Change Program Research Articles

Victim–Survivors Accounts of Men's Change: Findings From a Combined Alcohol and Other Drug Use and Domestic Violence Intervention

Purpose: This article is a process evaluation of a previously published outcome study. It provides an exploratory analysis of victim–survivor accounts of behavior change among men participating in a combined alcohol and other drug and domestic violence intervention and women's experiences of family safety contact services. Methods: Interviews with victim–survivors ( n = 10) and program participants ( n = 9). Results: Findings illustrate three patterns: victim–survivor accounts validating, challenging, and offering more nuanced perspectives on men's reports of behavior change. Conclusions: This article argues that victim–survivor engagement in behavior change programs is critical to assess and monitor risk to victim–survivors and other family members, validate other outcome measures related to men's behavior change (or lack thereof), and provide victim–survivor access to support.

The impact of a lifestyle behaviour change program on healthcare costs: Quasi-experimental real-world evidence from an open-access mobile health app in the Netherlands

ObjectiveRecognizing the substantial role of modifiable risk factors such as physical inactivity, unhealthy diets, and substance use in driving global healthcare expenses, this study aims to assess the impact of a lifestyle behaviour change mobile health (mHealth) app on healthcare costs within a real-world setting. MethodsEmploying a difference-in-difference approach, this research compared healthcare costs between users of an mHealth app (treatment group) and a propensity score-matched control group of non-users. The study included data from 15,506 participants in the Netherlands, covering healthcare cost records collected from 2015 to 2019. ResultsThe implementation of the mHealth app was linked to a steady reduction in healthcare costs, achieving a 4.9 % decrease (β=−0.05,95%CI:−0.10to0.00) during the first year following the program's implementation, and a further 5.3 % decrease (β=−0.05,95%CI:−0.10to−0.00) in the second year. This healthcare costs reduction is associated with lower expenses for general practitioner services as well as diminished specialist visits. Additionally, increased app use led to further cost reductions, with frequency of use proving more important than intensity. ConclusionsThis study demonstrates that a behaviour change mHealth app is linked to significant reductions in healthcare costs, with more frequent and intense use leading to greater savings. Given their relatively low cost and ability to reach diverse population groups, such apps not only enhance individual health outcomes but can also serve as effective policy tools for large-scale health promotion, supporting broader societal health improvements.

Individual and socio-psychological characteristics as predictors of physical activity among men living with overweight and obesity taking part in the Aussie Fans in Training weight management behaviour change programme

Background: Sufficient physical activity (PA) is important to reduce the risk of men developing chronic diseases and to improve mental health. The effectiveness of PA programmes can vary, however, among men. Individual and socio-psychological characteristics may affect the level of men’s PA before starting a behaviour change programme as well as changes in PA during the programme. Aims: The primary objective of this study was to examine the role of individual and socio-psychological characteristics in predicting men’s (a) accelerometer-assessed PA (step count and moderate to vigorous PA [MVPA]) upon presentation to a behaviour change programme and (b) changes in PA (step count and MVPA) during a behaviour change programme. Methods: A total of 109 men (mean age = 45.5 years, SD = 7.8 years, mean body mass index = 34.5 kg/m2, SD = 5.1 kg/m2) who participated in the Australian Fans in Training 3-month PA and dietary behaviour change programme in 2018 participated in this study. Before and after completing the 12-week programme, men completed assessments including individual (age, weight) and socio-psychological (psychological needs support, psychological needs satisfaction, positive affect and negative affect) characteristics. We used regression analysis to examine the relationship between these variables and PA. Results: At baseline, men’s weight (β = –.36, p < .001) and positive affect (β = .29, p < .01) were significant predictors of step count. At baseline, men’s weight (β = –.21, p < .05) and negative affect (β = .23, p < .05) were significant predictors of MVPA, though the overall model did not display statistical significance. The overall regression models did not significantly predict changes in either step count or MVPA pre- to post-programme. Conclusion: The influence of weight and positive and negative affect in predicting PA outcomes suggests that tailoring men’s health behaviour change interventions to individual circumstances and needs could enhance their effectiveness for some men.

