Willingness to pay for a cardiovascular prevention program in highly educated adults: A randomized controlled trial

Objectives: The aim of this study was to determine adults’ Willingness To Pay (WTP) for CardioVascular Disease (CVD) intervention programs of different intensities.Methods: Three hundred fourteen participants were randomized to two study conditions: (i) CVD risk assessment/communication; (ii) CVD risk assessment/communication + a behavior change program. The behavior change program was aimed at increasing physical activity, reducing saturated fat intake and smoking cessation. It consisted of a tailored Web site and individual coaching with a self-selected dose. At post-assessment, WTP and perceived autonomy support items were included. The intervention dose was registered throughout the trial and post-hoc intervention dose groups were created. Pearson Chi-Square tests, Student's t-tests, one-way analyses of variance were used to examine WTP-differences between the study conditions and intervention dose groups.Results: Twenty-four months after baseline, 61 and 135 participants of the control and intervention condition, respectively, completed the questionnaires. No WTP difference was found between the study conditions. However, participants that selected a higher intervention dose were willing to pay significantly more for their program (p < .05).Conclusions: In general, people want to pay the same amount of money for a CVD prevention program, irrespective of the inclusion of a behavior change program. However, there seems to be an association between the self-selected dose of the latter program and the WTP.

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Impact of a behavior change program and health education on social interactions in survivors of head and neck cancer: Randomized controlled trial

Psycho-Oncology ◽

10.1002/pon.4939 ◽

2018 ◽

Vol 28 (2) ◽

pp. 293-300 ◽

Cited By ~ 1

Author(s):

Shu‐Ching Chen ◽

Bing‐Shen Huang ◽

Tsung‐Min Hung ◽

Chien‐Yu Lin ◽

Ya‐Lan Chang

Keyword(s):

Randomized Controlled Trial ◽

Head And Neck Cancer ◽

Health Education ◽

Behavior Change ◽

Social Interactions ◽

Head And Neck ◽

Neck Cancer ◽

Controlled Trial ◽

Randomized Controlled ◽

Behavior Change Program

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Effectiveness of a 3-Month Mobile Phone–Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial (Preprint)

10.2196/preprints.18531 ◽

2020 ◽

Author(s):

Anna Ek ◽

Christina Alexandrou ◽

Emmie Söderström ◽

Patrick Bergman ◽

Christine Delisle Nyström ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Behavior Change ◽

Mobile Phone ◽

Controlled Trial ◽

Vigorous Physical Activity ◽

Intervention Group ◽

Active Transportation ◽

Randomized Controlled ◽

Behavior Change Program

BACKGROUND Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking. OBJECTIVE The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA). METHODS For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months. RESULTS No effect on MVPA was observed after 3 months (<i>P</i>=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; <i>P</i>=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day. CONCLUSIONS No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA. CLINICALTRIAL ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12889-018-5658-4

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Cost-effectiveness of a stepwise cardiometabolic disease prevention program: results of a randomized controlled trial in primary care

BMC Medicine ◽

10.1186/s12916-021-01933-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Daphne M. Stol ◽

Eelco A. B. Over ◽

Ilse F. Badenbroek ◽

Monika Hollander ◽

Mark M. J. Nielen ◽

...

Keyword(s):

Risk Assessment ◽

Primary Care ◽

Cost Effectiveness ◽

Prevention Program ◽

Healthcare Costs ◽

Controlled Trial ◽

Intervention Group ◽

Control Group

Abstract Background Cardiometabolic diseases (CMD) are the major cause of death worldwide and are associated with a lower quality of life and high healthcare costs. To prevent a further rise in CMD and related healthcare costs, early detection and adequate management of individuals at risk could be an effective preventive strategy. The objective of this study was to determine long-term cost-effectiveness of stepwise CMD risk assessment followed by individualized treatment if indicated compared to care as usual. A computer-based simulation model was used to project long-term health benefits and cost-effectiveness, assuming the prevention program was implemented in Dutch primary care. Methods A randomized controlled trial in a primary care setting in which 1934 participants aged 45–70 years without recorded CMD or CMD risk factors participated. The intervention group was invited for stepwise CMD risk assessment through a risk score (step 1), additional risk assessment at the practice in case of increased risk (step 2) and individualized follow-up treatment if indicated (step 3). The control group was not invited for risk assessment, but completed a health questionnaire. Results of the effectiveness analysis on systolic blood pressure (− 2.26 mmHg; 95% CI − 4.01: − 0.51) and total cholesterol (− 0.15 mmol/l; 95% CI − 0.23: − 0.07) were used in this analysis. Outcome measures were the costs and benefits after 1-year follow-up and long-term (60 years) cost-effectiveness of stepwise CMD risk assessment compared to no assessment. A computer-based simulation model was used that included data on disability weights associated with age and disease outcomes related to CMD. Analyses were performed taking a healthcare perspective. Results After 1 year, the average costs in the intervention group were 260 Euro higher than in the control group and differences were mainly driven by healthcare costs. No meaningful change was found in EQ 5D-based quality of life between the intervention and control groups after 1-year follow-up (− 0.0154; 95% CI − 0.029: 0.004). After 60 years, cumulative costs of the intervention were 41.4 million Euro and 135 quality-adjusted life years (QALY) were gained. Despite improvements in blood pressure and cholesterol, the intervention was not cost-effective (ICER of 306,000 Euro/QALY after 60 years). Scenario analyses did not allow for a change in conclusions with regard to cost-effectiveness of the intervention. Conclusions Implementation of this primary care-based CMD prevention program is not cost-effective in the long term. Implementation of this program in primary care cannot be recommended. Trial registration Dutch Trial Register NTR4277, registered on 26 November 2013

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Effectiveness of a Behavior Change Program on Physical Activity and Eating Habits in Patients With Hypertension: A Randomized Controlled Trial

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0268 ◽

2017 ◽

Vol 14 (12) ◽

pp. 943-952 ◽

Cited By ~ 5

Author(s):

Aline Mendes Gerage ◽

Tânia Rosane Bertoldo Benedetti ◽

Raphael Mendes Ritti-Dias ◽

Ana Célia Oliveira dos Santos ◽

Bruna Cadengue Coêlho de Souza ◽

...

