Effectiveness of Individual Versus Group Counseling for Clients with Hypercholesterolemia

Abstract

The development and implementation of effective and cost-effective nutrition and lifestyle intervention programs plays an important role in the treatment of clients with hypercholesterolemia. Since the majority of nutrition education research has focused on individual counseling, this poses the question as to whether there are measurable differences between individual and group counseling methods for clients with hypercholesterolemia. The purposes of this multidisciplinary project were to: 1) compare individual versus group counseling methods using percentage changes in serum cholesterol, knowledge and behavior scores, and satisfaction level as measures of effectiveness; and 2) complete a cost-effectiveness analysis for both interventions. One hundred thirty-one adults with hypercholesterolemia (total cholesterol ≥200mg/dL) were randomly assigned to either individual (n=66) or group (n=65) counseling programs. A standardized five-week cholesterol education program was presented by the same team of counselors (Registered Dietitian and Clinical Nurse Specialist) in both interventions. Participants had their pre- and post-counseling serum cholesterol measured, completed pre- and post-knowledge and behavior questionnaires, and responded to a post-satisfaction questionnaire. Student's paired t-test and analysis of variance were used to detect significant changes within each intervention strategy and compare the two counseling methods. Both intervention methods yielded a significant (P<.001) decrease in total cholesterol, a significant (P<.001) increase in knowledge level, and a significant (P<.001) decrease in fat intake. All of the participants were moderately to extremely satisfied with the counseling that they received. Furthermore, there were no significant (P>.05) differences between group and individual counseling for any of the effectiveness measures. The program benefits and potential savings outweighed the program costs in both interventions; however, group counseling was determined to be more cost-effective. Results of this study indicate that: 1) group education is just as effective as individual counseling in reducing serum cholesterol, improving knowledge, and changing behavior and 2) a multidisciplinary team can provide effective and cost-effective nutrition and lifestyle counseling that can reduce coronary heart disease risk and promote client satisfaction.