Multimodal intervention based on physical exercise, mindfulness, behaviour change and education to improve pain and health in patients with chronic primary low back pain: a study protocol of the HEALTHYBACK randomised controlled trial

The HEALTHYBACK trial is based on a multimodal intervention to determine the effectiveness of a supervised physical exercise, mindfulness, behaviour change and pain neuroscience education programme on several health variables...

Evaluation of the Victorian Safe Driving Program (SDP) for Hoon Drivers

This study aimed to determine whether the Safe Driving Program (SDP), a behaviour change program ordered by the courts operating in Victoria, Australia, was successful in reducing the offending and crashes by hoon drivers. A sample of 3,324 hoon drivers who completed the SDP were compared with 1,063 hoon drivers who were ordered to complete the program but failed to do so. These two groups were also compared with a third group consisting of 30,678 hoon drivers who, for various reasons, had not been ordered to complete the SDP. Longitudinal group comparisons were made regarding overall, hoon and serious offending, as well as the number of crashes, fatalities and serious injuries and the proportion of offenders receiving bans and vehicle impoundments. Generalised Estimating Equations were used for this purpose, providing estimates of group differences. It was found that statistically significant benefits were obtained through the placement of SDP orders. However, differences between the offenders that completed their SDP order and those that failed to complete their SDP order were not always as expected. Reasons for this are explained and implications for the program, policies and penalties are discussed. No changes are recommended for current impoundment and SDP arrangements.

Pragmatic online obesity treatment in primary care: a hybrid randomized clinical trial of implementation strategies

Online behavioral weight loss (BWL) in primary care is effective and disseminable. This trial compared two implementation approaches on program uptake, use, and weight loss via a pragmatic hybrid type 2 implementation-effectiveness design to evaluate online BWL implementation (Rx Weight Loss [RxWL]) and effectiveness. This manuscript presents the implementation results. RxWL was implemented across a state-wide network of primary care clinics using lower- and higher-intensity implementation strategies (Basic [base program] and Enhanced [base plus enhanced training and dashboard], respectively) between 2018 and 2022. Nurse care managers (NCMs; N = 23) were recruited and block-randomized to implementation condition. Adult primary care patients (body mass index [BMI] > 25 kg/m2, internet-connected device access) were referred and enrolled by their NCMs. Outcomes were the proportion of eligible patients who enrolled in and completed RxWL by NCM condition, initial weight loss and regain over 12 and 24 months by NCM condition, and clinician acceptability and feasibility. NCMs (N = 12 Enhanced, N = 11 Basic) in Enhanced enrolled more patients (N = 490) than in Basic (N = 164). Although the proportion of patients who completed RxWL and mean weight loss did not differ by condition, different enrollment rates resulted in the Enhanced condition engaging more patients. NCMs rated RxWL as acceptable and feasible with no difference by condition. Findings support connecting primary care patients with technology-based health behavior change programs. Clinical trial registration number: ClinicalTrials.Gov identifier NCT03488212: https://clinicaltrials.gov/ct2/show/NCT03488212. Trial registration: clinicaltrials.gov Identifier: https://clinicaltrials.gov/study/NCT03488212.

A behaviour change strategy to reduce greenhouse gas emissions from international scientific conferences and meetings

We estimated the environmental impact and financial cost of two exemplar in-person academic events organised by the European academic society, the European Academy of Nursing Science, identified the main sources of these emissions, and then mapped them against the COM-B behaviour change framework of capability, opportunity, motivation to identify strategies that could be applied by organisers and participants to reduce this impact. These events contributed 41 tonnes and 99 tonnes of CO2e emissions per event, a per-participant mean of either 0.324 (SD 0.173) or 0.724, (SD 0.263) tonnes, representing 2 to 5.5 times the daily per-person European average. Distance from home was the largest contributor to emissions. Costs were similar for both events. Our multi-component behavioural change programme includes environmental change, enablement, education, incentivisation and persuasion, by which organisers provide participants with the opportunity for less-polluting behaviour, and enhance participants capabilities and motivation to act on the opportunities provided.

