Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial Commentary: Treatment allocation by the method of minimisation
Key result
Brief behavioural counselling by practice nurses improved dietary fat intake, regular exercise, and cigarettes smoked per day at 12 months, but did not significantly change biological risk factors.
Why the study?
Does brief behavioural counselling by practice nurses improve healthy behaviour and biological risk factors in adults at increased risk of coronary heart disease?
Population
883 men and women selected for the presence of one or more modifiable risk factors: regular cigarette…
Design
RCT, Cluster randomised; treatment allocation by the method of minimisation
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Caution against expecting biological risk factor changes from brief counseling; challenges translation of behavioral gains into objective CHD risk reduction.
Study Design
Type
RCT (n=883)
Randomization
Cluster randomized
Multicenter
Yes
Structured PICO
Does brief behavioural counselling by practice nurses improve healthy behaviour and biological risk factors in adults at increased risk of coronary heart disease?
P
Population
883 men and women selected for the presence of one or more modifiable risk factors: regular cigarette smoking, high serum cholesterol concentration (6.5-9.0 mmol/l), and high body mass index (25-35) combined with low physical activity.
I
Intervention
Brief behavioural counselling, on the basis of the stage of change model, carried out by practice nurses to reduce smoking and dietary fat intake and to increase regular physical activity.
O
Outcome
Questionnaire measures of diet, exercise, and smoking habits, and blood pressure, serum total cholesterol concentration, weight, body mass index, and smoking cessation (with biochemical validation) at 4 and 12 months.surrogate
Brief behavioural counselling by practice nurses improves self-reported healthy behaviors but does not significantly alter biological risk factors at 12 months in patients at high risk for coronary heart disease.
Cite This Study
Steptoe et al. (1999) conducted an RCT in Increased risk of coronary heart disease (n=883). Brief behavioural counselling vs. Control was evaluated on Diet, exercise, smoking habits, blood pressure, serum total cholesterol, weight, body mass index, and smoking cessation. Brief behavioural counselling by practice nurses improved dietary fat intake, regular exercise, and cigarettes smoked per day at 12 months, but did not significantly change biological risk factors.