Key result
Participants completing the CHIP lifestyle intervention maintained significant reductions in BMI (-3.2%), diastolic blood pressure (-9.4%), total cholesterol (-5.5%), and triglycerides (-27.5%) at 4 years.
Why the study?
Does a 30-day community-based lifestyle modification program improve long-term biometrics in adults?
Cohort (n=106)
No
Does a 30-day community-based lifestyle modification program improve long-term biometrics in adults?
A volunteer-delivered 30-day community lifestyle intervention can lead to sustained improvements in BMI, blood pressure, and lipids over 4 years in individuals with elevated baseline risk factors.
Observed improvements may inform community programs; leaves open causality and generalizability pending RCTs.
OBJECTIVE: To examine the long-term (three or more years) effectiveness of the volunteer-delivered Complete Health Improvement Program (CHIP) intervention. DESIGN: Cohort study. SETTING: Hawera, New Zealand. PARTICIPANTS: Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age=64.9±7.4 years, range 42-87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration=49.2+10.4 months). INTERVENTION: 30-day lifestyle modification programme (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting. MAIN OUTCOME MEASURES: Changes in body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG). RESULTS: After approximately 4 years, participants with elevated biometrics at programme entry maintained significantly lowered BMI (-3.2%; 34.8±5.4 vs 33.7±5.3 kg/m(2), p=0.02), DBP (-9.4%; 89.1±4.1 vs 80.8±12.6 mm Hg, p=0.005), TC (-5.5%; 6.1±0.7 vs 5.8±1.0 mmol/L, p=0.04) and TG (-27.5%; 2.4±0.8 vs 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (-4.2%; 34.8±4.5 vs 33.4±4.8 kg/m(2), p=0.02), DBP (-13.3%; 88.3±3.2 vs 77.1±12.1 mm Hg, p=0.005) and FPG (-10.4%; 7.0±1.5 vs 6.3±1.3 mmol/L, p=0.02). CONCLUSIONS: Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than 3 years. The results suggest that the community-based CHIP lifestyle intervention can be effective in the longer term, even when delivered by volunteers.
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Kent et al. (2013) conducted a cohort in Elevated biometrics/risk factors (n=106). Complete Health Improvement Program (CHIP) lifestyle intervention vs. Baseline (pre-intervention) was evaluated on Changes in body mass index (BMI), systolic and diastolic blood pressure, fasting plasma glucose, total cholesterol, LDL, HDL, and triglycerides. Participants completing the CHIP lifestyle intervention maintained significant reductions in BMI (-3.2%), diastolic blood pressure (-9.4%), total cholesterol (-5.5%), and triglycerides (-27.5%) at 4 years.
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