Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial

Steptoe, Andrew, Doherty, Sheelagh, Rink, Elizabeth, Kerry, Sally, Kendrick, Tony and Hilton, Sean (1999) Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial. British Medical Journal, 319, (7215), 943-948. (PMID:10514155).


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OBJECTIVE: To measure the effect of behaviourally oriented counselling in general practice on healthy behaviour and biological risk factors in patients at increased risk of coronary heart disease.

DESIGN: Cluster randomised controlled trial.

PARTICIPANTS: 883 men and women selected for the presence of one or more modifiable risk factors: regular cigarette smoking, high serum cholesterol concentration (6.5-9.0 mmol/l), and high body mass index (25-35) combined with low physical activity.

INTERVENTION: Brief behavioural counselling, on the basis of the stage of change model, carried out by practice nurses to reduce smoking and dietary fat intake and to increase regular physical activity.

MAIN OUTCOME MEASURES: Questionnaire measures of diet, exercise, and smoking habits, and blood pressure, serum total cholesterol concentration, weight, body mass index, and smoking cessation (with biochemical validation) at 4 and 12 months.

RESULTS: Favourable differences were recorded in the intervention group for dietary fat intake, regular exercise, and cigarettes smoked per day at 4 and 12 months. Systolic blood pressure was reduced to a greater extent in the intervention group at 4 but not at 12 months. No differences were found between groups in changes in total serum cholesterol concentration, weight, body mass index, diastolic pressure, or smoking cessation.

CONCLUSIONS: Brief behavioural counselling by practice nurses led to improvements in healthy behaviour. More extended counselling to help patients sustain and build on behaviour changes may be required before differences in biological risk factors emerge.

Item Type: Article
ISSNs: 0959-8138 (print)
Related URLs:
Keywords: prevention & control, trial, methods, male, disease, health promotion, practice nurse, activity, smoking, women, diet, counselling, risk, cholesterol, body mass index, improvement, middle aged, hypercholesterolemia, research, adults, adult, smoking cessation, serum, controlled-trial, female, psychology, blood, heart, blood pressure, patients, controlled trial, exercise, outcome, clinical-trial, risk factors, model, weight, questionnaire, pressure, general-practice, coronary disease, nurses, coronary heart disease, health behavior, practice nurses, behaviour, general practice, humans, london, research support, design
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RT Nursing
Divisions : University Structure - Pre August 2011 > School of Medicine
Faculty of Medicine > Primary Care and Population Sciences
ePrint ID: 62150
Accepted Date and Publication Date:
9 October 1999Published
Date Deposited: 03 Sep 2008
Last Modified: 31 Mar 2016 12:45

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