title: Health improvement and prevention study (HIPS) - evaluation of an intervention to prevent vascular disease in general practice.
abstract: BACKGROUND
  The Health Improvement and Prevention Study (HIPS) study aims to evaluate the capacity of general practice to identify patients at high risk for developing vascular disease and to reduce their risk of vascular disease and diabetes through behavioural interventions delivered in general practice and by the local primary care organization.
  
  
  METHODS
  HIPS is a stratified randomized controlled trial involving 30 general practices in NSW, Australia. Practices are randomly allocated to an 'intervention' or 'control' group. General practitioners (GPs) and practice nurses (PNs) are offered training in lifestyle counselling and motivational interviewing as well as practice visits and patient educational resources. Patients enrolled in the trial present for a health check in which the GP and PN provide brief lifestyle counselling based on the 5As model (ask, assess, advise, assist, and arrange) and refer high risk patients to a diet education and physical activity program. The program consists of two individual visits with a dietician or exercise physiologist and four group sessions, after which patients are followed up by the GP or PN. In each practice 160 eligible patients aged between 40 and 64 years are invited to participate in the study, with the expectation that 40 will be eligible and willing to participate. Evaluation data collection consists of (1) a practice questionnaire, (2) GP and PN questionnaires to assess preventive care attitudes and practices, (3) patient questionnaire to assess self-reported lifestyle behaviours and readiness to change, (4) physical assessment including weight, height, body mass index (BMI), waist circumference and blood pressure, (5) a fasting blood test for glucose and lipids, (6) a clinical record audit, and (7) qualitative data collection. All measures are collected at baseline and 12 months except the patient questionnaire which is also collected at 6 months. Study outcomes before and after the intervention is compared between intervention and control groups after adjusting for baseline differences and clustering at the level of the practice.
  
  
  CONCLUSIONS
  This study will provide evidence of the effectiveness of a primary care intervention to reduce the risk of cardiovascular disease and diabetes in general practice patients. It will inform current policies and programs designed to prevent these conditions in Australian primary health care.
  
  
  BACKGROUND
  ACTRN12607000423415.
authors.affiliation: Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2052, Australia.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Fanaian
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Laws
authors.forename: Megan
authors.initials: M
authors.lastname: Passey
authors.forename: Suzanne
authors.initials: S
authors.lastname: McKenzie
authors.forename: Qing
authors.initials: Q
authors.lastname: Wan
authors.forename: Gawaine Powell
authors.initials: GP
authors.lastname: Davies
authors.forename: David
authors.initials: D
authors.lastname: Lyle
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003153:Community Health Services / Q000379:methods / Q000592:standards; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D017598:Efficiency, Organizational; D005194:Family Practice / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010353:Patient Education as Topic / Q000379:methods; D011314:Preventive Health Services / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior