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Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial

Laws, Rachel A, Fanaian, Mahnaz, Jayasinghe, Upali W, McKenzie, Suzanne, Passey, Megan, Powell Davies, Gawaine, Lyle, David and Harris, Mark F 2013, Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial, BMC Health Services Research, vol. 13, pp. 1-12, doi: 10.1186/1472-6963-13-201.

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Title Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial
Author(s) Laws, Rachel AORCID iD for Laws, Rachel A orcid.org/0000-0003-4328-1116
Fanaian, Mahnaz
Jayasinghe, Upali W
McKenzie, Suzanne
Passey, Megan
Powell Davies, Gawaine
Lyle, David
Harris, Mark F
Journal name BMC Health Services Research
Volume number 13
Article ID 201
Start page 1
End page 12
Total pages 12
Publisher BioMed Central
Place of publication London, England
Publication date 2013
ISSN 1472-6963
Keyword(s) Preventive health care
Chronic disease prevention
Family practice
Primary care
Reach
Attendance rates
Lifestyle modification
Summary Background
Previous research suggests that lifestyle intervention for the prevention of diabetes and cardiovascular disease (CVD) are effective, however little is known about factors affecting participation in such programs. This study aims to explore factors influencing levels of participation in a lifestyle modification program conducted as part of a cluster randomized controlled trial of CVD prevention in primary care.

Methods
This concurrent mixed methods study used data from the intervention arm of a cluster RCT which recruited 30 practices through two rural and three urban primary care organizations. Practices were randomly allocated to intervention (n = 16) and control (n = 14) groups. In each practice up to 160 eligible patients aged between 40 and 64 years old, were invited to participate. Intervention practice staff were trained in lifestyle assessment and counseling and referred high risk patients to a lifestyle modification program (LMP) consisting of two individual and six group sessions over a nine month period. Data included a patient survey, clinical audit, practice survey on capacity for preventive care, referral and attendance records at the LMP and qualitative interviews with Intervention Officers facilitating the LMP. Multi-level logistic regression modelling was used to examine independent predictors of attendance at the LMP, supplemented with qualitative data from interviews with Intervention Officers facilitating the program.

Results

A total of 197 individuals were referred to the LMP (63% of those eligible). Over a third of patients (36.5%) referred to the LMP did not attend any sessions, with 59.4% attending at least half of the planned sessions. The only independent predictors of attendance at the program were employment status - not working (OR: 2.39 95% CI 1.15-4.94) and having high psychological distress (OR: 2.17 95% CI: 1.10-4.30). Qualitative data revealed that physical access to the program was a barrier, while GP/practice endorsement of the program and flexibility in program delivery facilitated attendance.

Conclusion

Barriers to attendance at a LMP for CVD prevention related mainly to external factors including work commitments and poor physical access to the programs rather than an individuals’ health risk profile or readiness to change. Improving physical access and offering flexibility in program delivery may enhance future attendance. Finally, associations between psychological distress and attendance rates warrant further investigation.
Language eng
DOI 10.1186/1472-6963-13-201
Field of Research 111799 Public Health and Health Services not elsewhere classified
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30059406

Document type: Journal Article
Collections: School of Exercise and Nutrition Sciences
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Citation counts: TR Web of Science Citation Count  Cited 10 times in TR Web of Science
Scopus Citation Count Cited 12 times in Scopus
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Created: Thu, 09 Jan 2014, 12:29:29 EST by Jane Moschetti

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.