The association between individual counselling and health behaviour change: the See Kidney Disease (SeeKD) targeted screening programme for chronic kidney disease.

Abstract

BackgroundHealth behaviour change is an important component of management for patients with chronic kidney disease (CKD); however, the optimal method to promote health behaviour change for self-management of CKD is unknown. The See Kidney Disease (SeeKD) targeted screening programme screened Canadians at risk for CKD and promoted health behaviour change through individual counselling and goal setting.ObjectivesThe objectives of this study are to determine the effectiveness of individual counselling sessions for eliciting behaviour change and to describe participant characteristics associated with behaviour change.DesignThis is a cross-sectional, descriptive study.SettingThe study setting is the National SeeKD targeted screening programme.PatientsThe participants are all ‘at risk’ patients who were screened for CKD and returned a follow-up health behaviour survey (n = 1129).MeasurementsHealth behaviour change was defined as a self-reported change in lifestyle, including dietary changes or medication adherence.MethodsAn individual counselling session was provided to participants by allied healthcare professionals to promote health behaviour change. A survey was mailed to all participants at risk of CKD within 2–4 weeks following the screening event to determine if behaviour changes had been initiated. Descriptive statistics were used to describe respondent characteristics and self-reported behaviour change following screening events. Results were stratified by estimated glomerular filtration rate (eGFR) (< 60 and ≥ 60 mL/min/1.73 m2). Log binomial regression analysis was used to determine the predictors of behaviour change.ResultsOf the 1129 respondents, the majority (89.8 %) reported making a health behaviour change after the screening event. Respondents who were overweight (body mass index [BMI] 25–29.9 kg/m2) or obese (BMI ≥ 30.0 kg/m2) were more likely to report a behaviour change (prevalence rate ratio (PRR) 0.66, 95 % confidence interval (CI) 0.44–0.99 and PRR 0.49, 95 % CI 0.30–0.80, respectively). Further, participants with a prior intent to change their behaviour were more likely to make a behaviour change (PRR 0.58, 95 % CI 0.35–0.96). Results did not vary by eGFR category.LimitationsWe are unable to determine the effectiveness of the behaviour change intervention given the lack of a control group. Potential response bias and social desirability bias must also be considered when interpreting the study findings.ConclusionsIndividual counselling and goal setting provided at screening events may stimulate behaviour change amongst individuals at risk for CKD. However, further research is required to determine if this behaviour change is sustained and the impact on CKD progression and outcomes.