Waste the waist: a pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk

International Journal of Behavioral Nutrition and Physical Activity

Gordon Taylor²  Philip Evans⁴  Colin Green⁴  Mark Davis³  Margaret Francis⁶  Roger Chandler⁶  Daniel Messom¹  Rachel Perry²  James Dunbar⁵  Prasuna Reddy⁷  Paul Bennett²  Afroditi Stathi²  Fiona Gillison²  Colin Greaves⁴ 

[1] Bath, Gloucester, Swindon, Wiltshire Area Public Health Team, Public Health England, 1st Floor Bewley House, Marshfield Road, Chippenham SN15 1JW, Wiltshire, UK;University of Bath, Claverton Down, Bath BA2 7AY, UK;Centre for Exercise, Nutrition and Health Sciences, University of Bristol, 8 Priory Road, Bristol BS8 1TZ, UK;University of Exeter Medical School, St Luke’s Campus, Magdalen Road, Exeter EX1 2LU, UK;Greater Green Triangle University Department of Rural Health, Flinders and Deakin Universities, Warrnambool 3280, VIC, Australia;Waste the Waist Service User Advisory Group, c/o Colin Greaves, University of Exeter Medical School, St Luke’s Campus, Magdalen Road, Exeter EX1 2PU, UK;School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan 2308, NSW, Australia

关键词: Pilot trial;    Randomised controlled trial;    Physical activity;    Diet;    Behaviour change;    Weight loss;   

Others  :  1142565
DOI  :  10.1186/s12966-014-0159-z

 received in 2014-03-18, accepted in 2014-12-19,  发布年份 2015

【 摘 要 】

Background

In the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight.

Methods

Patients aged 40–74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months.

Results

108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: −4.8 to −0.3, p = 0.025). No significant differences were found in physical activity.

Conclusions

The Waste the Waist intervention is deliverable in UK primary care, has acceptable recruitment and retention rates and produces promising preliminary weight loss results. Subject to refinement of the physical activity component, it is now ready for evaluation in a full-scale trial.

Trial registration

Current Controlled Trials ISRCTN10707899 webcite.

【 授权许可】

   
2015 Greaves et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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