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dc.contributorIDIAP Jordi Gol
dc.contributor.authorZabaleta-del-Olmo, Edurne
dc.contributor.authorCasajuana-Closas, Marc
dc.contributor.authorLópez-Jiménez, Tomás
dc.contributor.authorPombo-Ramos, Haizea
dc.contributor.authorPons-Vigués, Mariona
dc.contributor.authorPujol-Ribera, Enriqueta
dc.contributor.authorCabezas-Peña, Carmen
dc.contributor.authorMartí Lluch, Ruth
dc.contributor.authorJacques Aviñó, Constanza
dc.contributor.authorRamos, Rafel
dc.contributor.authorBolíbar-Ribas, Bonaventura
dc.date.accessioned2021-12-09T12:16:37Z
dc.date.available2021-12-09T12:16:37Z
dc.date.issued2021-12-04
dc.identifier.citationZabaleta-Del-Olmo E , Casajuana-Closas M, López-Jiménez T, Pombo H, Pons-Vigués M, Pujol-Ribera E, et al. Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial. BMC Public Health. 2021 Dec 4;21:2208.
dc.identifier.issn1471-2458
dc.identifier.urihttp://hdl.handle.net/11351/6666
dc.descriptionHealth behaviour; Health promotion; Hybrid trial
dc.description.abstractBackground This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45–75 years compared to usual care; and b) an implementation strategy. Methods A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. Results 14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity ≥50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain. Conclusions Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness.
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofseriesBMC Public Health;21
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.sourceScientia
dc.subjectPromoció de la salut
dc.subjectAtenció primària
dc.subjectAssaigs clínics
dc.subject.meshHealth Promotion
dc.subject.meshRandomized Controlled Trial
dc.subject.meshPrimary Health Care
dc.titleMultiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1186/s12889-021-11982-4
dc.subject.decspromoción de la salud
dc.subject.decsensayo clínico controlado aleatorizado
dc.subject.decsatención primaria de la salud
dc.relation.publishversionhttps://doi.org/10.1186/s12889-021-11982-4
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.authoraffiliation[Zabaleta-Del-Olmo E] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Gerència Territorial de Barcelona, Institut Català de la Salut (ICS), Barcelona, Spain. Departament d’infermeria. Facultat d’infermeria. Universitat de Girona, Girona, Spain. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. [Casajuana-Closas M] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. [López-Jiménez T] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. [Pombo H] Ezkerraldea-Enkarterri-Cruces Integrated Health Organisation-Biocruces Bizkaia Health Research Institute Innovation Bizkaia, Spain. Deputy Directorate of Healthcare Assistance, Osakidetza-Servicio Vasco de Salud, Vitoria, Spain. [Pons-Vigués M] Departament d’infermeria. Facultat d’infermeria. Universitat de Girona, Girona, Spain. Àrea Assistencial. Servei Català de la Salut (CatSalut), Barcelona, Spain. [Pujol-Ribera E] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Departament d’infermeria. Facultat d’infermeria. Universitat de Girona, Girona, Spain. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. [Cabezas-Peña C] Subdirecció General de Promoció de la Salut, Secretaria de Salut Pública, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain. [Martí-Lluch R] Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. Unitat de suport a la recerca de Girona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Girona, Spain. Group of research in Vascular Health, Girona Biomedical Research Institute (IdibGi), Salt, Spain. [Jaques-Aviñó] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain. [Ramos R] Unitat de suport a la recerca de Girona, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Girona, Spain. Group of research in Vascular Health, Girona Biomedical Research Institute (IdibGi), Salt, Spain. Department of Medical Sciences, School of Medicine, Campus Salut, Universitat de Girona, Girona, Spain. [Bolíbar B] Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
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