Feasibility and Implementation of a Healthy Lifestyles Program

NCT ID: NCT03258138

Last Updated: 2022-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-15

Study Completion Date

2021-09-22

Brief Summary

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Chronic conditions, such as obesity and diabetes, are increasing worldwide. Lifestyle changes (e.g., physical activity, healthy diet, sufficient sleep, managing stress, smoking cessation) are often recommended to prevent or manage these conditions, but changing habits is difficult. Mental health can play a role in the ability to seek out and follow through on the changes necessary to achieve or maintain a healthy lifestyle, yet this aspect is rarely addressed, and access to mental health services is often limited. Furthermore, individuals are influenced by factors at the individual, interpersonal, community and policy levels (e.g., lack of socialization, unsafe neighborhoods). These factors can act as barriers and need to be addressed in order for individuals to make sustainable lifestyle changes.

A new year-long person-centered healthy lifestyles program is proposed to address the "how to" gap in making lifestyle changes through a combination of individual and group sessions. The feasibility and implementation of this new program will be evaluated through a pilot study looking at the full healthy lifestyles program compared to a less intensive version of the program. The study's hypothesis is that the full program will be feasible, acceptable and more effective for helping participants move across stages of change and for meeting their goals than the less intensive program.

Detailed Description

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A pragmatic mixed methods design including a randomized controlled trial and qualitative components will be used for this pilot study. The randomized controlled trial will include a 1:1 allocation comparing a more intensive program (MIP - usual care plus healthy lifestyles program) with a less intensive program (LIP - usual care plus development of health goals).

The qualitative components include semi-structured interviews of participants (exit interviews at 12 months), MIP staff and participants' healthcare providers (at 6 months and 12 months). In addition, focus groups will be conducted with family members of MIP participants at 9 months. These elements will provide perspectives from multiple stakeholders for improving the healthy lifestyles program and on their roles in creating and maintaining healthy lifestyles.

The primary aim of this study is to assess the feasibility and implementation of the healthy lifestyles program. Impact on participant experiences and outcomes will also be measured. Findings from this study will help inform a larger randomized trial to further look at effectiveness of the program and to determine health system implications. A 2-year extension was approved in order to determine sustainability of findings.

Conditions

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Health Behavior Quality of Life Chronic Disease Health Promotion Stress Mental Health Wellness 1

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Enrolled participants will be allocated to one of the two intervention groups for the duration of the study. One group will be assigned to the more intensive program (MIP= usual care plus healthy lifestyles program) and the other group will be assigned to the less intensive program (LIP= usual care plus health goal development).
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

The amount of exposure to the programs will be known to participants and providers.

Study Groups

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More Intensive Program (MIP)

Participants will receive the more intensive program, which combines usual care with the full version of the healthy lifestyles program. Participants in this arm will meet weekly for group health and wellness learning sessions or brainstorming group sessions. In addition, they will meet monthly for individual sessions with a multidisciplinary health team, including a family physician, physical therapist and dietician to tailor their health goal development and action plans to their particular needs and situations. They will be asked to maintain physical activity and nutrition journals for a week each every three months.

Group Type EXPERIMENTAL

Health and wellness learning sessions

Intervention Type BEHAVIORAL

The health and wellness learning sessions provide a platform for concepts from a variety of health behaviour theories and CBT to be combined with evidence- and practice-based recommendations for healthy lifestyles. They provide the basis for participants' development of an individualized action plan. The sessions will last one hour and participants will receive them in a group setting, 18 times throughout the duration of the program. Specifically, the sessions will be delivered during weeks: 1-8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48.

Brainstorming group sessions

Intervention Type BEHAVIORAL

The brainstorming group sessions allow for facilitated discussions where individuals explore barriers and facilitators to achieving their goals and provide an interpersonal component to the program through the building of social interactions. Participants will also receive help in finding community programs to support healthy lifestyles. These sessions will last one hour and participants will receive them in a group setting, 30 times throughout the duration of the program. Specifically, these sessions will be delivered during weeks: 9-11, 13-15, 17-19, 21-23, 25-27, 29-31, 33-35, 37-39, 41-43, 45-47.

