Home-based lifestyle intervention for rural adults improves metabolic syndrome parameters and cardiovascular risk factors: A randomised controlled trial

Blackford, Krysten; Jancey, Jonine; Lee, Andy H.; James, Anthony P.; Waddell, Tracy; Howat, Peter

doi:10.1016/j.ypmed.2016.05.012

Cited by 40 publications

(56 citation statements)

References 36 publications

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“…Primary outcome results have been reported elsewhere. 13,18 A total of 401 participants were recruited. They were 50 to 69 years old with, or at risk of, metabolic syndrome based on the International Diabetes Federation criteria.…”

Section: Setting and Participantsmentioning

confidence: 99%

Process evaluation of the Albany Physical Activity and Nutrition (APAN) program, a home‐based intervention for metabolic syndrome and associated chronic disease risk in rural Australian adults

Blackford

Lee

James

et al. 2016

Health Prom J of Aust

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Issue addressed: The Albany Physical Activity and Nutrition (APAN) study investigated the effects of the APAN program, a home-based intervention on dietary and physical activity behaviours and chronic disease risk for rural Australian adults. This paper reports on the process evaluation to gain insight into the link between intervention elements and outcomes. Methods: The APAN program comprised resources to improve participants' diet and physical activity. Printed and online resources were provided to participants, complemented by motivational interviews via telephone. Process evaluation used mixed-methods, with a sample of 201 intervention participants residing in a disadvantaged rural area. Participants were aged 50 to 69 years with, or at risk of, metabolic syndrome. Quantitative data were collected using an online survey (n = 73); qualitative data were collected via telephone exit interviews with intervention completers (n = 8) and non-completers (n = 8), and recruitment notes recorded by research assistants. Results: The attrition rate of the program was 18%; major reasons for withdrawal were health and personal issues and a loss of interest. The majority of participants found the printed resources useful, attractive, and suitable to their age group. The website was the least preferred resource. Reasons for completing the program included the desired health benefits, wanting to honour the commitment, and wanting to assist with research. Conclusions: Carefully planned recruitment will reduce the burden on resources and improve uptake. Understanding reasons for attrition such as family or personal barriers and health issues will assist practitioners to support participants overcome these barriers. Given participants' preference for printed resources, and the known effectiveness of these in combination with other strategies, investigating methods to encourage use of telephone and online support should be a priority. So what?This process evaluation provided an overview of recruitment challenges and preferred intervention components. It is desirable that future work determines the most effective intervention components for rural adults at risk of chronic disease.

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Section: Setting and Participantsmentioning

confidence: 99%

Process evaluation of the Albany Physical Activity and Nutrition (APAN) program, a home‐based intervention for metabolic syndrome and associated chronic disease risk in rural Australian adults

Blackford

Lee

James

et al. 2016

Health Prom J of Aust

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“…Six intervention and nine control group participants were excluded from the CVD risk score analysis since their systolic blood pressure was >180 mm Hg or total cholesterol >7.5 mmol/L and their score was unable to be calculated as per NVDPA guidelines . There were no significant between‐group differences in demographic characteristics, MetS status ( P = 0.66) and CVD risk score ( P = 0.96) (Table ).…”

Section: Resultsmentioning

confidence: 96%

“…At the end of the intervention, the MetS and CVD risk score was lower for the intervention group, as a result of significant improvements in dietary and physical activity behaviours (fat and fibre intake; moderate intensity physical activity) . Improvements in MetS and CVD parameters (triglyceride, total cholesterol and non‐HDL cholesterol concentrations; waist circumference, waist‐to‐hip ratio, weight and body mass index) were reported elsewhere …”

Section: Discussionmentioning

confidence: 91%

“…The attrition rate for the intervention was 18% and the main reasons for withdrawal were due to health issues, personal reasons and loss of interest . The protocol for recruitment, process and intervention outcomes has been described elsewhere …”

Section: Methodsmentioning

confidence: 99%

“…Improvement in health outcomes through effective prevention, early detection and appropriate management strategies are priorities for the prevention of chronic diseases . The Albany Physical Activity and Nutrition (APAN) study specifically targeted rural adults with or at risk of MetS, who were therefore at increased risk of chronic diseases . Albany was selected as a study site because of its ageing population (32% aged 50 and over) and low Socio‐Economic Indexes for Areas (SEIFA) score (989) .…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome in rural Australia: An opportunity for primary health care

Jancey

James

Lee

et al. 2019

Australian J Rural Health

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Objective: To measure the impact of a 6-month home-based behaviour change intervention on reducing the risk of chronic disease as determined by metabolic syndrome status and cardiovascular risk score, and discuss implications for primary care in rural areas. Design: A two-arm randomised controlled trial of rural adults. Setting: The rural town of Albany in the Great Southern region of Western Australia.Participants: Participants (n = 401) aged 50-69 years who were classified with or at risk of metabolic syndrome and randomly assigned to intervention (n = 201) or waitlisted control (n = 200) group. Interventions: A 6-month intervention program incorporating goal setting, selfmonitoring and feedback, with motivational interviewing was conducted. Main outcome measures: Change in metabolic syndrome status and cardiovascular risk. Results: Significant improvements in metabolic syndrome status and cardiovascular disease risk score (−0.82) were observed for the intervention group relative to control group from baseline to post-test. Conclusion: This home-based physical activity and nutrition intervention reduced participants' risk of experiencing a cardiovascular event in the next 5 years by 1%. Incorporating such prevention orientated approaches in primary care might assist in reducing the burden of long-term chronic diseases. However, for realistic application in this setting, hurdles such as current national health billing system and availability of resources will need to be considered. K E Y W O R D Scardiovascular diseases, health promotion, obesity, preventive health, rural health

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Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors

Patnode

Evans

Senger

et al. 2017

JAMA

304

196

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Diet and physical activity behavioral interventions for adults not at high risk for cardiovascular disease result in consistent modest benefits across a variety of important intermediate health outcomes across 6 to 12 months, including blood pressure, low-density lipoprotein and total cholesterol levels, and adiposity, with evidence of a dose-response effect, with higher-intensity interventions conferring greater improvements. There is very limited evidence on longer-term intermediate and health outcomes or on harmful effects of these interventions.

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Home-based lifestyle intervention for rural adults improves metabolic syndrome parameters and cardiovascular risk factors: A randomised controlled trial

Abstract: anzctr.org.au Identifier: ACTRN12614000512628.

Cited by 40 publications

References 36 publications

Process evaluation of the Albany Physical Activity and Nutrition (APAN) program, a home‐based intervention for metabolic syndrome and associated chronic disease risk in rural Australian adults

Process evaluation of the Albany Physical Activity and Nutrition (APAN) program, a home‐based intervention for metabolic syndrome and associated chronic disease risk in rural Australian adults

Metabolic syndrome in rural Australia: An opportunity for primary health care

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors

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