A randomized comparative effectiveness study of Healthy Directions 2-A multiple risk behavior intervention for primary care

PREVENTIVE MEDICINE

卷:64

Article

Emmons, Karen M.¹  Puleo, Elaine²  Greaney, Mary L.³  Gillman, Matthew W.⁴  Bennett, Gary G.⁷  Haines, Jess⁵  Sprunck-Harrild, Kim⁶  Viswanath, K.⁶ 

[1] Kaiser Fdn Res Inst, Oakland, CA 94612 USA

[2] Univ Massachusetts, Amherst, MA 01003 USA

[3] Univ Rhode Isl, Kingston, RI USA

[4] Harvard Univ, Sch Med, Harvard Pilgrim Hlth Care Inst, Boston, MA USA

[5] Univ Guelph, Guelph, ON N1G 2W1, Canada

[6] Dana Farber Canc Inst, Boston, MA 02115 USA

[7] Duke Univ, Dept Psychol & Neurosci, Durham, NC 27708 USA

关键词: Multimorbidities;    Primary care intervention;    Smoking cessation;    Cancer prevention;    Red meat;    Physical activity;   

DOI  :  10.1016/j.ypmed.2014.03.011

来源: Elsevier

【 摘 要 】

Objective. To evaluate the effectiveness of the Healthy Directions 2 (HD2) intervention in the primary care setting. Methods. HD2 was a cluster randomized trial (conducted 3/09-11/11). The primary sampling unit was provider (n = 33), with secondary sampling of patients within provider (n = 2440). Study arms included: 1) usual care (UC); 2) HD2 a patient self-guided intervention. targeting 5 risk behaviors; and 3) HD2 plus 2 brief telephone coaching calls (HD2 + CC). The outcome measure was the proportion of participants with a lower multiple risk behavior (MRB) score by follow-up. Results. At baseline, only 4% of the participants met all behavioral recommendations. Both HD2 and HD2 + CC led to improvements in MRB score, relative to UC, with no differences between the two HD2 conditions. Twenty-eight percent of the UC participants had improved MRB scores at 6 months, vs. 39% and 43% in HD2 and HD2 + CC, respectively (ps <= .001); results were similar at 18 months (p <= .05). The incremental cost of one risk factor reduction in MRB score was $310 for HD2 and $450 for HD2 + CC Conclusions. Self-guided and coached intervention conditions had equivalent levels of effect in reducing multiple chronic disease risk factors, were relatively low cost, and thus are potentially useful for routine implementation in similar health settings. (C) 2014 Elsevier Inc. All rights reserved.

【 授权许可】

Free