Individual sessions with a multidisciplinary health team

Intervention Type BEHAVIORAL

Monthly individual sessions with a family physician trained in medical CBT, a dietician and a physical therapist help individuals tailor their action plans and recommendations to their particular circumstances and provide supports based on their needs. The initial session will last 3 hours and occur at baseline. The follow-up sessions will last 1 hour.

Health goal development

Intervention Type BEHAVIORAL

Participants in both arms will develop health goals. Several components of these goals will be measured throughout the study, including the stage of change, self-efficacy and actual goal achievement. In the more intensive program arm, participants will develop health goals and learn about how to meet those goals through the group and individual sessions. In the less intensive program arm, participants will receive support in developing health goals from a research assistant trained in theories of health behaviour and in goal setting at baseline, 3 months, 6 months, 9 months and 12 months. The initial goal setting session will be provided within a time period of 2 hours, and the follow-up sessions will be provided within one hour time periods.

Physical activity and nutrition journals

Intervention Type BEHAVIORAL

Participants in both arm will be asked to maintain a physical activity journal and a nutrition journal for a week each every three months. These journals help participants reflect on current behaviours and areas for change.

Less Intensive Program (LIP)

Participants will receive the less intensive program, which combines usual care along with health goal development. Participants in this arm will meet at baseline to set health goals with the support of a research assistant trained in theories of health behaviour and goal setting. They will also meet every three months to measure progress in achieving their goals. They will be asked to maintain physical activity and nutrition journals for a week each every three months.

Group Type EXPERIMENTAL

Health goal development

Intervention Type BEHAVIORAL

Participants in both arms will develop health goals. Several components of these goals will be measured throughout the study, including the stage of change, self-efficacy and actual goal achievement. In the more intensive program arm, participants will develop health goals and learn about how to meet those goals through the group and individual sessions. In the less intensive program arm, participants will receive support in developing health goals from a research assistant trained in theories of health behaviour and in goal setting at baseline, 3 months, 6 months, 9 months and 12 months. The initial goal setting session will be provided within a time period of 2 hours, and the follow-up sessions will be provided within one hour time periods.

Physical activity and nutrition journals

Intervention Type BEHAVIORAL

Participants in both arm will be asked to maintain a physical activity journal and a nutrition journal for a week each every three months. These journals help participants reflect on current behaviours and areas for change.

Interventions

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Health and wellness learning sessions

The health and wellness learning sessions provide a platform for concepts from a variety of health behaviour theories and CBT to be combined with evidence- and practice-based recommendations for healthy lifestyles. They provide the basis for participants' development of an individualized action plan. The sessions will last one hour and participants will receive them in a group setting, 18 times throughout the duration of the program. Specifically, the sessions will be delivered during weeks: 1-8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48.

Intervention Type BEHAVIORAL

Brainstorming group sessions

The brainstorming group sessions allow for facilitated discussions where individuals explore barriers and facilitators to achieving their goals and provide an interpersonal component to the program through the building of social interactions. Participants will also receive help in finding community programs to support healthy lifestyles. These sessions will last one hour and participants will receive them in a group setting, 30 times throughout the duration of the program. Specifically, these sessions will be delivered during weeks: 9-11, 13-15, 17-19, 21-23, 25-27, 29-31, 33-35, 37-39, 41-43, 45-47.

Intervention Type BEHAVIORAL

Individual sessions with a multidisciplinary health team

Monthly individual sessions with a family physician trained in medical CBT, a dietician and a physical therapist help individuals tailor their action plans and recommendations to their particular circumstances and provide supports based on their needs. The initial session will last 3 hours and occur at baseline. The follow-up sessions will last 1 hour.

