Efficacy of tailored recommendations to promote healthy lifestyles: a post hoc analysis of a randomized controlled trial

María Barroso; M Dolors Zomeño; Jorge L Díaz; Silvia Pérez; Ruth Martí-Lluch; Ferran Cordón; Rafel Ramos; Carmen Cabezas; Gemma Salvador; Conxa Castell; Helmut Schröder; María Grau

doi:10.1093/tbm/ibab035

Efficacy of tailored recommendations to promote healthy lifestyles: a post hoc analysis of a randomized controlled trial

Transl Behav Med. 2021 Aug 13;11(8):1548-1557. doi: 10.1093/tbm/ibab035.

Authors

María Barroso^{1

2

3}, M Dolors Zomeño^{4

5}, Jorge L Díaz¹, Silvia Pérez^{6

7}, Ruth Martí-Lluch⁸, Ferran Cordón⁹, Rafel Ramos^{8

10

11}, Carmen Cabezas¹², Gemma Salvador¹², Conxa Castell¹², Helmut Schröder^{4

13}, María Grau^{1

13

14}

Affiliations

¹ Cardiovascular Epidemiology and Genetics Research Group, IMIM-Hospital del Mar Research Institute, 08003 Barcelona, Spain.
² Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, School of Medicine, Autonomous University of Barcelona, 08193 Barcelona, Spain.
³ Eastfield Health, Ashburton 7700, New Zealand.
⁴ Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain.
⁵ School of Health Sciences, Blanquerna-Ramon Llull University, 08022 Barcelona, Spain.
⁶ Regicor Research Group, IMIM-Hospital del Mar Medical Research Institute, 08003 Barcelona, Spain.
⁷ Consortium for Biomedical Research in Cardiovascular Disease (CIBERCV), 08003 Barcelona, Spain.
⁸ Unitat de Suport a la Recerca de Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, 17002 Girona, Spain.
⁹ Centre d'Atenció Primària Montilivi, Direcció d'Atenció Primària Girona, Institut Català de la Salut, 17003 Girona, Spain.
¹⁰ Department of Medical Sciences, School of Medicine, University of Girona, 17071 Girona, Spain.
¹¹ Girona Biomedical Research Institute, 17190 Girona, Spain.
¹² Catalan Agency of Public Health, 08005 Barcelona, Spain.
¹³ Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 08003 Barcelona, Spain.
¹⁴ Serra-Húnter Fellow, Department of Medicine, University of Barcelona, #143 Casanova St., 08036 Barcelona, Spain.

PMID: 33837787
DOI: 10.1093/tbm/ibab035

Abstract

Prevention is the key to stopping the ravages of cardiovascular diseases, the main cause of death worldwide. The objective was to analyze the efficacy of tailored recommendations to promote healthy lifestyles. Parallel-arm randomized controlled trial with 1 year follow-up. Individuals aged 35-74 years from Girona (Spain) randomly selected from a population with no cardiovascular diseases at baseline were included. Participants in the intervention group received a brochure with tailored healthy choices according to the individual risk profile and a trained nurse explained all recommendations in detail in a 30 min consultation. One year changes in smoking, Mediterranean diet adherence, physical activity, and weight were analyzed with McNemar, Student's t, Wilcoxon, and Fisher exact tests according to an intention-to-treat strategy. Of 955 individuals (52.3% women; mean age 50 [±10] years) randomly allocated to the intervention or control group, one participant in each group presented a cardiovascular event and 768 (81%) were reexamined at 1 year follow-up. The prevalence of nonsmokers increased in both the intervention and control groups (78.1%-82.5%, p = <.001, and 76.7% to 78.8%, p = .015, respectively); however, significance persisted only in the intervention group when stratified by sex, age group, and educational level. Adherence to a Mediterranean diet increased in the intervention group (22.3%-26.5%, p = .048). In conclusion, a brief personalized intervention with science-based recommendations according to individual risk profiles appears to improve healthy lifestyles, particularly nonsmoking and adherence to a Mediterranean diet. This promising intervention system offers evidence-based recommendations to develop healthy lifestyles.

Trial registration: ClinicalTrials.gov NCT02373319.

Keywords: Cardiovascular Diseases; Empowerment; Lifestyles; Mediterranean Diet; Physical activity; Prevention.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / epidemiology
Cardiovascular Diseases* / prevention & control
Diet, Mediterranean*
Exercise
Female
Healthy Lifestyle
Humans
Male
Middle Aged
Spain / epidemiology

Associated data

ClinicalTrials.gov/NCT02373319