Abstract
BackgroundCardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders. These chronic diseases share the same four primary behavioural risk factors i.e. excessive alcohol use, smoking, low intake of fruit and vegetables and physical inactivity. In addition to addressing problematic alcohol use, there is the potential for substance abuse treatment services to also address these other behaviours. Healthy Recovery is an 8-session group-based intervention that targets these multiple behavioural health risk factors and was developed specifically for people attending substance abuse treatment. This protocol describes a Cancer Institute NSW funded study that assesses the effectiveness of delivering Healthy Recovery for people who are attending residential alcohol and other substance abuse treatment.Methods/DesignThe study uses a stepped wedge randomised controlled design, where randomisation occurs at the service level. Participants will be recruited from residential rehabilitation programs provided by The Australian Salvation Army. All participants who (1) currently smoke tobacco and (2) are expected to be in the residential program for the duration of the 5-week intervention will be asked to participate in the study. Those participants residing at the facilities assigned to the treatment condition will complete Healthy Recovery. The intervention is manual guided and will be delivered over a 5-week period, with participants attending 8 group sessions. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based, modified therapeutic community. Participants in the control condition will complete treatment as usual. Research staff blind to treatment allocation will complete the primary and secondary outcome assessments at baseline and then at weeks 8, 20 and 32 weeks post intervention.DiscussionThis study will provide comprehensive data on the effect of delivering a healthy lifestyle intervention (i.e. Healthy Recovery) within a residential substance abuse setting. If shown to be effective, this intervention can be disseminated within other residential substance abuse programs.Trial registrationAustralian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12615000165583. Registered 19th February 2015.
Highlights
Cardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders
Smoking Rates of smoking are much higher for people with alcohol or other substance abuse problems compared to people in the general population [3,4,5]
Analysis will be conducted independently by statisticians in the Clinical Research Design, IT and Statistical Support Unit, University of Newcastle. It is common for people accessing substance abuse treatment to smoke cigarettes, have poor dietary habits and engage in low levels of physical activity [4]. In conjunction with their extensive history of alcohol and other substance abuse, these unhealthy behaviours increase the risk of this population developing cardiovascular disease, cancer and other lifestyle related chronic diseases
Summary
Cardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders. These chronic diseases share the same four primary behavioural risk factors i.e. excessive alcohol use, smoking, low intake of fruit and vegetables and physical inactivity. The high incidence of chronic diseases is largely the result of this population engaging in multiple unhealthy lifestyle behaviours In addition to their use of alcohol and illicit substances, people with a history of alcohol or other substance abuse problems commonly demonstrate high rates of smoking, poor dietary behaviours, and low levels of physical activity. Mental health history (e.g. previous treatment, previous diagnosis, use of medication) Physical health
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