Intervention Type BEHAVIORAL

Health goal development

Participants in both arms will develop health goals. Several components of these goals will be measured throughout the study, including the stage of change, self-efficacy and actual goal achievement. In the more intensive program arm, participants will develop health goals and learn about how to meet those goals through the group and individual sessions. In the less intensive program arm, participants will receive support in developing health goals from a research assistant trained in theories of health behaviour and in goal setting at baseline, 3 months, 6 months, 9 months and 12 months. The initial goal setting session will be provided within a time period of 2 hours, and the follow-up sessions will be provided within one hour time periods.

Intervention Type BEHAVIORAL

Physical activity and nutrition journals

Participants in both arm will be asked to maintain a physical activity journal and a nutrition journal for a week each every three months. These journals help participants reflect on current behaviours and areas for change.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* English-speaking
* 18 years of age or older


* English-speaking
* 16 years of age or older
* related to participants in randomized controlled trial


* Provide services within the more intensive program


* Provide health care outside of the healthy lifestyles program for participants in randomized controlled trial

Exclusion Criteria

* NA
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Elizabeth Alvarez

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elizabeth Alvarez, MD, MPH, PhD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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McMaster University

Hamilton, Ontario, Canada

Site Status

Countries

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Canada

References

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Choban PS, Flancbaum L. The impact of obesity on surgical outcomes: a review. J Am Coll Surg. 1997 Dec;185(6):593-603. doi: 10.1016/s1072-7515(97)00109-9. No abstract available.

Reference Type BACKGROUND
PMID: 9404886 (View on PubMed)

Mehrotra C, Remington PL, Naimi TS, Washington W, Miller R. Trends in total knee replacement surgeries and implications for public health, 1990-2000. Public Health Rep. 2005 May-Jun;120(3):278-82. doi: 10.1177/003335490512000310.

Reference Type BACKGROUND
PMID: 16134568 (View on PubMed)

El Nakeeb A, Hamed H, Shehta A, Askr W, El Dosoky M, Said R, Abdallah T. Impact of obesity on surgical outcomes post-pancreaticoduodenectomy: a case-control study. Int J Surg. 2014;12(5):488-93. doi: 10.1016/j.ijsu.2014.01.017. Epub 2014 Jan 30.

Reference Type BACKGROUND
PMID: 24486933 (View on PubMed)

Liu W, Wahafu T, Cheng M, Cheng T, Zhang Y, Zhang X. The influence of obesity on primary total hip arthroplasty outcomes: A meta-analysis of prospective cohort studies. Orthop Traumatol Surg Res. 2015 May;101(3):289-96. doi: 10.1016/j.otsr.2015.01.011. Epub 2015 Mar 25.

Reference Type BACKGROUND
PMID: 25817907 (View on PubMed)

Gibbons CJ, Fournier JC, Stirman SW, DeRubeis RJ, Crits-Christoph P, Beck AT. The clinical effectiveness of cognitive therapy for depression in an outpatient clinic. J Affect Disord. 2010 Sep;125(1-3):169-76. doi: 10.1016/j.jad.2009.12.030. Epub 2010 Jan 18.

Reference Type BACKGROUND
PMID: 20080305 (View on PubMed)

Porto PR, Oliveira L, Mari J, Volchan E, Figueira I, Ventura P. Does cognitive behavioral therapy change the brain? A systematic review of neuroimaging in anxiety disorders. J Neuropsychiatry Clin Neurosci. 2009 Spring;21(2):114-25. doi: 10.1176/jnp.2009.21.2.114.

Reference Type BACKGROUND
PMID: 19622682 (View on PubMed)

Chesson AL Jr, Anderson WM, Littner M, Davila D, Hartse K, Johnson S, Wise M, Rafecas J. Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 1999 Dec 15;22(8):1128-33. doi: 10.1093/sleep/22.8.1128.

