A randomized comparative effectiveness study of Healthy Directions 2--a multiple risk behavior intervention for...

Area of Science:

• Public Health
• Health Behavior Change
• Primary Care Interventions

Background:

• Chronic disease prevention is a major public health goal.
• Lifestyle risk factors significantly contribute to chronic disease development.
• Effective interventions are needed for primary care settings to address multiple risk behaviors.

Purpose of the Study:

• To assess the effectiveness of the Healthy Directions 2 (HD2) intervention in primary care.
• To compare a self-guided HD2 intervention with one including telephone coaching.
• To evaluate the impact on multiple risk behavior scores.

Main Methods:

• Cluster randomized trial involving 33 providers and 2440 patients.
• Intervention arms: usual care (UC), HD2 (self-guided), and HD2 plus coaching (HD2+CC).
• Outcome measured by the proportion of participants with a lower multiple risk behavior (MRB) score.

Main Results:

• Both HD2 and HD2+CC improved MRB scores compared to UC.
• No significant difference in effectiveness between HD2 and HD2+CC.
• Improved MRB scores observed at 6 and 18 months follow-up.

Conclusions:

• Self-guided and coached HD2 interventions are equally effective in reducing chronic disease risk factors.
• These interventions are relatively low-cost and suitable for primary care implementation.
• HD2 interventions offer a viable strategy for routine practice to improve population health.