Analysis of the psychological impact of a vascular risk factor intervention: results from a cluster randomized controlled trial in Australian general practice
Screening for vascular disease, risk assessment and management are encouraged in general practice however there is limited evidence about the emotional impact on patients. The Health Improvement and Prevention Study evaluated the impact of a general practice-based vascular risk factor intervention o...
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| Veröffentlicht in: | BMC family practice 2013-12, Vol.14 (1), p.190-190, Article 190 |
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| description | Screening for vascular disease, risk assessment and management are encouraged in general practice however there is limited evidence about the emotional impact on patients. The Health Improvement and Prevention Study evaluated the impact of a general practice-based vascular risk factor intervention on behavioural and physiological risk factors in 30 Australian practices. The primary aim of this analysis is to investigate the psychological impact of participating in the intervention arm of the trial. The secondary aim is to identify the mediating effects of changes in behavioural risk factors or BMI.
This study is an analysis of a secondary outcome from a cluster randomized controlled trial. Patients, aged 40-65 years, were randomly selected from practice records. Those with pre-existing cardiovascular disease were excluded. Socio-demographic details, behavioural risk factors and psychological distress were measured at baseline and 12 months. The Kessler Psychological Distress Score (K10) was the outcome measure for multi-level, multivariable analysis and a product-of-coefficient test to assess the mediating effects of behaviour change.
Baseline data were available 384 participants in the intervention group and 315 in the control group. Twelve month data were available for 355 in the intervention group and 300 in the control group. The K10 score of patients in the intervention group (14.78, SD 5.74) was lower at 12 months compared to the control group (15.97, SD 6.30). K10 at 12 months was significantly associated with the score at baseline and being unable to work but not with age, gender, change in behavioural risk factors or change in BMI.
The reduction of K10 in the intervention group demonstrates that a general practice based intervention to identify and manage vascular risk factors did not adversely impact on the psychological distress of the participants. The impact of the intervention on distress was not mediated by a change in the behavioural risk factors or BMI, suggesting that there must be other mediators that might explain the positive impact of the intervention on emotional wellbeing.
Australian New Zealand Clinical Trials Registry ACTRN12607000423415. |
| doi_str_mv | 10.1186/1471-2296-14-190 |
| format | Article |
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This study is an analysis of a secondary outcome from a cluster randomized controlled trial. Patients, aged 40-65 years, were randomly selected from practice records. Those with pre-existing cardiovascular disease were excluded. Socio-demographic details, behavioural risk factors and psychological distress were measured at baseline and 12 months. The Kessler Psychological Distress Score (K10) was the outcome measure for multi-level, multivariable analysis and a product-of-coefficient test to assess the mediating effects of behaviour change.
Baseline data were available 384 participants in the intervention group and 315 in the control group. Twelve month data were available for 355 in the intervention group and 300 in the control group. The K10 score of patients in the intervention group (14.78, SD 5.74) was lower at 12 months compared to the control group (15.97, SD 6.30). K10 at 12 months was significantly associated with the score at baseline and being unable to work but not with age, gender, change in behavioural risk factors or change in BMI.
The reduction of K10 in the intervention group demonstrates that a general practice based intervention to identify and manage vascular risk factors did not adversely impact on the psychological distress of the participants. The impact of the intervention on distress was not mediated by a change in the behavioural risk factors or BMI, suggesting that there must be other mediators that might explain the positive impact of the intervention on emotional wellbeing.
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This study is an analysis of a secondary outcome from a cluster randomized controlled trial. Patients, aged 40-65 years, were randomly selected from practice records. Those with pre-existing cardiovascular disease were excluded. Socio-demographic details, behavioural risk factors and psychological distress were measured at baseline and 12 months. The Kessler Psychological Distress Score (K10) was the outcome measure for multi-level, multivariable analysis and a product-of-coefficient test to assess the mediating effects of behaviour change.
Baseline data were available 384 participants in the intervention group and 315 in the control group. Twelve month data were available for 355 in the intervention group and 300 in the control group. The K10 score of patients in the intervention group (14.78, SD 5.74) was lower at 12 months compared to the control group (15.97, SD 6.30). K10 at 12 months was significantly associated with the score at baseline and being unable to work but not with age, gender, change in behavioural risk factors or change in BMI.
