1. Effectiveness of the nurse-led Activate intervention in patients at risk of cardiovascular disease in primary care: a cluster-randomised controlled trial.
- Author
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Westland, Heleen, Schuurmans, Marieke J, Bos-Touwen, Irene D, de Bruin-van Leersum, Marjolein A, Monninkhof, Evelyn M, Schröder, Carin D, de Vette, Daphne A, and Trappenburg, Jaap CA
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AGE distribution , *ANALYSIS of covariance , *BEHAVIOR modification , *CARDIOVASCULAR diseases risk factors , *COMPARATIVE studies , *CONFIDENCE intervals , *MENTAL depression , *HEALTH behavior , *HEALTH promotion , *HEALTH status indicators , *LONGITUDINAL method , *MEDICAL referrals , *NURSE-patient relationships , *PRIMARY health care , *RESEARCH funding , *SELF-efficacy , *SELF-management (Psychology) , *WEARABLE technology , *MULTIPLE regression analysis , *SOCIAL support , *EFFECT sizes (Statistics) , *EDUCATIONAL attainment , *BODY mass index , *RANDOMIZED controlled trials , *SEDENTARY lifestyles , *PHYSICAL activity , *EVALUATION of human services programs , *DATA analysis software , *DESCRIPTIVE statistics , *NURSING interventions - Abstract
Background: To understand better the success of self-management interventions and to enable tailoring of such interventions at specific subgroups of patients, the nurse-led Activate intervention is developed targeting one component of self-management (physical activity) in a heterogeneous subgroup (patients at risk of cardiovascular disease) in Dutch primary care. Aim: The aim of this study was to evaluate the effectiveness of the Activate intervention and identifying which patient-related characteristics modify the effect. Methods: A two-armed cluster-randomised controlled trial was conducted comparing the intervention with care as usual. The intervention consisted of four nurse-led behaviour change consultations within a 3-month period. Data were collected at baseline, 3 months and 6 months. Primary outcome was the daily amount of moderate to vigorous physical activity at 6 months. Secondary outcomes included sedentary behaviour, self-efficacy for physical activity, patient activation for self-management and health status. Prespecified effect modifiers were age, body mass index, level of education, social support, depression, patient provider relationship and baseline physical activity. Results: Thirty-one general practices (n = 195 patients) were included (intervention group n = 93; control group n = 102). No significant between-group difference was found for physical activity (mean difference 2.49 minutes; 95% confidence interval -2.1; 7.1; P = 0.28) and secondary outcomes. Patients with low perceived social support (P = 0.01) and patients with a low baseline activity level (P = 0.02) benefitted more from the intervention. Conclusion: The Activate intervention did not improve patients' physical activity and secondary outcomes in primary care patients at risk of cardiovascular disease. To understand the results, the intervention fidelity and active components for effective self-management require further investigation. Trial registration: ClinicalTrials.gov NCT02725203. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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