Goode AD, Winkler EAH, Lawler SP, Reeves MM, Owen N, Eakin EG. A telephone-delivered physical activity and dietary intervention for type 2 diabetes and hypertension: does intervention dose influence outcomes?
Am J Health Promot 2011;
25:257-63. [PMID:
21361811 DOI:
10.4278/ajhp.090223-quan-75]
[Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE
To examine associations of intervention dose with behavior change outcomes in a telephone counseling intervention for physical activity and dietary change.
DESIGN
Secondary analysis of intervention participants from a cluster-randomized controlled trial.
SETTING
Primary care practices in a disadvantaged community in Queensland, Australia.
SUBJECTS
Adult patients with type 2 diabetes or hypertension.
INTERVENTION
Patients (n = 228) received telephone counseling over a 12-month period. The initiation phase (1-4 months) consisted of up to 10 weekly or fortnightly calls; the maintenance-enhancement phase (5-12 months) consisted of up to eight monthly calls.
MEASURES
Intervention dose was defined as the number of calls completed in total and during each phase and was categorized into tertiles. Diet and physical activity were measured using validated self-report instruments.
ANALYSIS
Multivariate analyses of call completion and change in health behaviors.
RESULTS
Those completing a high number of calls were more likely to be female, white, older than 60 years, retired, and earning less than an average weekly Australian wage. Relative to low call completion, high completion during the maintenance-enhancement phase was associated with significantly greater (least squares mean [SE]) behavioral improvement for the following: total fat intake as percentage of calories (-3.58% [.74%]), saturated fat intake (-2.51% [.51%]), fiber intake (4.23 [1.20] g), and moderate-to-vigorous physical activity (187.82 [44.78] minutes).
CONCLUSION
Interventions of longer duration may be required to influence complex behaviors such as physical activity and fat and fiber intake.
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