The reduction of K10 in the intervention group demonstrates that a general practice based intervention to identify and manage vascular risk factors did not adversely impact on the psychological distress of the participants. The impact of the intervention on distress was not mediated by a change in the behavioural risk factors or BMI, suggesting that there must be other mediators that might explain the positive impact of the intervention on emotional wellbeing.
Australian New Zealand Clinical Trials Registry ACTRN12607000423415.</description><subject>Adult</subject><subject>Age</subject><subject>Alcohol Drinking - psychology</subject><subject>Alcohol use</subject><subject>Australia</subject><subject>Blood circulation disorders</subject><subject>Body mass index</subject><subject>Clinical trials</subject><subject>Diabetes</subject><subject>Disease prevention</subject><subject>Exercise - psychology</subject><subject>Family medicine</subject><subject>Feeding Behavior - psychology</subject><subject>Female</subject><subject>General Practice</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Intervention</subject><subject>Lifestyles</subject><subject>Linear Models</subject><subject>Male</subject><subject>Mass Screening - psychology</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Multilevel Analysis</subject><subject>Overweight - psychology</subject><subject>Prevention</subject><subject>Psychological aspects</subject><subject>Public health</subject><subject>Questionnaires</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Risk Reduction Behavior</subject><subject>Smoking</subject><subject>Smoking - psychology</subject><subject>Smoking Cessation - psychology</subject><subject>Stress, Psychological - psychology</subject><subject>Studies</subject><subject>Vascular Diseases - diagnosis</subject><subject>Vascular Diseases - prevention & control</subject><subject>Vascular Diseases - psychology</subject><issn>1471-2296</issn><issn>1471-2296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNqFUk1v1DAQjRCIlsKdE7LEhUuKv-LYHJBWK76kSlzgbDmOvevi2MFOVtr-GH4rDluWLipCPng0897zzDxX1XMELxHi7DWiLaoxFqxGtEYCPqjOj6mHd-Kz6knO1xCilmP8uDrDlBBIaHte_VgF5ffZZRAtmLYGjHmvt9HHjdPKAzeMSk9LTYGdynr2KoHk8jdgSz4m4MJk0s6EycXwBiSTZz9lYFMcCkP7OZcySCr0cXA3pgc6hilF70s4Jbe8EMCqoJLyTgWwMcGUEIypyDttnlaPrPLZPLu9L6qv7999WX-srz5_-LReXdVdw-lUc9xaSDptiSFdT4VokO0a2nYGCc5aKARDHDcCc65hoxFiCvEyP1ZWtJa05KJ6e9Ad524wvS4DlTbkmNyg0l5G5eRpJbit3MSdJFzABuMisD4IdC7-Q-C0ouMgF3_k4k-JZLGvqLy6bSPF77PJkxxc1sZ7FUycs0QNwoQgxun_oVTAFmL4C_ryL-h1nFPxfUG1rMGIQfEHtVHeSBdsLH3qRVSuGkIbziBnBXV5D6qc3gyumGusK_kTAjwQdIo5J2OPO0FQLp_4vi28uGvGkfD715KfusXuHQ</recordid><startdate>20131213</startdate><enddate>20131213</enddate><creator>McKenzie, Suzanne Helen</creator><creator>Jayasinghe, Upali W</creator><creator>Fanaian, Mahnaz</creator><creator>Passey, Megan</creator><creator>Harris, Mark Fort</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20131213</creationdate><title>Analysis of the psychological impact of a vascular risk factor intervention: results from a cluster randomized controlled trial in Australian general practice</title><author>McKenzie, Suzanne Helen ; Jayasinghe, Upali W ; Fanaian, Mahnaz ; Passey, Megan ; Harris, Mark Fort</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b584t-827f03bcf3e3bd49951fb547be19867099618259288c05c116a183472af97f373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Age</topic><topic>Alcohol Drinking - psychology</topic><topic>Alcohol use</topic><topic>Australia</topic><topic>Blood circulation disorders</topic><topic>Body mass index</topic><topic>Clinical trials</topic><topic>Diabetes</topic><topic>Disease prevention</topic><topic>Exercise - psychology</topic><topic>Family medicine</topic><topic>Feeding Behavior - psychology</topic><topic>Female</topic><topic>General Practice</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Intervention</topic><topic>Lifestyles</topic><topic>Linear Models</topic><topic>Male</topic><topic>Mass Screening - psychology</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Multilevel Analysis</topic><topic>Overweight - psychology</topic><topic>Prevention</topic><topic>Psychological aspects</topic><topic>Public health</topic><topic>Questionnaires</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Risk Reduction Behavior</topic><topic>Smoking</topic><topic>Smoking - psychology</topic><topic>Smoking Cessation - psychology</topic><topic>Stress, Psychological - psychology</topic><topic>Studies</topic><topic>Vascular