Reference Type BACKGROUND
PMID: 10617175 (View on PubMed)

Resnicow K, DiIorio C, Soet JE, Ernst D, Borrelli B, Hecht J. Motivational interviewing in health promotion: it sounds like something is changing. Health Psychol. 2002 Sep;21(5):444-51.

Reference Type BACKGROUND
PMID: 12211511 (View on PubMed)

Sherman MD, Miller LW, Keuler M, Trump L, Mandrich M. Managing Behavioral Health Issues in Primary Care: Six Five-Minute Tools. Fam Pract Manag. 2017 Mar/Apr;24(2):30-35. No abstract available.

Reference Type BACKGROUND
PMID: 28291312 (View on PubMed)

Dubord G. Part 1. Goalification. Can Fam Physician. 2010 Dec;56(12):1312. No abstract available.

Reference Type BACKGROUND
PMID: 21375060 (View on PubMed)

Dubord G. Part 2. Scalification. Can Fam Physician. 2011 Jan;57(1):54. No abstract available.

Reference Type BACKGROUND
PMID: 21322287 (View on PubMed)

Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983 Jun;51(3):390-5. doi: 10.1037//0022-006x.51.3.390. No abstract available.

Reference Type BACKGROUND
PMID: 6863699 (View on PubMed)

Patsopoulos NA. A pragmatic view on pragmatic trials. Dialogues Clin Neurosci. 2011;13(2):217-24. doi: 10.31887/DCNS.2011.13.2/npatsopoulos.

Reference Type BACKGROUND
PMID: 21842619 (View on PubMed)

Thabane L, Kaczorowski J, Dolovich L, Chambers LW, Mbuagbaw L; CHAP Investigators. Reducing the confusion and controversies around pragmatic trials: using the Cardiovascular Health Awareness Program (CHAP) trial as an illustrative example. Trials. 2015 Sep 2;16:387. doi: 10.1186/s13063-015-0919-3.

Reference Type BACKGROUND
PMID: 26329614 (View on PubMed)

Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Serv Res. 2013 Dec;48(6 Pt 2):2134-56. doi: 10.1111/1475-6773.12117. Epub 2013 Oct 23.

Reference Type BACKGROUND
PMID: 24279835 (View on PubMed)

Anderson TJ, Gregoire J, Pearson GJ, Barry AR, Couture P, Dawes M, Francis GA, Genest J Jr, Grover S, Gupta M, Hegele RA, Lau DC, Leiter LA, Lonn E, Mancini GB, McPherson R, Ngui D, Poirier P, Sievenpiper JL, Stone JA, Thanassoulis G, Ward R. 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult. Can J Cardiol. 2016 Nov;32(11):1263-1282. doi: 10.1016/j.cjca.2016.07.510. Epub 2016 Jul 25.

Reference Type BACKGROUND
PMID: 27712954 (View on PubMed)

Padwal RS, Pajewski NM, Allison DB, Sharma AM. Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ. 2011 Oct 4;183(14):E1059-66. doi: 10.1503/cmaj.110387. Epub 2011 Aug 15.

Reference Type BACKGROUND
PMID: 21844111 (View on PubMed)

Brazier JE, Harper R, Jones NM, O'Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul 18;305(6846):160-4. doi: 10.1136/bmj.305.6846.160.

Reference Type BACKGROUND
PMID: 1285753 (View on PubMed)

Marshall D, Pericak D, Grootendorst P, Gooch K, Faris P, Frank C, Bellamy N, Torrance G, Feeny D. Validation of a prediction model to estimate health utilities index Mark 3 utility scores from WOMAC index scores in patients with osteoarthritis of the hip. Value Health. 2008 May-Jun;11(3):470-7. doi: 10.1111/j.1524-4733.2007.00258.x.

Reference Type BACKGROUND
PMID: 18489670 (View on PubMed)

Kohrt BA, Luitel NP, Acharya P, Jordans MJ. Detection of depression in low resource settings: validation of the Patient Health Questionnaire (PHQ-9) and cultural concepts of distress in Nepal. BMC Psychiatry. 2016 Mar 8;16:58. doi: 10.1186/s12888-016-0768-y.

