The BeHealthyR Study: a randomized trial of a multicomponent intervention to reduce stress, smoking and improve financial health of low-income residents in Rotterdam

Abstract

BackgroundCompared to higher socioeconomic status (SES) groups, those in lower SES groups are financially strained, experience higher rates of smoking-related morbidity, are in poorer health and have reduced life expectancy. This is especially true for the city of Rotterdam, where a large inequality in health is observed between low and high SES groups. The BeHealthyR study (Dutch: Grip en Gezondheid) is a randomized controlled trial (RCT) which will evaluate the impact of a theory-based multicomponent behavior intervention aiming to reduce stress, smoking, and improve financial health by means of a group-based stress management program combining cognitive and behavioral techniques, and nudges in low-SES residents living in Rotterdam.MethodsThe BeHealthyR study is a three-arm RCT. Between February 2018 and July 2019, low-SES participants who perceive stress, smoke, are financially strained and reside in Rotterdam (one of the four largest cities in The Netherlands) are recruited. Subsequently, participants are randomly assigned to either a stress management condition (SM), stress management with a buddy condition (SM-B) or a control condition (CC). Participants in the SM and SM-B conditions will attend four weekly group sessions (1.5 h/session) and a follow-up session eight weeks later. The SM condition includes psychoeducation and exercises, and cognitive and behavioral intervention techniques. Demographic data and objective measures will be collected at baseline (T0), four weeks post-baseline (T1), and twelve weeks post-baseline (T2). Primary outcome measures are to reduce stress, smoking and improve financial health. We hypothesize that low-SES participants in the intervention conditions, compared with those in the control condition, will experience less stress, smoke less and have improved financial health.DiscussionThis study is a group-based intervention which aims to investigate the effects of a theory-based behavioral change intervention employing several components on reducing stress, smoking, and improving financial health in low-SES residents living in Rotterdam. If effective, the findings from the present study will serve to inform future directions of research and clinical practice with regard to behavioral change interventions for low-SES groups.Trial registrationClinicalTrials.gov (ID: NCT03553979). Registered on January 1 2018.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5728-7) contains supplementary material, which is available to authorized users.

Evaluating the effectiveness of the BeHealthyR study: A group-randomized controlled trial using an integrated approach to improve smoking cessation behavior among disadvantaged smokers

“…The study was prospectively registered on January 1, 2018, as NCT03553979 in clinicaltrials.gov registry. A detailed description of the study design, methods, implementation strategies, and sample size computation has been published elsewhere [15]. This study was conducted in line with the Declaration of Helsinki, and all participants provided written consent to use their data for research purposes.…”

“…The randomization process is described in detail in the study protocol [15]. After consenting, groups of participants ( ve-ten participants per group) were randomized either to a stress management course only (SM), stress management with a buddy component (SMb), or a waitlist group with postponed intervention three months later.…”

“…A detailed description of the theoretical foundations of the intervention has been published elsewhere [15]. In brief, the intervention was designed using a multicomponent approach compromising three components including: 1) a group-based stress management program integrating principles of CBT, positive psychology and behavior change techniques (e.g., goal setting); 2) a buddy component; and 3) a nudge component for participation retention.…”

“…It became evident shortly after the start of the group-delivered intervention that it was challenging to recruit disadvantaged smokers for the intervention. Despite using a multilayered recruitment approach, the total nal sample size for the study was 218 instead of 300, as reported in the study protocol [15]. Second, given the limited sample size, additional assessments reported in the study protocol ( nancial strain and self-perceived health) were not described and analyzed in the current study, as advised by a statistician who performed the analyses of the current study.…”

Psikoedukasi Bauran sebagai Alternatif Efektif Mengatasi Kecemasan pada Kanker

“…Penelitian dari Shagiwal et al, (2018) dengan metode RCT melibatkan 150 responden secara acak mereka ditugaskan ke kondisi manajemen stres (SM), manajemen stres dengan kondisi teman (SM-B) atau kondisi kontrol (CC). Peserta dalam kondisi SM dan SM-B akan menghadiri empat sesi grup mingguan (1,5 jam/sesi) dan sesi tindak lanjut delapan minggu kemudian.…”