Abstract

Understanding the interactions among health risk behaviors, such as poor diet, smoking, high-risk alcohol use and physical inactivity, is important for designing effective interventions. Limited data are available to describe how interventions to modify one risk behavior may influence changes in other behaviors. Interaction of behaviors was examined as part of a one-year randomized clinical trial designed to assess the effect of a brief physician- and nurse practitioner-delivered counseling intervention versus usual care to reduce alcohol consumption by high-risk drinkers in a primary care setting. Self-reported data were collected at baseline, 6 and 12 months using the Time Line Follow-Back interview methodology, which inquired about alcohol consumption over the previous 7 days embedded in questions on diet, physical activity and smoking as a way to minimize reporting bias associated with self-report of alcohol use. The physical activity component was a modified 7-day physical activity recall. Of the 531 high-risk drinkers enrolled, 78% had complete data on leisure time physical activity (LTPA) at baseline and 12 months. Overall, there was a small statistically significant increase in LTPA (3.8 minutes, p < 0.03) between baseline and 12 months. This result did not differ significantly between the intervention (4.8 minutes) and control (2.7 minutes) groups (p = 0.5). Individuals in the intervention group significantly decreased weekly alcohol consumption compared to the control group at 6 and 12 months; however, change in alcohol was not related to a change in LTPA for either group. Results indicate that an intervention to modify high-risk drinking is not likely to result in meaningful, positive changes to LTPA. This suggests that interventions aimed at changing multiple risk behaviors must be purposeful and tailored to each specific health behavior of interest. Supported by NIAAA 9153-04

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