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Randomized Controlled Trial ◽

Behavior Change ◽

Eating Habits ◽

Controlled Trial ◽

Control Group ◽

Randomized Controlled ◽

Behavior Change Program

Background: This study aimed to analyze the effect of a behavior change program, called Vida Ativa Melhorando a Saúde (VAMOS), on physical activity, eating habits, and quality of life in patients with hypertension. Methods: A randomized controlled trial was carried out in 90 patients with hypertension (57.8 ± 9.9 y). They were randomly assigned to 2 groups: VAMOS group (n = 45) and control group (n = 45). The VAMOS group participated in a behavioral change program aimed at motivating changes in physical activity and nutrition behavior for 12 weeks. Physical activity, eating habits, quality of life, self-efficacy, and social support were evaluated at preintervention and postintervention. Results: The control group increased sedentary time (407 ± 87 vs 303 ± 100 min/d; P < .05) and sedentary bouts (434 ± 86 vs 336 ± 98 min/d; P < .05) and reduced total physical activity (553 ± 87 vs 526 ± 86 min/d; P < .05). The VAMOS group improved the general healthy eating habits score (36.9 ± 6.6 vs 43.4 ± 5.8; P < .05) and quality of life (44% vs 92%; P < .05). Conclusion: The VAMOS program was effective in improving eating habits and quality of life in patients with hypertension.

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Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/jmir.5634 ◽

2016 ◽

Vol 18 (10) ◽

pp. e265 ◽

Cited By ~ 18

Author(s):

Catharina A Nordin ◽

Peter Michaelson ◽

Gunvor Gard ◽

Margareta K Eriksson

Keyword(s):

Randomized Controlled Trial ◽

Behavior Change ◽

Controlled Trial ◽

Randomized Controlled ◽

Behavior Change Program ◽

The Web

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Spices in a High-Saturated-Fat, High-Carbohydrate Meal Reduce Postprandial Proinflammatory Cytokine Secretion in Men with Overweight or Obesity: A 3-Period, Crossover, Randomized Controlled Trial

Journal of Nutrition ◽

10.1093/jn/nxaa063 ◽

2020 ◽

Vol 150 (6) ◽

pp. 1600-1609 ◽

Cited By ~ 5

Author(s):

Ester S Oh ◽

Kristina S Petersen ◽

Penny M Kris-Etherton ◽

Connie J Rogers

Keyword(s):

Randomized Controlled Trial ◽

Risk Factor ◽

Proinflammatory Cytokine ◽

Mononuclear Cells ◽

Controlled Trial ◽

Saturated Fat ◽

Cvd Risk ◽

High Carbohydrate ◽

Randomized Controlled ◽

Carbohydrate Meal

ABSTRACT Background Postprandial inflammation that occurs concurrently with hyperglycemia and hyperlipidemia after ingestion of a high-saturated-fat, high-carbohydrate meal (HFCM) is a risk factor for cardiovascular disease (CVD). Numerous preclinical and clinical studies demonstrate anti-inflammatory effects of individual spices. However, the effect of consumption of a spice blend on inflammatory mediators has not been examined in a randomized controlled trial. Objectives The objective of this study was to investigate the postprandial effect of a blend of spices in a HFCM on inflammatory cytokine responses. Methods Nonsmoking men (40–65 y old) with overweight/obesity (25 ≤ BMI ≤ 35 kg/m2), elevated waist circumference (≥ 94 cm), and ≥ 1 CVD risk factor were recruited for a 3-period crossover study ( n = 12). In random order, participants consumed the following: a HFCM (∼1000 kcal, 33% kcal from saturated fat and 36% kcal from carbohydrate), a HFCM containing 2 g spice blend, or an HFCM containing 6 g spice blend. The spice blend consisted of basil, bay leaf, black pepper, cinnamon, coriander, cumin, ginger, oregano, parsley, red pepper, rosemary, thyme, and turmeric. Blood was collected before, and hourly for 4 h after the HFCM. Peripheral blood mononuclear cells (PBMCs) were isolated, and the percentage of CD14 +/Human Leukocyte Antigen-DR isotype + (HLA-DR +) monocytes and proinflammatory cytokine concentrations in plasma and LPS-stimulated PBMCs were quantified as secondary outcomes. Results There was a significant spice-by-time interaction on IL-1β (P < 0.001), IL-8 (P = 0.020), and TNF-α (P = 0.009) secretion from LPS-stimulated PBMCs. IL-1β secretion from LPS-stimulated PBMCs was significantly reduced (1314%) at 240 min after HFCM consumption containing 6 g, but not 2 g, of spice blend compared with 0 g spice blend. Conclusions A HFCM containing 6 g spice blend attenuated HFCM-induced postprandial IL-1β secretion in men with overweight/obesity. This trial was registered at clinicaltrials.gov as NCT03064958.

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