title: Improving diet, physical activity and other lifestyle behaviours using computer-tailored advice in general practice: a randomised controlled trial.
abstract: BACKGROUND
  The adoption and maintenance of healthy behaviours is essential in the primary prevention of chronic non-communicable diseases. This study evaluated the effectiveness of a minimal intervention on multiple lifestyle factors such as diet, physical activity, smoking and alcohol, delivered through general practice, using computer-tailored feedback.
  
  
  METHODS
  Adult patients visiting 21 general practitioners in Brisbane, Australia, were surveyed about ten health behaviours that are risk factors for chronic, non-communicable diseases. Those who completed the self-administered baseline questionnaire entered a randomised controlled trial, with the intervention group receiving computer-tailored printed advice, targeting those health behaviours for which respondents were not meeting current recommendations. The primary outcome was change in summary lifestyle score (Prudence Score) and individual health behaviours at three months. A repeated measures analysis compared change in these outcomes in intervention and control groups after adjusting for age and education.
  
  
  RESULTS
  2306 patients were randomised into the trial. 1711 (76%) returned the follow-up questionnaire at 3 months. The Prudence Score (10 items) in the intervention group at baseline was 5.88, improving to 6.25 at 3 months (improvement = 0.37), compared with 5.84 to 5.96 (improvement = 0.12) in the control group (F = 13.3, p = 0.01). The intervention group showed improvement in meeting recommendations for all individual health behaviours compared with the control group. However, these differences were significant only for fish intake (OR 1.37, 95% CI 1.11-1.68), salt intake (OR 1.19, 95% CI 1.05-1.38), and type of spread used (OR 1.28, 95% CI 1.06-1.51).
  
  
  CONCLUSIONS
  A minimal intervention using computer-tailored feedback to address multiple lifestyle behaviours can facilitate change and improve unhealthy behaviours. Although individual behaviour changes were modest, when implemented on a large scale through general practice, this intervention appears to be an effective and practical tool for population-wide primary prevention.
  
  
  BACKGROUND
  The Australian New Zealand Clinical Trials Registry: ACTRN12611001213932.
authors.affiliation: School of Population Health & Healthy Communities Research Centre, The University of Queensland Herston, Queensland 4006, Australia. s.parekh@uq.edu.au
authors.forename: Sanjoti
authors.initials: S
authors.lastname: Parekh
authors.forename: Corneel
authors.initials: C
authors.lastname: Vandelanotte
authors.forename: David
authors.initials: D
authors.lastname: King
authors.forename: Frances M
authors.initials: FM
authors.lastname: Boyle
mesh_terms: D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology / Q000517:prevention & control; D004032:Diet / Q000592:standards; D005246:Feedback; D005260:Female; D058006:General Practice / Q000379:methods*; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D016017:Odds Ratio; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires