High adherence to lifestyle Interventions helps improve health outcomes

Greater adherence to a lifestyle intervention may improve health outcomes, but no overall significant differences are seen between intervention and control groups, according to the results of the FAMILIA* trial involving adults from underserved communities.

“It also suggests a potential contributory role of the presentation of atherosclerosis pictures, providing helpful information to improve future lifestyle interventions in adults,” the authors said.

This trial randomly assigned 15 Head Start preschools in Harlem, New York, including their children’s parents/caregivers, to receive either an “individual-focused” or “peer-to-peer–based” lifestyle intervention programme for 12 months or control.

Change from baseline to 12 months in a composite health score related to blood pressure (BP), exercise, weight, alimentation and tobacco (Fuster-BEWAT Score [FBS]), ranging from 0 to 15 (ideal health=15) was the primary outcome. The authors also evaluated the change in FBS at 24 months to assess the sustainability of the intervention.

Secondary outcomes included changes in FBS subcomponents and the effect of the knowledge of atherosclerosis presence as assessed by bilateral carotid/femoral vascular ultrasound. Intervention effects were examined by fitting mixed-effects models.

Of the 635 parents/caregivers (mean age, 38±11 years; baseline FBS, 9.3±2.4 points) who were enrolled in the trial, 83 percent were women and 57 percent were of Hispanic/Latino ethnicity.

From baseline to 12 months, all groups had a mean within-group change in FBS of ∼0.20 points. No overall between-group differences were observed, but high adherence to the intervention (0.30 points, 95 percent confidence interval [CI], 0.03–0.57; p=0.027) showed a higher change in FBS compared to low adherence (0.00 points, 95 percent CI, –0.43 to –0.43; p=1.0).

In addition, the intervention effects were significantly increased by the participant’s knowledge of the presence of atherosclerosis. Similar results were sustained at 24 months.

“The current trends of unhealthy lifestyle behaviours in underserved communities are disturbing,” the authors said. “Thus, effective health promotion strategies constitute an unmet need.”

*Family-Based Approach in a Minority Community Integrating Systems-Biology for Promotion of Health