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Impact of a 3-year multi-centre community-based intervention on risk factors for chronic disease and obesity among free-living adults: the Healthy Alberta Communities study.

Lytvyak E, Olstad DL, Schopflocher DP, Plotnikoff RC, Storey KE, Nykiforuk CI, Raine KD - BMC Public Health (2016)

Bottom Line: Changes in parameters over time between groups were compared using meta-analysis.The net difference in change in outcomes (change in intervention communities minus change in comparison group) represented the effect of the intervention.Evaluating the success of community-based interventions based on their efficacy in changing individual-level clinical indicators may, however, underestimate their potential.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, University of Alberta, 3-300 ECHA, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada.

ABSTRACT

Background: Healthy Alberta Communities (HAC) was a 3-year community-based intervention to reduce lifestyle-related risk factors for chronic disease and obesity at a population-level. The current paper examines changes in blood pressure (BP) and anthropometric indicators within HAC communities compared to secular trends.

Methods: Between 2006 and 2009, this community-academic partnership sought to create environments supportive of healthier dietary and physical activity behaviours within four diverse communities in Alberta, Canada. Height, weight, waist and hip circumference and BP were measured among 1554 and 1808 community residents at baseline (2006) and follow-up (2009), respectively. A comparison sample was drawn from a representative national survey. Samples were stratified by age and change between pre- and post-intervention was assessed using t-tests. Changes in parameters over time between groups were compared using meta-analysis. The net difference in change in outcomes (change in intervention communities minus change in comparison group) represented the effect of the intervention.

Results: Adjusted systolic (SBP) and diastolic (DBP) BP declined within most age groups in HAC communities from pre- to post-intervention. The net decline in SBP was 1 mmHg in 20-39 year olds (p = 0.006) and 2 mmHg in 40-59 year olds (p = 0.001), while the net decline in DBP was 3 mmHg in 20-39 year olds (p < 0.001), 2 mmHg in 40-59 year olds (p < 0.001) and 3 mmHg in 60-79 year olds (p < 0.001). The net increase in the proportion of individuals with normal BP was 5.9 % (p < 0.001), while the net decline in the proportion of individuals with stage 1 hypertension was 4.5 % (p < 0.001). BMI and body weight were unchanged. There was a significant net increase in waist and hip circumference among 20-39 year olds within intervention communities.

Conclusions: Findings suggest HAC succeeded in shifting the population distribution of BP in a leftward direction. By contrast, anthropometric parameters remained unchanged or worsened within intervention communities. Therefore, while improvements in some clinical risk factors can be achieved through relatively diffuse and shorter-term community-level environmental changes, improvements in others may require interventions of greater intensity and duration. Evaluating the success of community-based interventions based on their efficacy in changing individual-level clinical indicators may, however, underestimate their potential.

No MeSH data available.


Related in: MedlinePlus

Change in mean systolic blood pressure within and between intervention and comparison groups. *p < 0.05 between follow-up and baseline for intervention communities. **p < 0.01 between follow-up and baseline for intervention communities. ***p < 0.001 between follow-up and baseline for intervention communities. &&p < 0.01 between follow-up and baseline changes in intervention and comparison groups. &&&p < 0.001 between follow-up and baseline changes in intervention and comparison groups
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Fig1: Change in mean systolic blood pressure within and between intervention and comparison groups. *p < 0.05 between follow-up and baseline for intervention communities. **p < 0.01 between follow-up and baseline for intervention communities. ***p < 0.001 between follow-up and baseline for intervention communities. &&p < 0.01 between follow-up and baseline changes in intervention and comparison groups. &&&p < 0.001 between follow-up and baseline changes in intervention and comparison groups

Mentions: Changes in BP within intervention and comparison groups from 2006–2009 are presented in Table 2. At baseline, mean SBP and DBP values were higher in intervention communities than in the comparison group. There was a significant decline in the net adjusted SBP and DBP within most age groups in HAC communities from baseline to follow-up. The net decline in SBP was 1 mmHg in 20-39 year olds (p=0.006) and 2 mmHg in 40–59 year olds (p = 0.001) (Fig. 1), while the net decline in DBP was 3 mmHg in 20–39 year olds (p < 0.001), 2 mmHg in 40–59 year olds (p < 0.001) and 3 mmHg in 60–79 year olds (p < 0.001; Fig. 2). As a result, at follow-up mean SBP and DBP within intervention communities was equal to, or lower than values in the comparison group for all age categories, with the exception of SBP values within the 20–39 year old age group.Table 2


Impact of a 3-year multi-centre community-based intervention on risk factors for chronic disease and obesity among free-living adults: the Healthy Alberta Communities study.