Reference Type BACKGROUND
PMID: 26951403 (View on PubMed)

Seo JG, Park SP. Validation of the Generalized Anxiety Disorder-7 (GAD-7) and GAD-2 in patients with migraine. J Headache Pain. 2015;16:97. doi: 10.1186/s10194-015-0583-8. Epub 2015 Nov 23.

Reference Type BACKGROUND
PMID: 26596588 (View on PubMed)

Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004 Dec;42(12):1194-201. doi: 10.1097/00005650-200412000-00006.

Reference Type BACKGROUND
PMID: 15550799 (View on PubMed)

Lynch DJ, McGrady A, Alvarez E, Forman J. Recent life changes and medical utilization in an academic family practice. J Nerv Ment Dis. 2005 Sep;193(9):633-5. doi: 10.1097/01.nmd.0000177778.27069.77.

Reference Type BACKGROUND
PMID: 16131948 (View on PubMed)

Reis RS, Hino AA, Anez CR. Perceived stress scale: reliability and validity study in Brazil. J Health Psychol. 2010 Jan;15(1):107-14. doi: 10.1177/1359105309346343.

Reference Type BACKGROUND
PMID: 20064889 (View on PubMed)

Leung DY, Lam TH, Chan SS. Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke. BMC Public Health. 2010 Aug 25;10:513. doi: 10.1186/1471-2458-10-513.

Reference Type BACKGROUND
PMID: 20735860 (View on PubMed)

Grygiel P, Humenny G, Rebisz S. Using the De Jong Gierveld Loneliness Scale With Early Adolescents: Factor Structure, Reliability, Stability, and External Validity. Assessment. 2019 Mar;26(2):151-165. doi: 10.1177/1073191116682298. Epub 2016 Dec 8.

Reference Type BACKGROUND
PMID: 27932403 (View on PubMed)

Horowitz CR, Robinson M, Seifer S. Community-based participatory research from the margin to the mainstream: are researchers prepared? Circulation. 2009 May 19;119(19):2633-42. doi: 10.1161/CIRCULATIONAHA.107.729863.

Reference Type BACKGROUND
PMID: 19451365 (View on PubMed)

Anderson JB. Unraveling health disparities: examining the dimensions of hypertension and diabetes through community engagement. J Health Care Poor Underserved. 2005 Nov;16(4 Suppl A):91-117. doi: 10.1353/hpu.2005.0121.

Reference Type BACKGROUND
PMID: 16327099 (View on PubMed)

Alvarez E, Qutob M, Mbuagbaw L, Lavis J, Lokker C, Walli-Attaei M, Samaan Z, Sutton A, Singh J, Feeny D, Fortuna J. Feasibility and implementation of a healthy lifestyles program in a community setting in Ontario, Canada: protocol for a pragmatic mixed methods pilot study. BMJ Open. 2019 Oct 16;9(10):e031298. doi: 10.1136/bmjopen-2019-031298.

Reference Type DERIVED
PMID: 31619429 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form: Participants

View Document

Document Type: Informed Consent Form: Healthcare providers

View Document

Document Type: Informed Consent Form: Program staff

View Document

Document Type: Informed Consent Form: Family members

View Document

Related Links

Access external resources that provide additional context or updates about the study.

http://digitalcommons.unl.edu/dissertations/AAI3487306

Mixed methods embedded design in medical education, mental health and health services research: A methodological analysis

http://guidelines.diabetes.ca/browse/chapter4

Chapter 4: Screening for Type 1 and Type 2 Diabetes

http://www.phqscreeners.com/

Patient Healthcare Questionnaire

https://doi.org/10.1016/S1389-9457(00)00065-4

Validation of the Insomnia Severity Index as an outcome measure for insomnia research

Other Identifiers

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Healthy lifestyles pilot

Identifier Type: -

Identifier Source: org_study_id

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