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

Andrew Steptoe, Sheelagh Doherty, Elizabeth Rink, Sally Kerry, Tony Kendrick, Sean Hilton

Research output: Contribution to journalArticle

185 Citations (Scopus)

Abstract

Objective. To compare the effect of behaviourally orientes counselling in general practice on healthy behavior and biological risk factors in patients at increased risk of coronary heart disease. Design. Cluster randomised control disease. 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 behavioral 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 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 cigarette smoking 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 behavioral 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.

Original languageEnglish
Pages (from-to)943-947
Number of pages5
JournalBritish Medical Journal
Volume319
Issue number7215
Publication statusPublished - 9 Oct 1999

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