Lytvyak E, Olstad DL, Schopflocher DP, Plotnikoff RC, Storey KE, Nykiforuk CI, Raine KD - BMC Public Health (2016)

Change in mean systolic blood pressure within and between intervention and comparison groups. *p < 0.05 between follow-up and baseline for intervention communities. **p < 0.01 between follow-up and baseline for intervention communities. ***p < 0.001 between follow-up and baseline for intervention communities. &&p < 0.01 between follow-up and baseline changes in intervention and comparison groups. &&&p < 0.001 between follow-up and baseline changes in intervention and comparison groups
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835846&req=5

Fig1: Change in mean systolic blood pressure within and between intervention and comparison groups. *p < 0.05 between follow-up and baseline for intervention communities. **p < 0.01 between follow-up and baseline for intervention communities. ***p < 0.001 between follow-up and baseline for intervention communities. &&p < 0.01 between follow-up and baseline changes in intervention and comparison groups. &&&p < 0.001 between follow-up and baseline changes in intervention and comparison groups
Mentions: Changes in BP within intervention and comparison groups from 2006–2009 are presented in Table 2. At baseline, mean SBP and DBP values were higher in intervention communities than in the comparison group. There was a significant decline in the net adjusted SBP and DBP within most age groups in HAC communities from baseline to follow-up. The net decline in SBP was 1 mmHg in 20-39 year olds (p=0.006) and 2 mmHg in 40–59 year olds (p = 0.001) (Fig. 1), while the net decline in DBP was 3 mmHg in 20–39 year olds (p < 0.001), 2 mmHg in 40–59 year olds (p < 0.001) and 3 mmHg in 60–79 year olds (p < 0.001; Fig. 2). As a result, at follow-up mean SBP and DBP within intervention communities was equal to, or lower than values in the comparison group for all age categories, with the exception of SBP values within the 20–39 year old age group.Table 2

Bottom Line: Changes in parameters over time between groups were compared using meta-analysis.The net difference in change in outcomes (change in intervention communities minus change in comparison group) represented the effect of the intervention.Evaluating the success of community-based interventions based on their efficacy in changing individual-level clinical indicators may, however, underestimate their potential.

View Article: PubMed Central - PubMed

Affiliation: School of Public Health, University of Alberta, 3-300 ECHA, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada.

ABSTRACT

Background: Healthy Alberta Communities (HAC) was a 3-year community-based intervention to reduce lifestyle-related risk factors for chronic disease and obesity at a population-level. The current paper examines changes in blood pressure (BP) and anthropometric indicators within HAC communities compared to secular trends.

Methods: Between 2006 and 2009, this community-academic partnership sought to create environments supportive of healthier dietary and physical activity behaviours within four diverse communities in Alberta, Canada. Height, weight, waist and hip circumference and BP were measured among 1554 and 1808 community residents at baseline (2006) and follow-up (2009), respectively. A comparison sample was drawn from a representative national survey. Samples were stratified by age and change between pre- and post-intervention was assessed using t-tests. Changes in parameters over time between groups were compared using meta-analysis. The net difference in change in outcomes (change in intervention communities minus change in comparison group) represented the effect of the intervention.

Results: Adjusted systolic (SBP) and diastolic (DBP) BP declined within most age groups in HAC communities from pre- to post-intervention. The net decline in SBP was 1 mmHg in 20-39 year olds (p = 0.006) and 2 mmHg in 40-59 year olds (p = 0.001), while the net decline in DBP was 3 mmHg in 20-39 year olds (p < 0.001), 2 mmHg in 40-59 year olds (p < 0.001) and 3 mmHg in 60-79 year olds (p < 0.001). The net increase in the proportion of individuals with normal BP was 5.9 % (p < 0.001), while the net decline in the proportion of individuals with stage 1 hypertension was 4.5 % (p < 0.001). BMI and body weight were unchanged. There was a significant net increase in waist and hip circumference among 20-39 year olds within intervention communities.

Conclusions: Findings suggest HAC succeeded in shifting the population distribution of BP in a leftward direction. By contrast, anthropometric parameters remained unchanged or worsened within intervention communities. Therefore, while improvements in some clinical risk factors can be achieved through relatively diffuse and shorter-term community-level environmental changes, improvements in others may require interventions of greater intensity and duration. Evaluating the success of community-based interventions based on their efficacy in changing individual-level clinical indicators may, however, underestimate their potential.

No MeSH data available.


Related in: MedlinePlus