Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial

Abstract Background This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45–75 years compared to usual care; and b) an implementation strategy. Methods A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. Results 14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity ≥50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain. Conclusions Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. Trial registration ClinicalTrials.gov, NCT03136211. Registered 2 May 2017, “retrospectively registered”.

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Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial

10.21203/rs.3.rs-52192/v1 ◽

2020 ◽

Author(s):

Edurne Zabaleta-del-Olmo ◽

Marc Casajuana-Closas ◽

Tomàs López-Jiménez ◽

Haizea Pombo ◽

Mariona Pons-Vigués ◽

...

Keyword(s):

Physical Activity ◽

Usual Care ◽

Behaviour Change ◽

Health Behaviour ◽

Implementation Strategy ◽

Health Behaviour Change ◽

Implementation Outcomes ◽

Cluster Randomised ◽

Multiple Health ◽

Determinants Of Implementation

Abstract Background This aim of this study was to evaluate the effectiveness of: a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45-75 years compared to usual care; and b) an implementation strategy. Methods A cluster randomised effectiveness-implementation hybrid trial type 2 with two parallel groups was conducted in 25 Primary Health Care centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention focused on all target behaviours and used individual, group and community approaches. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR) and a set of discrete implementation strategies which included planning, educating, financing, restructuring and managing quality. Data were analysed using generalised linear mixed models, accounting for clustering. A mixed methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. Results MHBC was greater in the intervention (14.5%) than in the usual care group (8.9%). The overall adoption rate by professionals was 48.7. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate, with a lower initial than final appropriateness perception. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of percentage of approaches with fidelity ≥ 50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five of them corresponding to the Inner Setting domain. Conclusions Compared to usual care, the EIRA intervention was more effective in promoting MHBC. Implementation outcomes were satisfactory except for the fidelity to the planned intervention which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. Trial registration ClinicalTrials.gov, NCT03136211. Registered 2 May 2017, “retrospectively registered”: https://clinicaltrials.gov/ct2/show/NCT03136211

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Consumer accounts of favourable dietary behaviour change and comparison with official dietary guidelines

Public Health Nutrition ◽

10.1017/s1368980018000241 ◽

2018 ◽

Vol 21 (10) ◽

pp. 1952-1960 ◽

Cited By ~ 1

Author(s):

Gastón Ares ◽

Jessica Aschemann-Witzel ◽

Leticia Vidal ◽

Leandro Machín ◽

Ximena Moratorio ◽

...

Keyword(s):

Behaviour Change ◽

Dietary Patterns ◽

Online Survey ◽

Social Activity ◽

Dietary Guidelines ◽

Dietary Behaviour ◽

Eating Patterns ◽

Healthy Foods ◽

Dietary Behaviour Change

AbstractObjectiveThe current study aimed to assess Uruguayan consumers’ accounts of their own need to change their dietary patterns, their intended changes and the barriers related to doing so, and to compare the intentions and barriers with the recommendations of the national dietary guidelines.DesignAn online survey with 2381 Uruguayan employed adults, aged between 18 and 65 years, 65 % females, was conducted. Participants had to answer two open-ended questions related to changes they could make in the foods they eat and/or the way in which they eat to improve the quality of their diet and the reasons why they had not implemented those changes yet. Content analysis using inductive coding by two researchers was used to analyse the responses.ResultsConsumers mainly intended to change consumption of types of foods, particularly eating more fruits, vegetables and legumes and consuming less flour, but also intended to alter their eating patterns. Lack of time and the fact that healthy foods are perceived as being more expensive than unhealthy foods were major barriers to behaviour change. Some of the recommendations of the dietary guidelines, particularly those related to enjoying cooking and meals and engaging in it as a social activity, were not represented in consumer accounts.ConclusionsAccompanying policies to the dietary guidelines need to underline the importance of changes in dietary patterns, including greater enjoyment and sharing food preparation and meals in the company with others, address misconceptions about flour, and provide concrete, consumer-derived recommendations on how to enact the guidelines.

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From Comorbidity to Multiple Health Behaviour Change

Emerging Perspectives on Substance Misuse ◽

10.1002/9781118306604.ch9 ◽

2013 ◽

pp. 152-169

Author(s):

Amanda Baker ◽

Sarah Hiles ◽

Louise Thornton ◽

Amanda Searl ◽

Peter Kelly ◽

...

Keyword(s):

Behaviour Change ◽

Health Behaviour ◽

Health Behaviour Change ◽

Multiple Health

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The Promotion of Eating Behaviour Change through Digital Interventions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207488 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7488

Author(s):

Yang Chen ◽

Federico J. A. Perez-Cueto ◽

Agnès Giboreau ◽

Ioannis Mavridis ◽

Heather Hartwell

Keyword(s):

Chronic Disease ◽

Behaviour Change ◽

Behavioural Change ◽

Eating Behaviour ◽

Dietary Behaviour ◽

Cochrane Library ◽

Personal Digital Assistants ◽

Behaviour Change Techniques ◽

Digital Interventions ◽

Dietary Behaviour Change

Diet-related chronic disease is a global health epidemic giving rise to a high incidence of morbidity and mortality. With the rise of the digital revolution, there has been increased interest in using digital technology for eating behavioural change as a mean of diet-related chronic disease prevention. However, evidence on digital dietary behaviour change is relatively scarce. To address this problem, this review considers the digital interventions currently being used in dietary behaviour change studies. A literature search was conducted in databases like PubMed, Cochrane Library, CINAHL, Medline, and PsycInfo. Among 119 articles screened, 15 were selected for the study as they met all the inclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search strategy. Four primary digital intervention methods were noted: use of personal digital assistants, use of the internet as an educational tool, use of video games and use of mobile phone applications. The efficiency of all the interventions increased when coupled with tailored feedback and counselling. It was established that the scalable and sustainable properties of digital interventions have the potential to bring about adequate changes in the eating behaviour of individuals. Further research should concentrate on the appropriate personalisation of the interventions, according to the requirements of the individuals, and proper integration of behaviour change techniques to motivate long-term adherence.

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