Implementation of the EIRA 3 Intervention by Targeting Primary Health Care Practitioners: Effectiveness in Increasing Physical Activity.

Sara Contreras-Martos,Emma Motrico,Rosa Magallón-Botaya,Bonaventura Bolíbar,Susana Aldecoa Landesa,Alfonso Leiva,José-Ángel Maderuelo,Joan Llobera,Edurne Zabaleta-Del-Olmo,Álvaro Sanchez,Juan Bellón,Marc Casajuana-Closas

doi:10.3390/ijerph181910537

Abstract

The World Health Organization (WHO) estimated that physical inactivity (PI) is responsible for 20 to 30% of all non-communicable diseases. We aimed to analyze the effectiveness of a multiple health behavior change (MHBC) intervention to increase physical activity (PA) in patients 45 to 75 years old who had at least 2 of 3 unhealthy behaviors (tobacco use, reduced fruit and vegetable consumption, and insufficient PA). The MHBC intervention is based on the Transtheoretical Model and the conceptual framework of the “5 A’s” and includes an individually tailored intervention, group sessions, and the use of community resources. We included 3062 participants, 1481 in the intervention group and 1581 in the control group. After 12 months, there were no differences in PA intensity measured by metabolic_equivalent_of_task_minutes/week (adjusted mean difference: 284.093, 95% CI: −298.24, 866.42) nor in the proportion of participants who increased PA levels to moderate or high (OR: 1.02, 95% CI: 0.85, 1.23; p = 0.822), and no differences in blood pressure, weight loss, or waist circumference. We found an increased proportion of patients in the intervention group who followed the WHO recommendations for PA (OR: 1.29; 95% CI: 1.04, 1.60; p = 0.02). We concluded that the intervention did not lead to a significant increase in PA.

Highlights

Non-communicable diseases (NCDs) are the leading cause of mortality worldwide and are responsible for 15 million premature deaths each year
Had 1581 participants, with 1448 (91.6%) classified as inactive; these individuals were managed according to the usual care practice established in each health center
SD: standard deviation; 95% confidence intervals (CIs): 95% interval of confidence; body mass index (BMI): Body Mass index; MET: metabolic equivalent of task minutes; WHO: World Health Organization; EQ5D5L: 5-level EQ-5D version questionnaire; REGICOR: cardiovascular risk calculator; LDL: low-density lipoprotein; HDL: high-density lipoprotein

Summary

Introduction

Non-communicable diseases (NCDs) are the leading cause of mortality worldwide and are responsible for 15 million premature deaths each year. Cardiovascular diseases, cancer, and diabetes account for 80% of these premature deaths. Modifiable behaviors, such as poor diet, inadequate physical activity (PI), and the use of tobacco and alcohol, increase the risk for most NCDs [1]. Engagement in PA decreases with age, with sedentary behaviors being highly prevalent in older adults [5,6]. The increase in sedentary behaviors and the concurrent decrease in PA are positively associated with increased incidences of obesity and hypertension [7,8,9]. Greater PA is associated with decreases in blood pressure, body mass index, and lipid concentrations [10]

Objectives

Methods

Results

Discussion

Conclusion