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Predictors of primary care referrals to a vascular disease prevention lifestyle program among participants in a cluster randomised trial

Passey, Megan E., Laws, Rachel A., Jayasinghe, Upali W., Fanaian, Mahnaz, McKenzie, Suzanne, Powell-Davies, Gawaine, Lyle, David and Harris, Mark F. 2012, Predictors of primary care referrals to a vascular disease prevention lifestyle program among participants in a cluster randomised trial, BMC health services research, vol. 12, Article Number : 234, pp. 1-9, doi: 10.1186/1472-6963-12-234.

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Title Predictors of primary care referrals to a vascular disease prevention lifestyle program among participants in a cluster randomised trial
Author(s) Passey, Megan E.
Laws, Rachel A.ORCID iD for Laws, Rachel A. orcid.org/0000-0003-4328-1116
Jayasinghe, Upali W.
Fanaian, Mahnaz
McKenzie, Suzanne
Powell-Davies, Gawaine
Lyle, David
Harris, Mark F.
Journal name BMC health services research
Volume number 12
Season Article Number : 234
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2012
ISSN 1472-6963
Keyword(s) Preventive health care
general practice
health behaviour
lifestyle modification
referral
Summary Background

Cardiovascular disease accounts for a large burden of disease, but is amenable to prevention through lifestyle modification. This paper examines patient and practice predictors of referral to a lifestyle modification program (LMP) offered as part of a cluster randomised controlled trial (RCT) of prevention of vascular disease in primary care.

Methods

Data from the intervention arm of a cluster RCT which recruited 36 practices through two rural and three urban primary care organisations were used. In each practice, 160 eligible high risk patients were invited to participate. Practices were randomly allocated to intervention or control groups. Intervention practice staff were trained in screening, motivational interviewing and counselling and encouraged to refer high risk patients to a LMP involving individual and group sessions. Data include patient surveys; clinical audit; practice survey on capacity for preventive care; referral records from the LMP. Predictors of referral were examined using multi-level logistic regression modelling after adjustment for confounding factors.

Results

Of 301 eligible patients, 190 (63.1%) were referred to the LMP. Independent predictors of referral were baseline BMI ≥ 25 (OR 2.87 95%CI:1.10, 7.47), physical inactivity (OR 2.90 95%CI:1.36,6.14), contemplation/preparation/action stage of change for physical activity (OR 2.75 95%CI:1.07, 7.03), rural location (OR 12.50 95%CI:1.43, 109.7) and smaller practice size (1–3 GPs) (OR 16.05 95%CI:2.74, 94.24).

Conclusions

Providing a well-structured evidence-based lifestyle intervention, free of charge to patients, with coordination and support for referral processes resulted in over 60% of participating high risk patients being referred for disease prevention. Contrary to expectations, referrals were more frequent from rural and smaller practices suggesting that these practices may be more ready to engage with these programs.
Language eng
DOI 10.1186/1472-6963-12-234
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 929999 Health not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083458

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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.