The Quest for Educational Equity in Schools in Multicultural Australia

Abstract Australia's migration history has produced one of the most ethnically diverse nations in the world, but this has presented challenges for educational equity. The introduction of multiculturalism in the 1970s coincided with an increasing focus on structural inequities in education. In this essay, we examine the context of changing educational policies and programs over the last half century, arguing that there has not been a steady process of reform involving measures redressing various inequalities but a period of policy turbulence. We consider the impact of the competing logics of multiculturalism-incorporation, recognition, civility-upon educational policy and practice to argue that, together with the consequences of neoliberal reforms, the equitable delivery of multiculturalism in schools has proved challenging. We conclude that multicultural education must refocus on the critical capacities that teachers and students alike need to understand the cultural complexities of a globalized world.

Integration of indigenous knowledge systems (IKS) into climate change mitigation and adaptation endeavours: milestones and gaps in South Africa and Zimbabwe’s climate policy frameworks

This article was poised to unravel the merits of integrating IKS and the demerits of its exclusion in climate change programmes and policies. The harrowing impacts of climate change in Sub-Saharan Africa make adaptation and mitigation unescapable discourses. As such, climate change policies demonstrate governments’ commitment to fostering adaptation and mitigating climate change impacts evident in every sector of society. The effectiveness of climate policies is measured by their responsiveness to the different needs, aspirations and circumstances of populations plagued by climate change. In the absence of technoscience-based adaptation and mitigation mechanisms, African communities still rely on the repository of indigenous knowledge systems as a source of information, decision-making, and prediction tools for predicting weather changes. For this reason, in formulating climate change mitigation and adaptation endeavours at policy level, it is critical to identify specific strategies where IKS has been used as a warrant towards its usage. This study was qualitative and operated within the traditional descriptive, analytical and interpretive approaches. It relied on a desktop review of journal articles on climate change and IKS, and climate change policies of South Africa and Zimbabwe. These were purposively sampled based on their relevance to the aim of the study. The Discourse Content Analysis was utilised to analyse data from which the findings were derived. The article established that despite the wide recognition of the role played by IKS in climate change adaptation, mitigation and disaster risk reduction, IKS has not featured predominantly South Africa’s climate change policies as compared to Zimbabwe’s climate policies. Notably, disregarding IKS in climate change policies makes them bereft of effectiveness in vulnerability reduction, fostering adaptation and resilience building for African communities that rely on IKS, among other capitals essential in fostering mitigation and adaptation in the face of climate change.

Harnessing Emerging Technologies for Sustainable Child Health: Rethinking Strategies for Advancing SDG 3.2 in Resource-Constrained Environments

PurposeDespite the various interventions by governments and partnering organizations, many children under five continue to lose their lives to preventable causes. Therefore, the purpose of this study was to investigate, from healthcare professionals’ perspectives, the strategies implemented to fight under-five mortality in Zimbabwe’s public healthcare and to propose a rethought of the strategies towards emerging technologies-driven interventions to advance the attainment of the United Nations Sustainable Development Goals (UN SDGs) 3.2. Design/methodology/approachThis study was a part of a broader study that used a sequential exploratory mixed-methods research design, in which interviews and focus groups were used in the qualitative phase, followed by questionnaires in the quantitative phase. However, this paper only reports on the exploratory (qualitative) phase’s findings, in which twenty participants from a public provincial hospital and clinics participated in online interviews and focus group discussions. Participants were selected using purposive sampling and snowballing. NVivo software facilitated data analysis. FindingsFindings revealed that the current under-five mortality containment strategies in Zimbabwe include free access to care under-fives and expectant mothers in public health facilities, provision of nutritional supplements, prevention of mother-to-child transmission, child immunization programs, maternal and child health programs, health education and behaviour change programs, integrated management of childhood illnesses, and community-based health initiatives. However, under-five mortality in Zimbabwe, just like in many sub-Sahara African countries, is still high. The poor under-five mortality outcomes are in part, due to challenges like high off-facility (home) births, late bookings for antenatal care services, inconsistent and insufficient supply of medicinal drugs, especially in hard-to-reach areas like rural areas, and an unresponsive national medicinal drug supply chain. The paper recommends rethinking the current strategies to address these challenges by harnessing emerging digital technologies to enhance sustainable child health., with the recent deployment of the electronic health record system in the country providing a facilitating condition for the successful implementation of a technology-driven public child healthcare system. Practical implicationsThis study seeks to provide an alternative, technology-driven approach to ending preventable child deaths and enhance the achievement of the UN SDG 3.2. Though one could argue about the practicality of implementing emerging technologies in a resource-constrained setting, it should be noted that such settings have numerous nongovernmental players (such as the UNDP, World Bank, UNICEF and others) funding various programs to promote child and maternal health initiatives. Originality/valueInformed by the challenges faced by Zimbabwe in tackling under-five mortality, and the potential of emerging technologies in advancing child health, this study proffers implementable recommendations to assist the healthcare policymakers in Zimbabwe and similar settings to harness the power of technology in advancing child health and reduce under-five mortality.

