A randomized comparative effectiveness study of Healthy Directions 2--a multiple risk behavior intervention for primary care.
Journal Article (Journal Article)
Objective
To evaluate the effectiveness of the Healthy Directions 2 (HD2) intervention in the primary care setting.Methods
HD2 was a cluster randomized trial (conducted 3/09-11/11). The primary sampling unit was provider (n=33), with secondary sampling of patients within provider (n=2440). Study arms included: 1) usual care (UC); 2) HD2--a patient self-guided intervention targeting 5 risk behaviors; and 3) HD2 plus 2 brief telephone coaching calls (HD2+CC). The outcome measure was the proportion of participants with a lower multiple risk behavior (MRB) score by follow-up.Results
At baseline, only 4% of the participants met all behavioral recommendations. Both HD2 and HD2+CC led to improvements in MRB score, relative to UC, with no differences between the two HD2 conditions. Twenty-eight percent of the UC participants had improved MRB scores at 6 months, vs. 39% and 43% in HD2 and HD2+CC, respectively (ps≤.001); results were similar at 18 months (p≤.05). The incremental cost of one risk factor reduction in MRB score was $310 for HD2 and $450 for HD2+CC.Conclusions
Self-guided and coached intervention conditions had equivalent levels of effect in reducing multiple chronic disease risk factors, were relatively low cost, and thus are potentially useful for routine implementation in similar health settings.Full Text
Duke Authors
Cited Authors
- Emmons, KM; Puleo, E; Greaney, ML; Gillman, MW; Bennett, GG; Haines, J; Sprunck-Harrild, K; Viswanath, K
Published Date
- July 2014
Published In
Volume / Issue
- 64 /
Start / End Page
- 96 - 102
PubMed ID
- 24642140
Pubmed Central ID
- PMC4204110
Electronic International Standard Serial Number (EISSN)
- 1096-0260
International Standard Serial Number (ISSN)
- 0091-7435
Digital Object Identifier (DOI)
- 10.1016/j.ypmed.2014.03.011
Language
- eng