CVD Risk Reduction Trial

University Health Network, Toronto827 enrolled

Overview

The purpose of this study is to provide lifestyle counselling for protective health behavior (exercise, diet, smoking cessation) to small groups (6-8 subjects) via teleconference. The sample includes individuals at elevated risk for cardiovascular disease (CVD) as well as individuals with established CVD. Our hypothesis is that telephone-based lifestyle counselling will (1) significantly increase protective lifestyle behavior (diet, exercise, smoke-free living) and (2) significantly reduce CVD risk factors at 6-month follow-up.

COHRT was a 2 parallel-group randomized controlled trial that was designed to assess the efficacy of a community outreach strategy for cardiovascular disease (CVD) risk reduction among individuals at elevated risk for CV events. Randomization was stratified for diagnosis of CHD, type 1 or 2 diabetes, sex, and clinical depression, and blocked within our northern, rural, and urban recruitment sites. A 2X3 mixed factorial design was utilized: 2 Groups (Usual Care, UC/Lifestyle Counselling,LC) X 3 Intervals (Baseline, post-treatment, 6-month follow-up). All subjects received personal CVD risk factor feedback and standardized handouts on heart healthy lifestyle change. The LC group received 6 weekly 1-hour sessions of lifestyle counseling that was provided via teleconference in small groups (4-8 persons). Group facilitators were trained in a manualized protocol of motivational interviewing that was designed for CVD risk reduction through lifestyle change. Weekly supervision was also provided. We hypothesized that the LC group (vs. UC) would significantly increase protective health behavior (exercise, diet, smoke-free living) at post-treatment and 6-month follow-up. The secondary hypothesis was that LC would significantly reduce (1) CVD risk factors, (SBP, DBP, total cholesterol, LDL cholesterol), (2) 10-year absolute risk among subjects without CVD, and (3) significantly increase quality of life as measured by symptoms of depression, psychological stress, and social support.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

827

Conditions

Cardiovascular Disease

Interventions

Group-based motivational interviewingBEHAVIORAL

Individual CVD-risk factor feedbackBEHAVIORAL

Education for protective health behavior changeBEHAVIORAL

Eligibility

Sex: ALLMin age: 35 YearsMax age: 74 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 35 to 74 years of age, * Diagnosis of CVD or Type 1 or 2 diabetes, or * ≥2 of the following CVD risk factors: * Confirmed diagnosis of hypertension, * Dyslipidemia, * Males aged ≥55 years/females aged ≥60 years, * Family history of CHD or stroke; * Current smoker, or * BMI ≥ 27. Exclusion Criteria: * Diagnosis of clinically significant cardiac complications (e.g. arrhythmia, unstable angina) or a congenital cardiac condition; * Major psychiatric illness (e.g. psychosis), history of alcohol or drug dependence within the previous year, or residence in a non-private setting.

Locations (3)

Laurentian University / Sudbury and District Health Unit

Greater Sudbury, Ontario, Canada

Grey-Bruce Health Unit

Owen Sound, Ontario, Canada

University Health Network / Sunnybrook and Women's College Health Sciences Centre

Toronto, Ontario, Canada

Outcomes

Primary Outcomes

Psychometric assessment of change in exercise, diet and smoking

Time frame: Post-treatment and 6-month follow-up

Secondary Outcomes

SBP, DBP, total cholesterol, HDL, LDL, triglycerides and 10-year absolute CVD risk

Time frame: 6-month follow-up

Psychometric assessment of symptoms of depression, psychological stress, and social support.

Time frame: post-treatment and 6-month follow-up

Data from ClinicalTrials.gov

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