Title Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial
Authors Recio-Rodriguez J.I. , Garcia-Ortiz L. , Garcia-Yu I.A. , Lugones-Sanchez C. , Olmo E.Z.-D. , Bolibar B. , Casajuana-Closas M. , Lopez-Jimenez T. , Llobera J. , Ramos R. , Pombo H. , MOTRICO MARTINEZ, EMMA, Gil-Girbau M. , Lopez-Mendez F. , Represas-Carrera F. , Maderuelo-Fernandez J.A.
External publication No
Means BMC Public Health
Scope Article
Nature Científica
JCR Quartile 2
SJR Quartile 1
JCR Impact 4.50000
SJR Impact 1.30700
Web https://www.scopus.com/inward/record.uri?eid=2-s2.0-85142256897&doi=10.1186%2fs12889-022-14590-y&partnerID=40&md5=0bd058647b56a10e8658e04016b01596
Publication date 19/11/2022
ISI 000885310700003
Scopus Id 2-s2.0-85142256897
DOI 10.1186/s12889-022-14590-y
Abstract Background: The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD). Methods: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45–75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor’s office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. Results: Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9–17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. Conclusions: A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. Trial registration: ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211 © 2022, The Author(s).
Keywords adult; aged; article; cardiovascular risk factor; controlled study; cost effectiveness analysis; female; health behavior; health care personnel; health center; health promotion; human; implementation
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