Analysis of the psychological impact of a vascular risk factor intervention: results from a cluster randomized controlled trial in Australian general practice

BMC Family Practice

Research Article

Upali W Jayasinghe¹  Mark Fort Harris¹  Mahnaz Fanaian²  Suzanne Helen McKenzie³  Megan Passey⁴ 

[1] Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW, Australia;Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW, Australia;Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia;Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Kensington, NSW, Australia;School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia;University Centre for Rural Health – North Coast, School of Public Health, University of Sydney, Darlington, NSW, Australia;

关键词: Psychological Distress;    Vascular Risk Factor;    Health Check;    Behavioural Risk Factor;    Zealand Clinical Trial Registry;   

DOI  :  10.1186/1471-2296-14-190

 received in 2013-09-13, accepted in 2013-12-11,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundScreening for vascular disease, risk assessment and management are encouraged in general practice however there is limited evidence about the emotional impact on patients. The Health Improvement and Prevention Study evaluated the impact of a general practice-based vascular risk factor intervention on behavioural and physiological risk factors in 30 Australian practices. The primary aim of this analysis is to investigate the psychological impact of participating in the intervention arm of the trial. The secondary aim is to identify the mediating effects of changes in behavioural risk factors or BMI.MethodsThis study is an analysis of a secondary outcome from a cluster randomized controlled trial. Patients, aged 40–65 years, were randomly selected from practice records. Those with pre-existing cardiovascular disease were excluded. Socio-demographic details, behavioural risk factors and psychological distress were measured at baseline and 12 months. The Kessler Psychological Distress Score (K10) was the outcome measure for multi-level, multivariable analysis and a product-of-coefficient test to assess the mediating effects of behaviour change.ResultsBaseline data were available 384 participants in the intervention group and 315 in the control group. Twelve month data were available for 355 in the intervention group and 300 in the control group. The K10 score of patients in the intervention group (14.78, SD 5.74) was lower at 12 months compared to the control group (15.97, SD 6.30). K10 at 12 months was significantly associated with the score at baseline and being unable to work but not with age, gender, change in behavioural risk factors or change in BMI.ConclusionsThe reduction of K10 in the intervention group demonstrates that a general practice based intervention to identify and manage vascular risk factors did not adversely impact on the psychological distress of the participants. The impact of the intervention on distress was not mediated by a change in the behavioural risk factors or BMI, suggesting that there must be other mediators that might explain the positive impact of the intervention on emotional wellbeing.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12607000423415.

【 授权许可】

CC BY   
© McKenzie et al.; licensee BioMed Central Ltd. 2013