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Long-term effectiveness of the community-based Complete Health Improvement Program (CHIP) lifestyle intervention: a
Lillian Kent1, Darren Morton, Trevor Hurlow
1Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia.
Insights
The Complete Health Improvement Program (CHIP) demonstrated sustained effectiveness over 3 years for individuals with elevated risk factors. This volunteer-delivered lifestyle intervention significantly improved key health metrics long-term.
Area of Science:
- Public Health
- Preventive Medicine
- Lifestyle Interventions
Background:
- Community-based lifestyle interventions are crucial for managing chronic disease risk factors.
- Long-term effectiveness data for volunteer-delivered programs like CHIP are essential for public health planning.
Purpose of the Study:
- To evaluate the long-term (3+ years) effectiveness of the volunteer-delivered Complete Health Improvement Program (CHIP).
- To assess the sustained impact of CHIP on key health biometrics in a community setting.
Main Methods:
- A cohort study followed 106 participants who completed the CHIP intervention between 2007-2009, with a follow-up assessment in 2012 (mean 49.2 months).
- The intervention involved a 30-day lifestyle modification program focusing on diet, physical activity, substance use, and stress management, delivered by volunteers.
- Key outcome measures included changes in body mass index (BMI), blood pressure (BP), fasting plasma glucose (FPG), and lipid profiles (TC, LDL, HDL, TG).
Main Results:
- Participants with elevated baseline biometrics maintained significant reductions in BMI (-3.2%), diastolic blood pressure (-9.4%), total cholesterol (-5.5%), and triglycerides (-27.5%) after approximately 4 years.
- Those reporting compliance to lifestyle principles showed further improvements, including a -10.4% reduction in FPG.
- Systolic blood pressure, HDL, LDL, and FPG were not significantly different from baseline for the overall follow-up group.
Conclusions:
- The CHIP lifestyle intervention demonstrated sustained effectiveness in improving health biometrics for over 3 years in individuals with elevated risk factors.
- Community-based, volunteer-delivered lifestyle programs like CHIP show potential for long-term public health impact.
- Maintaining adherence to lifestyle principles is associated with further health improvements.
Objective:
To examine the long-term (three or more years) effectiveness of the volunteer-delivered Complete Health Improvement Program (CHIP) intervention.
Design:
Cohort study.
Setting:
Hawera, New Zealand.
Participants:
Of the total cohort of 284 individuals who self-selected to complete the CHIP lifestyle intervention between 2007 and 2009, 106 (37% of the original cohort, mean age=64.9±7.4 years, range 42-87 years; 35% males, 65% female) returned in 2012 for a complimentary follow-up health assessment (mean follow-up duration=49.2+10.4 months).
Intervention:
30-day lifestyle modification programme (diet, physical activity, substance use and stress management) delivered by volunteers in a community setting.
Main Outcome Measures:
Changes in body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG).
Results:
After approximately 4 years, participants with elevated biometrics at programme entry maintained significantly lowered BMI (-3.2%; 34.8±5.4 vs 33.7±5.3 kg/m(2), p=0.02), DBP (-9.4%; 89.1±4.1 vs 80.8±12.6 mm Hg, p=0.005), TC (-5.5%; 6.1±0.7 vs 5.8±1.0 mmol/L, p=0.04) and TG (-27.5%; 2.4±0.8 vs 1.7±0.7 mmol/L, p=0.002). SBP, HDL, LDL and FPG were not significantly different from baseline. Participants with elevated baseline biometrics who reported being compliant to the lifestyle principles promoted in the intervention (N=71, 67% of follow-up participants) recorded further reductions in BMI (-4.2%; 34.8±4.5 vs 33.4±4.8 kg/m(2), p=0.02), DBP (-13.3%; 88.3±3.2 vs 77.1±12.1 mm Hg, p=0.005) and FPG (-10.4%; 7.0±1.5 vs 6.3±1.3 mmol/L, p=0.02).
Conclusions:
Individuals who returned for follow-up assessment and entered the CHIP lifestyle intervention with elevated risk factors were able to maintain improvements in most biometrics for more than 3 years. The results suggest that the community-based CHIP lifestyle intervention can be effective in the longer term, even when delivered by volunteers.
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