Community-based healthy lifestyle support for cardiovascular disease prevention: a systematic review and development of a community centre-based intervention for older women.

Research output: Contribution to conferencePoster

Abstract

Background/Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide, with an increasing number of people living with the disease. Improved efforts to reduce CVD risk factors are needed but the effectiveness of comprehensive community-based interventions, accessible to all population sub-groups, is unclear.

Purpose: The project aimed to develop an intervention to promote secondary prevention of CVD and reduce risk factors by providing healthy lifestyle support in a community-based setting. Objectives were 1) to conduct a systematic review to assess the current evidence base and 2) use the findings to develop a logic model for the intervention.

Methods: We searched five databases (MEDLINE, Embase, CINAHL, PsycINFO, Cochrane library) to identify health behaviour interventions for adults with CVD in community-based settings. Primary outcomes were behavioural change in smoking, diet, physical activity (PA) and/or alcohol consumption. Two reviewers independently assessed articles for eligibility and risk of bias; statistical analysis used Revman v5.3. Results were put into a logic model, following Medical Research Council guidance, from which an intervention to increase PA in older women (≤50 years) living in socio-economically disadvantaged areas was developed.

Results: Of 5905 articles identified, 38 studies (41 articles) were included. Interventions were multifactorial, educational, psychological and PA-based. The review identified that studies included relatively few women, reported little data regarding socio-economic status and often failed to provide outcome data that could be included in meta-analyses. Meta-analyses identified increased steps/week (Mean Difference (MD): 7480; 95% CI 1940, 13020), increased minutes of PA/week (MD: 60.03; 95% CI 14.22, 105.84) and reduced waist circumference (MD: -3.10; 95% CI -6.06, -0.15) associated with the interventions. Effective intervention components appeared to include education, PA and a theoretical framework. Utilising Social Practice Theory (SPT) as a framework and these components in the design, the outcome of the logic model for the intervention was a 12 week programme, providing education about PA, encouragement of social support and information about local opportunities for PA and walking routes, targeting an increase in PA among women attending pre-existing groups in community centres, in socio-economically disadvantaged areas.

Conclusions: Our review found beneficial effects on outcomes for community-based lifestyle interventions for the secondary prevention of CVD, suggesting that community-based opportunities should be promoted. Our findings have informed the development of an innovative approach, based in community centres and using SPT, to increase PA for women in areas of socio-economic disadvantage. An evaluation of the intervention is currently underway, using a randomised trial with a cross-over design.
Original languageEnglish
Publication statusPublished - 08 Apr 2017
EventEuroprean Congress on Preventive Cardiology : Euro Prevent 2017 - Malaga, Spain
Duration: 06 Apr 201708 Apr 2017
https://www.escardio.org/vgn-ext-templating/Congresses-&-Events/EuroPrevent

Conference

ConferenceEuroprean Congress on Preventive Cardiology
CountrySpain
CityMalaga
Period06/04/201708/04/2017
Internet address

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