Investigating changes in mental illness stigma and discrimination after the Time to Change programme in England.

Between 2008 and 2019, we reported positive change relating to mental health stigma and discrimination among the adult population of England, supporting the effectiveness of the Time to Change campaign. Using data from the Attitudes to Mental Illness survey (2008/2009 to 2023), we investigated the extent to which positive changes in stigma were sustained by 2023, 2 years after the programme's end in 2021. We used regression analyses to evaluate trends in outcomes. Measures were of stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes toward the Mentally Ill scale (CAMI)) and desire for social distance (Reported and Intended Behaviour Scale (RIBS)). We also examined willingness to interact with people based on vignettes of depression and schizophrenia, and attitudes toward workplace discrimination, using data from the British Social Attitudes Survey for comparison. CAMI scores improved between 2008 and 2023 (s.d. 0.24, 95% CI 0.16-0.31), but decreased since 2019 (P = 0.015). After improvements between 2009 and 2019, 2023 MAKS and RIBS scores no longer differed from 2009 scores, indicating decreases in stigma-related knowledge (MAKS scores declined 7.8%; P < 0.001) and willingness to interact (RIBS scores declined by 10.2%; P < 0.001) since 2019. Conversely, comparison with British Social Attitudes Survey data indicated that willingness to interact with people with depression and schizophrenia increased gradually between 2007, 2015 and 2023, and attitudes to workplace discrimination also improved. The lasting positive changes reflect support for non-discrimination and willingness to interact with someone after a sense of familiarity is evoked. Besides the end of Time to Change, interpretations for declines in other outcomes include the COVID-19 pandemic and economic stress.

INTIMATE PARTNER VIOLENCE AS PREDICTOR OF MENTAL WELL-BEING AMONG MARRIED INDIVIDUALS

Several studies have shown that Intimate Partner Violence (IPV) has a negative influence on the mental well-being of married individuals in the contexts where they were conducted. However, the influence of intimate partner violence (IPV) on the mental well-being of married individuals in many developing countries, especially those in Africa, have been under-reported. The study reported here should thus add much value to the pool of literature aimed at exploring the predictive influence of IPV on mental well-being among married individuals in developing contexts. This cross-sectional survey adopted a purposive sampling technique to select 686 married individuals. The results showed that demographic variables (age, educational level, and marriage duration) and IPV dimensions (humiliation and afraid) jointly and independently predicted mental well-being with a variation of 11%. Regarding the contributions of each variable to mental well-being, age, educational level, marriage duration, humiliation, and afraid predicted mental well-being. Based on these findings it is recommended that more relevant training on attitudinal change programs and mechanisms to prevent and respond to violence among married individuals should be strengthened by relevant stakeholders.

Blood pressure management protocol based on transtheoretical model effectiveness on self- care: A systematic review.