Diseases - diagnosis</topic><topic>Vascular Diseases - prevention & control</topic><topic>Vascular Diseases - psychology</topic><toplevel>online_resources</toplevel><creatorcontrib>McKenzie, Suzanne Helen</creatorcontrib><creatorcontrib>Jayasinghe, Upali W</creatorcontrib><creatorcontrib>Fanaian, Mahnaz</creatorcontrib><creatorcontrib>Passey, Megan</creatorcontrib><creatorcontrib>Harris, Mark Fort</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC family practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McKenzie, Suzanne Helen</au><au>Jayasinghe, Upali W</au><au>Fanaian, Mahnaz</au><au>Passey, Megan</au><au>Harris, Mark Fort</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analysis of the psychological impact of a vascular risk factor intervention: results from a cluster randomized controlled trial in Australian general practice</atitle><jtitle>BMC family practice</jtitle><addtitle>BMC Fam Pract</addtitle><date>2013-12-13</date><risdate>2013</risdate><volume>14</volume><issue>1</issue><spage>190</spage><epage>190</epage><pages>190-190</pages><artnum>190</artnum><issn>1471-2296</issn><eissn>1471-2296</eissn><abstract>Screening for vascular disease, risk assessment and management are encouraged in general practice however there is limited evidence about the emotional impact on patients. The Health Improvement and Prevention Study evaluated the impact of a general practice-based vascular risk factor intervention on behavioural and physiological risk factors in 30 Australian practices. The primary aim of this analysis is to investigate the psychological impact of participating in the intervention arm of the trial. The secondary aim is to identify the mediating effects of changes in behavioural risk factors or BMI.
This study is an analysis of a secondary outcome from a cluster randomized controlled trial. Patients, aged 40-65 years, were randomly selected from practice records. Those with pre-existing cardiovascular disease were excluded. Socio-demographic details, behavioural risk factors and psychological distress were measured at baseline and 12 months. The Kessler Psychological Distress Score (K10) was the outcome measure for multi-level, multivariable analysis and a product-of-coefficient test to assess the mediating effects of behaviour change.
Baseline data were available 384 participants in the intervention group and 315 in the control group. Twelve month data were available for 355 in the intervention group and 300 in the control group. The K10 score of patients in the intervention group (14.78, SD 5.74) was lower at 12 months compared to the control group (15.97, SD 6.30). K10 at 12 months was significantly associated with the score at baseline and being unable to work but not with age, gender, change in behavioural risk factors or change in BMI.
The reduction of K10 in the intervention group demonstrates that a general practice based intervention to identify and manage vascular risk factors did not adversely impact on the psychological distress of the participants. The impact of the intervention on distress was not mediated by a change in the behavioural risk factors or BMI, suggesting that there must be other mediators that might explain the positive impact of the intervention on emotional wellbeing.
Australian New Zealand Clinical Trials Registry ACTRN12607000423415.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24330347</pmid><doi>10.1186/1471-2296-14-190</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Alcohol Drinking - psychology Alcohol use Australia Blood circulation disorders Body mass index Clinical trials Diabetes Disease prevention Exercise - psychology Family medicine Feeding Behavior - psychology Female General Practice Health risk assessment Humans Intervention Lifestyles Linear Models Male Mass Screening - psychology Medical screening Middle Aged Multilevel Analysis Overweight - psychology Prevention Psychological aspects Public health Questionnaires Risk Assessment Risk factors Risk Reduction Behavior Smoking Smoking - psychology Smoking Cessation - psychology Stress, Psychological - psychology Studies Vascular Diseases - diagnosis Vascular Diseases - prevention & control Vascular Diseases - psychology |
| title | Analysis of the psychological impact of a vascular risk factor intervention: results from a cluster randomized controlled trial in Australian general practice |
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