Changes in Health-Risk Behavior, Body Mass Index, Mental Well-Being, and Risk Status Following Participation in a Stepwise Web-Based and Face-to-Face Intervention for Prevention of Lifestyle-Related Diseases: Nonrandomized Follow-Up Cohort Study

Abstract

<jats:sec> <jats:title>Background</jats:title> <jats:p>Recent evidence suggests the effectiveness of stepwise, targeted approaches for the prevention of lifestyle-related diseases with combinations of web-based and face-to-face interventions showing promising results.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective</jats:title> <jats:p>This paper reports on 1-year changes in health-risk behaviors, BMI, self-rated health, mental well-being, and risk of disease at 1-year follow-up after participation in a stepwise intervention that targeted persons at high risk of disease and persons with health-risk behavior. To this end, we distinguish between participants who took up the full intervention (web-based plus face-to-face) and those who received only the web-based intervention.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The Early Detection and Prevention (Danish acronym: TOF) pilot study was conducted as a nonrandomized, 1-year follow-up intervention study in two municipalities in the Region of Southern Denmark. A total of 9400 citizens born between 1957 and 1986 (aged 29 to 60 years) were randomly sampled from participating general practitioner (GP) patient-list systems and were invited to take part in the study. Participants were subsequently stratified into risk groups based on their responses to a questionnaire on health-risk behavior and data from their GP’s electronic patient record (EPR) system. All participants received a digital personal health profile with individualized information on current health-risk behavior and targeted advice on relevant health-risk behavior changes. In addition, patients at high risk of disease, as indicated by their digital health profile, were offered a targeted intervention at their GP. Patients who were not deemed at high risk of disease but who exhibited health-risk behaviors were offered a targeted intervention at their municipal health center (MHC). At 1-year follow-up, health-risk behaviors, self-rated health, BMI, and mental well-being were reassessed by questionnaire, and current information on diagnoses and medical treatment was retrieved from the EPRs.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of 598 patients at high risk of disease or with health-risk behavior, 135 took up the targeted intervention at their GP or MHC and 463 received the personal health profile only. From baseline to 1-year follow-up, the number of patients with unhealthy eating habits decreased, mean mental well-being increased, and smoking prevalence decreased in patients who had received the digital personal health profile alone. Among patients who took up the targeted intervention, unhealthy eating habits and sedentary lifestyles decreased and significant reductions in mean BMI were observed. At 1-year follow up, no health-risk behaviors were detected among 17.4% of patients who at baseline had exhibited health-risk behaviors or high risk of disease.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>A stepwise targeted preventive approach using web-based and face-to-face elements may lead to favorable lifestyle changes. Specifically, a web-based approach may improve smoking and eating habits and mental well-being, whereas supplementary face-to-face interventions may be necessary to improve exercise habits and BMI.</jats:p> </jats:sec> <jats:sec> <jats:title>Trial Registration</jats:title> <jats:p>ClinicalTrials.gov NCT02797392; https://clinicaltrials.gov/ct2/show/NCT02797392</jats:p> </jats:sec> <jats:sec> <jats:title>International Registered Report Identifier (IRRID)</jats:title> <jats:p>RR2-10.1186/s12875-018-0820-8</jats:p> </jats:sec>

Digital solutions for decision support in general practice – a rapid review focused on systems developed for the universal healthcare setting in Denmark

“…A total of 15 studies [ 12 – 26 ] were included in the review as key studies and 7 studies/articles [ 27 – 33 ] were included as supplementary sources for further description of identified digital solutions. The characteristics of the 15 key studies are outlined in Table 1 .…”

“… Nationwide To test psychometric testing of potentially depressive patients in general practice through a telemedicine solution WebPatient and the possibility to order eMDI testing was implemented nationally in 2015 Electronic Decision Support (EDS) to support end-of-life care [ 19 ] The EDS consisted of a pop-up window in the patient’s medical record and a list of patients with end-of-life needs and key elements in their care Cancer and COPD COPD prevalence is estimated to 300.000 to 400.000 patients and approximately 14% among individuals aged 35 years and above [ 36 ]. Central Denmark Region To support end-of-life care in general practice for patients with cancer or COPD Pilot-tested in the Central Denmark Region in 2014 Early Detection and Prevention (TOF) [ 20 – 22 , 32 , 33 ] Patient results from a risk stratification model and a digital data collection tool were made available to GPs through a digital health folder Multiple lifestyle-related diseases Not applicable as the definition included a range of lifestyle-related diseases and risk behavior. Varde and Haderslev municipalities To develop a health intervention for early detection of citizens at risk of developing lifestyle-related disease and initiation of preventive care TOF pilot study took place from September 2016 to December 2016 AI to identify patients at risk of cancer [ 23 ] AI risk score to predict cancer within 90 days Cancer 45.205 incident cancer cases as of 2020 [ 41 ].…”

Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines

“…Лица с высоким уровнем ФР, кроме этого, были приглашены в муниципальный центр здоровья для очного консультирования. Максимальный эффект получен в группе, сочетающей цифровые технологии и очное консультирование, в этой группе получена достоверная коррекция пищевых привычек, увеличение ФА и снижение ИМТ [261].…”