Abstract
BackgroundThe adoption and maintenance of healthy behaviours is essential in the primary prevention of chronic non-communicable diseases. This study evaluated the effectiveness of a minimal intervention on multiple lifestyle factors such as diet, physical activity, smoking and alcohol, delivered through general practice, using computer-tailored feedback.MethodsAdult patients visiting 21 general practitioners in Brisbane, Australia, were surveyed about ten health behaviours that are risk factors for chronic, non-communicable diseases. Those who completed the self-administered baseline questionnaire entered a randomised controlled trial, with the intervention group receiving computer-tailored printed advice, targeting those health behaviours for which respondents were not meeting current recommendations. The primary outcome was change in summary lifestyle score (Prudence Score) and individual health behaviours at three months. A repeated measures analysis compared change in these outcomes in intervention and control groups after adjusting for age and education.Results2306 patients were randomised into the trial. 1711 (76%) returned the follow-up questionnaire at 3 months. The Prudence Score (10 items) in the intervention group at baseline was 5.88, improving to 6.25 at 3 months (improvement = 0.37), compared with 5.84 to 5.96 (improvement = 0.12) in the control group (F = 13.3, p = 0.01). The intervention group showed improvement in meeting recommendations for all individual health behaviours compared with the control group. However, these differences were significant only for fish intake (OR 1.37, 95% CI 1.11-1.68), salt intake (OR 1.19, 95% CI 1.05-1.38), and type of spread used (OR 1.28, 95% CI 1.06-1.51).ConclusionA minimal intervention using computer-tailored feedback to address multiple lifestyle behaviours can facilitate change and improve unhealthy behaviours. Although individual behaviour changes were modest, when implemented on a large scale through general practice, this intervention appears to be an effective and practical tool for population-wide primary prevention.Trial RegistrationThe Australian New Zealand Clinical Trials Registry: ACTRN12611001213932
Highlights
Non-communicable diseases (NCDs) are, to varying degrees, associated with a limited set of modifiable health risk behaviours [1,2,3,4,5]
Invitations and questionnaires were mailed to 8243 patients, after 38 were excluded by their treating general practitioner (GP). 4678 patients agreed to participate in the study by returning completed questionnaires, giving a baseline response of 56.5%, see Figure 1
This intervention was effective in increasing the lifestyle score over a three month period, a statistically significant positive change was observed in only three individual health behaviours
Summary
Non-communicable diseases (NCDs) are, to varying degrees, associated with a limited set of modifiable health risk behaviours [1,2,3,4,5]. These behaviours are highly prevalent in developed countries; for example, 61% of the Australian population consumes more alcohol than recommended by current guidelines, 50% and 86% respectively fails to eat sufficient fruit and vegetables [6] and 50% is physically inactive [7]. This study evaluated the effectiveness of a minimal intervention on multiple lifestyle factors such as diet, physical activity, smoking and alcohol, delivered through general practice, using computer-tailored feedback
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