The impact of a brief lifestyle intervention delivered by generalist community nurses (CN SNap trial)

Harris, Mark F., Chan, Bibiana, Laws, Rachel A., Williams, Anna M., Powell-Davies, Gawaine, jayasinghe, Upali W., Fanain, Mahnaz, Orr, Neil and Milat, Andrew 2013, The impact of a brief lifestyle intervention delivered by generalist community nurses (CN SNap trial), BMC Public Health, vol. 13, no. 1, pp. 1-11.

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Title The impact of a brief lifestyle intervention delivered by generalist community nurses (CN SNap trial)
Author(s) Harris, Mark F.
Chan, Bibiana
Laws, Rachel A.
Williams, Anna M.
Powell-Davies, Gawaine
jayasinghe, Upali W.
Fanain, Mahnaz
Orr, Neil
Milat, Andrew
Journal name BMC Public Health
Volume number 13
Issue number 1
Start page 1
End page 11
Total pages 11
Publisher BioMed Central
Place of publication London, England
Publication date 2013
ISSN 1471-2458
Keyword(s) Primary health care
Lifestyle behaviours
Smoking
Nutrition
Alcohol
Physical activity
Community nursing
Summary Background
The risk factors for chronic disease, smoking, poor nutrition, hazardous alcohol consumption, physical inactivity and weight (SNAPW) are common in primary health care (PHC) affording opportunity for preventive interventions. Community nurses are an important component of PHC in Australia. However there has been little research evaluating the effectiveness of lifestyle interventions in routine community nursing practice. This study aimed to address this gap in our knowledge.

Methods
The study was a quasi-experimental trial involving four generalist community nursing (CN) services in New South Wales, Australia. Two services were randomly allocated to an ‘early intervention’ and two to a ‘late intervention’ group. Nurses in the early intervention group received training and support in identifying risk factors and offering brief lifestyle intervention for clients. Those in the late intervention group provided usual care for the first 6 months and then received training. Clients aged 30–80 years who were referred to the services between September 2009 and September 2010 were recruited prior to being seen by the nurse and baseline self-reported data collected. Data on their SNAPW risk factors, readiness to change these behaviours and advice and referral received about their risk factors in the previous 3 months were collected at baseline, 3 and 6 months. Analysis compared changes using univariate and multilevel regression techniques.

Results
804 participants were recruited from 2361 (34.1%) eligible clients. The proportion of clients who recalled receiving dietary or physical activity advice increased between baseline and 3 months in the early intervention group (from 12.9 to 23.3% and 12.3 to 19.1% respectively) as did the proportion who recalled being referred for dietary or physical activity interventions (from 9.5 to 15.6% and 5.8 to 21.0% respectively). There was no change in the late intervention group. There a shift towards greater readiness to change in those who were physically inactive in the early but not the comparison group. Clients in both groups reported being more physically active and eating more fruit and vegetables but there were no significant differences between groups at 6 months.

Conclusion
The study demonstrated that although the intervention was associated with increases in advice and referral for diet or physical activity and readiness for change in physical activity, this did not translate into significant changes in lifestyle behaviours or weight. This suggests a need to facilitate referral to more intensive long-term interventions for clients with risk factors identified by primary health care nurses.
Language eng
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Persistent URL http://hdl.handle.net/10536/DRO/DU:30058956

Document type: Journal Article
Collections: Faculty of Health
School of Exercise and Nutrition Sciences
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