Compliance with the Very Integrated Program (VIP) for Smoking Cessation, Nutrition, Physical Activity and Comorbidity Education Among Patients in Treatment for Alcohol and Drug Addiction.

Michelle Günther,Hanne Tønnesen,Karen Hovhannisyan,Johanna Adami,Rie Raffing,Maria Wikström

doi:10.3390/ijerph16132285

Abstract

Meeting adherence is an important element of compliance in treatment programmes. It is influenced by several factors one being self-efficacy. We aimed to investigate the association between self-efficacy and meeting adherence and other factors of importance for adherence among patients with alcohol and drug addiction who were undergoing an intensive lifestyle intervention. The intervention consisted of a 6-week Very Integrated Programme. High meeting adherence was defined as >75% participation. The association between self-efficacy and meeting adherence were analysed. The qualitative analyses identified themes important for the patients and were performed as text condensation. High self-efficacy was associated with high meeting adherence (ρ = 0.24, p = 0.03). In the multivariate analyses two variables were significant: avoid complications (OR: 0.51, 95% CI: 0.29–0.90) and self-efficacy (OR: 1.28, 95% CI: 1.00–1.63). Reflections on lifestyle change resulted in the themes of Health and Wellbeing, Personal Economy, Acceptance of Change, and Emotions Related to Lifestyle Change. A higher level of self-efficacy was positively associated with meeting adherence. Patients score high on avoiding complications but then adherence to the intervention drops. There was no difference in the reflections on lifestyle change between the group with high adherence and the group with low adherence.

Highlights

Patients with alcohol and drug addiction often have additional risky lifestyle behaviours, e.g., smoking, poor nutrition and physical inactivity, as well as comorbidity; all these have a social gradient and add to the already high substance-induced morbidity and pre-mortality [1,2,3]
We found that only self-efficacy (Line 3) was positively associated with meeting adherence, ρ =
In the univariate analyses the only significant difference between the two groups with high and low adherence were the perception of self-efficacy, which remained significant in the multivariate analyses (OR: 1.23; 95% confidence interval (CI): 1.01–1.51)

Summary

Introduction

Patients with alcohol and drug addiction often have additional risky lifestyle behaviours, e.g., smoking, poor nutrition and physical inactivity, as well as comorbidity; all these have a social gradient and add to the already high substance-induced morbidity and pre-mortality [1,2,3]. Effective health promotion aiming at those factors is relevant to offer to this disadvantaged patient group as an integrated part of addiction treatment. Lifestyle change is a complex process influenced by many factors related to the programme, the therapist and the individual person. Res. Public Health 2019, 16, 2285; doi:10.3390/ijerph16132285 www.mdpi.com/journal/ijerph

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