) . The EI consisted of an intensive phase ( 6 months ) including 2 individual counseling sessions , 3 group sessions , and 3 phone calls from a peer counselor followed by a maintenance phase ( 6 months ) including 1 individual counseling session and 7 monthly peer counselor calls . Both phases included efforts to increase participants ' use of community re sources that promote positive lifestyle change . The MI consisted of a one-time mailing of pamphlets on diet and PA . Outcomes , measured at 6 and 12 months , included the comparison of moderate intensity PA between study groups as assessed by accelerometer ( primary outcome ) and question naire , and dietary intake assessed by question naire and serum carotenoids ( 6 months only ) . RESULTS For accelerometer outcomes , follow-up was 75 % at 6 months and 73 % at 12 months . Though moderate intensity PA increased in the EI and decreased in the MI , the difference between groups was not statistically significant ( p=0.45 ; multivariate model , p=0.08 ) ; however , moderate intensity PA assessed by question naire ( 92 % follow-up at 6 months and 75 % at 12 months ) was greater in the EI ( p=0.01 ; multivariate model , p=0.001 ) . For dietary outcomes , follow-up was 90 % for question naire and 92 % for serum carotenoids at 6 months and 74 % for question naire at 12 months . Dietary intake improved more in the EI compared to the MI ( question naire at 6 and 12 months , p<0.001 ; serum carotenoid index , p=0.05 ; multivariate model , p=0.03 ) . CONCLUSION The EI did not improve objective ly measured PA , but was associated with improved self-reported and objective measures of dietary intake
Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change .
Follow-up period and intervention characteristics impacted effectiveness for some outcomes .
Interventions comprising education ( e.g. , providing information about behaviors associated with health risks ) and skills training ( e.g. , teaching skills that equip participants to engage in less risky behavior ) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity .
Although on average smoking was reduced , it appeared changes in smoking were negatively associated with changes in other behaviors , suggesting it may not be optimal to target smoking simultaneously with other risk behaviors
CONTEXT Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease , cancer , or Type 2 diabetes .