title: The impact of a brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial).
abstract: BACKGROUND
  The risk factors for chronic disease, smoking, poor nutrition, hazardous alcohol consumption, physical inactivity and weight (SNAPW) are common in primary health care (PHC) affording opportunity for preventive interventions. Community nurses are an important component of PHC in Australia. However there has been little research evaluating the effectiveness of lifestyle interventions in routine community nursing practice. This study aimed to address this gap in our knowledge.
  
  
  METHODS
  The study was a quasi-experimental trial involving four generalist community nursing (CN) services in New South Wales, Australia. Two services were randomly allocated to an 'early intervention' and two to a 'late intervention' group. Nurses in the early intervention group received training and support in identifying risk factors and offering brief lifestyle intervention for clients. Those in the late intervention group provided usual care for the first 6 months and then received training. Clients aged 30-80 years who were referred to the services between September 2009 and September 2010 were recruited prior to being seen by the nurse and baseline self-reported data collected. Data on their SNAPW risk factors, readiness to change these behaviours and advice and referral received about their risk factors in the previous 3 months were collected at baseline, 3 and 6 months. Analysis compared changes using univariate and multilevel regression techniques.
  
  
  RESULTS
  804 participants were recruited from 2361 (34.1%) eligible clients. The proportion of clients who recalled receiving dietary or physical activity advice increased between baseline and 3 months in the early intervention group (from 12.9 to 23.3% and 12.3 to 19.1% respectively) as did the proportion who recalled being referred for dietary or physical activity interventions (from 9.5 to 15.6% and 5.8 to 21.0% respectively). There was no change in the late intervention group. There a shift towards greater readiness to change in those who were physically inactive in the early but not the comparison group. Clients in both groups reported being more physically active and eating more fruit and vegetables but there were no significant differences between groups at 6 months.
  
  
  CONCLUSIONS
  The study demonstrated that although the intervention was associated with increases in advice and referral for diet or physical activity and readiness for change in physical activity, this did not translate into significant changes in lifestyle behaviours or weight. This suggests a need to facilitate referral to more intensive long-term interventions for clients with risk factors identified by primary health care nurses.
  
  
  BACKGROUND
  ACTRN12609001081202.
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. m.f.harris@unsw.edu.au.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
authors.forename: Bibiana C
authors.initials: BC
authors.lastname: Chan
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Laws
authors.forename: Anna M
authors.initials: AM
authors.lastname: Williams
authors.forename: Gawaine Powell
authors.initials: GP
authors.lastname: Davies
authors.forename: Upali W
authors.initials: UW
authors.lastname: Jayasinghe
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Fanaian
authors.forename: Neil
authors.initials: N
authors.lastname: Orr
authors.forename: Andrew
authors.initials: A
authors.lastname: Milat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000451:nursing / Q000517:prevention & control; D003153:Community Health Services; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D009736:Nursing Process; D011320:Primary Health Care; D040242:Risk Reduction Behavior