Hypertension is a prevalent medical condition associated with cardiovascular and kidney diseases, leading to premature death and disability. Despite medication use, hypertension continues to rise due to unhealthy lifestyles. Self-care strategies play crucial roles in effectively treating hypertension. We aimed to evaluate the effectiveness of interventions based on the transtheoretical model (TTM) in improving self-care, self-efficacy, and health-related quality of life (HRQOL) in hypertensive adults. A comprehensive search was performed in multiple databases using appropriate search strategies. Two independent reviewers screened articles, and assessed their adherence to the inclusion and exclusion criteria. The risk of bias in randomized controlled trials was assessed by the Cochrane Collaboration tool and quasi-experimental studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies. The review included 24 studies with a total of 6553 participants. Most interventions aimed to encourage a healthier lifestyle and improve diet and physical activity. The message was delivered through various methods such as slide/tape messages, individual education/counseling sessions, telephone-delivered interventions, and multimedia training software based on the TTM. Control groups received physician visits or attended lifestyle lectures but did not receive specific behavior change programs like the intervention groups. Our results indicated that the TTM and stage of change model can be an appropriate framework for delivering educational messages to patients.

Recruitment and Retention in the National Diabetes Prevention Program Lifestyle Change Program in Two Federally Qualified Health Centers in Rural Hawai'i.

Prediabetes disproportionately affects racial and ethnic minority groups in Hawai'i. The National Diabetes Prevention Program lifestyle change program (National DPP LCP) decreases the risk of developing diabetes. However, enrolling and retaining participants is a challenge for program providers. This evaluation aimed to understand factors that influence racial and ethnic minority groups in Hawai'i to enroll in and complete the program. From 2018 through 2023, two federally qualified health centers (FQHCs) in rural Hawai'i administered 6 year-long cohorts. Trained lifestyle coaches, who were FQHC staff members, recruited participants and facilitated the evidence-based curriculum. In 2023, the evaluation team conducted semistructured interviews with 14 of the 40 enrolled participants (35%), all of whom were women aged 25 to 74 years. Six participants identified as Native Hawaiian or Other Pacific Islander and 3 as Filipino. Eight participants reported completing the program. We used qualitative methodology to analyze transcripts. We identified themes around motivators, barriers, facilitators, and suggestions for improvement. Recruitment by trusted individuals in their communities motivated participants to enroll. Caregiving and work obligations were attendance barriers for early withdrawers and graduates. Social support from lifestyle coaches and enrolled friends and family were facilitators for program completion. Suggestions included improving class availability and incorporating culturally relevant recipes. Barriers experienced by Native Hawaiian or Other Pacific Islander and Filipino participants were similar to those reported by racial and ethnic groups in other studies. Program providers in rural communities should use trusted individuals as lifestyle coaches and recruit family and friends, regardless of National DPP LCP eligibility, to reduce caregiving barriers and engage critical support systems to facilitate completion.

Pursuing systemic improvement through heterarchical school systems: A case of educational resources

AbstractEngland's schooling landscape is being remodelled and the move from hierarchical to heterarchical modes of governance has implications for systemic change strategies. Balancing local and networked autonomy with centralising policies complexifies choices for schools, creating tensions that this article explores through the context of curriculum resourcing policies. In particular, we consider the contemporary case of mathematics textbook schemes in England's heterarchical school system, comparing them with an earlier resource‐driven systemic change programme—the National Numeracy Strategy—which was implemented in a more hierarchical governance system. Drawing on key ideas from implementation science and data from a Wellcome‐funded study of primary teacher professional learning in mathematics in England, we exemplify the challenges of implementing centralised improvement policies in a nominally schools‐led, self‐improving, heterarchical education system. Each of the 19 participating schools had evolved a bespoke curriculum, and these hybridised ‘mashups’ of different resources were enacted with varying degrees of fidelity by teachers. We discuss the implications of this comparative case for systemic improvement, both in the use of educational resources and for policy implementation more generally.

Cost per kilogram weight-lost - Lifestyle change program at the Public Health Institute in Croatia

Abstract According to the 2019 European Health Survey, 42% and 23% of the Croatian adult population were affected by overweight or obesity, respectively. Counselling services are available in some Public Health Institutes for free or paid out-of-pocket. The estimated cost per kilogram lost in programs in Europe and the USA ranges from 100-340€, with a justifiable cost estimation for a weight loss intervention being 120-210€. Aim was to demonstrate the cost of losing one kilogram by analysing necessary initial material and human resources, including equipping counselling centres, and estimating the cost of continuous implementation. In the year 2023, 47 participants (31F,10M) with a BMI higher than 30 kg/m2 enrolled in the three-month free Program in the County Public Health Institute in Pozega. The program consisted of personalized assessment, habit change plan, education, counselling and follow-up. An analysis of the minimal required equipment and working hours of physician and a nurse (contracted gross hourly wage rates) was conducted. The main outcome measure was the cost of one kilogram lost by participants at the end of the Program. Program was completed by 41 (22F, 9M) participants (87.2%). Their initial BMI ranged from 30.3 to 47.4 kg/m2. Collectively, they lost 323.2 kg (1.3-24.4kg), with an average of 7.9 kg or 7.4% (1.7-19.8%) of their initial weight lost. The estimated total cost of medical, IT and office equipment, was 9363€. The human resources cost was 9509€, with a specialist and nurse spending 249 and 116 hours, respectively (27.6€/hour and 13€/hour). The initial cost per kilogram lost, including the prerequisites for the work of the counselling centre, was 58.4€. The continuous program cost with equipment already in place is estimated at 27.9€ per kilogram lost. We have shown that the lifestyle management program in the Croatia without extra cost to patients delivers results with a cost of 27.9€ per kilogram weight-lost in continuous implementation. Key messages • The significant impact of obesity on premature mortality and healthcare systems calls for the systematic implementation of effective weight management programs that are available to patients for free. • It is possible to implement effective weight management program in Croatia without extra cost to patients for 27.9 € per kilogram weight-lost.

A university-based counseling program for perpetrators of family violence in Greece: initial evidence

Abstract Penal mediation is defined in Greek Law 3500/2006 and aims at repairing the harm caused to the victim of family violence and rebuild family relationships. Mediation process starts upon victims’ unreserved consent and perpetrators’ willingness to stop further acts of violence, attend a counseling program and restore any harm/damage caused to the victim. Then the prosecutor ceases the case for 3 years and refers the perpetrator to counseling. If any of the previous conditions are violated during this period the criminal procedure continues at the stage before mediation. A university lab in Crete, Greece (LaHeRS, HMU) offers one of the few in Greece perpetrators’ behavior change programs in collaboration with the Prosecutor’s Office. LaHeRS counseling program consists of a minimum of 24 sessions per offender based on an individual or group approach. Emphasis is placed on perceptions of power and control, anger management, trauma management, emotional expression, and social/communication skills. Each perpetrator is offered 2 sessions (intake/violence documentation and assessment of individual/couples’ needs), 2-3 sessions for psychiatric and risk assessment, 12-15 individual or group counseling sessions (combined with couples’ sessions, as necessary), 2-4 individual social support sessions. Sessions are conducted by trained psychologists and social workers. The current presentation reports on the Intimate partner violence (IPV) cases referred between February 2022 and December 2023. A total of 70 IPV cases attended the program (male n = 65; mean age 43.4; Greek n = 56; urban residence n = 49; children average=1.92). Physical violence was reported in 54 cases and verbal aggression in 43 cases. Four perpetrators had mental health problems and 6 were identified with some form of drug and alcohol misuse. Lack of communication and emotional skills, lack of parent emotional support, gender roles stereotypes and patriarchal attitudes were common among perpetrators. Key messages • It is important for perpetrators’ programs to address the underlying causes of criminal behavior to promote positive changes in perpetrators’ lives. • Effective penal mediation programs require collaboration and partnership between justice agencies, academia and community organizations.

Changes Take Place in Stages! A Gradational Perspective on the Influence of Homeowners Associations on the Adoption of Wildlife-Friendly Landscape Maintenance

Lack of demand for professional wildlife-friendly landscape maintenance (WFLM) is not well understood, and further complicated by institutional and non-institutional influences. Framed by the Transtheoretical Model of Change, this study evaluated behaviors and perceptions pertaining to WFLM. A cross-sectional research design with quota sampling gathered stage of change, perceived motivators and barriers, processes of change, and self-efficacy from 1,219 Florida residents who hired a professional for landscape maintenance services. Comparisons were conducted to disentangle the relationship between living in a homeowners association and requesting WFLM. More residents were in earlier pre-action stages than later behavioral stages. There were stronger perceptions of some external barriers and motivators among homeowners association residents with perceptions of neighbors’ expectations being the greater motivator and barrier among this audience segment. Findings reveal a need to support residents in earlier stages of behavior change and integrate social norms into behavior change programs, especially within homeowners associations.

Preventing cardiovascular disease in at-risk patients: Results of a pilot behavioural health programme in general practice

Background The ‘High-Risk Prevention Programme’ (HRPP) involved a six-week health behaviour change programme based in general practices and aimed to address cardiovascular disease (CVD) risk in disadvantaged Irish communities. Objectives This pilot study aimed to establish the HRPP’s likely effectiveness and acceptability to inform the development of a future definitive trial. Methods The HRPP was conducted at six general practices in disadvantaged areas in the Ireland East region. Patients with high CVD risk were recruited by participating practices and were allocated to either a General Practice Nurse (GPN) or Health Promotion Professional (HPP) led programme focusing on positive health behavioural change. Baseline and 12-month follow-up data were collected to capture the HRPP’s likely effectiveness in promoting health outcomes and health behavioural change. Results The HRPP programme was completed by 270 patients. Out of these 270 patients, 245 (90.74%) completed baseline assessments, and 176 (65.19%) completed follow-up assessments at 12 months. Baseline data indicated a high level of CVD risk among patients and follow-up demonstrated positive change in several areas, especially weight (−1.95 kg, p < 0.001), BMI (−0.72, p < 0.001), exercise during the last week ( p <0.001), and consumption of healthy fats in the HPP group (+60%, p < 0.001). Conclusion The HRPP was a much-needed pilot intervention, and positive results were seen in both GPN and HPP arms, especially with regards to weight loss, exercise, and dietary improvements. Future definitive trials of the HRPP are likely to be effective and acceptable in terms of combatting these issues among high-risk patients.

Healthy Change Intervention: A Cluster RCT in Preschooler Mothers in Mexico and the United States.

To assess effects of Healthy Change intervention on maternal perception of her child's body weight (MPCW), maternal feeding style, and obesogenic home environment. A randomized control trial was conducted, consisting of two arms: the intervention group received the Healthy Change program, and the control group received the Hygiene and Accident Prevention program. A total of 356 mother-preschool child dyads participated, 182 in the intervention group and 174 in the control group, residing in Mexico and the United States. Data were collected at baseline and after the program through self-administered questionnaires completed by mothers and child anthropometric measurements. Although no significant between-group difference in pre- and post-intervention change of MPCW was found, sub-analyses revealed that a higher proportion of mothers in the intervention group accurately perceived their child's body weight at the study endpoint using categorical (67% vs. 57.1%, p < 0.005) and visual scales (48.9% vs. 41.8%, p < 0.015). Additionally, more mothers of overweight children in the intervention group accurately perceived their children's overweight and obese status compared to those in the control group (29.8% vs. 10.3%, X2 = 4.26, df = 1, p < 0.039). The intervention group also displayed a higher proportion of mothers with authoritative feeding style (26.4% vs. 16.5%, p < 0.036) and significantly higher family nutrition and physical activity scores (29.1 vs. 28.0, p < 0.000) at the study endpoint. Healthy Change Intervention led to improved accuracy of MPCW, a shift toward maternal authoritative feeding styles, and positive changes in obesogenic home environments.