title: Exploring the Range of Lifestyle Interventions Used in Dutch Health Care Practice: A Qualitative Description.
abstract: BACKGROUND
  The application of evidence-based lifestyle interventions is suboptimal, but little is known what interventions are actually used. This study aimed to explore the range of lifestyle interventions used in Dutch ambulatory health care settings.
  
  
  METHODS
  We conducted interviews (n = 67) in purposefully selected hospitals, general practices, and community care organizations. Interviews focused on identifying activities to help patients stop smoking, reduce alcohol consumption, increase physical activity, eat a healthy diet, and lose weight. We also asked who developed the interventions. All reported activities were registered and analyzed.
  
  
  RESULTS
  Four categories of health promotion activities emerged: giving advice, making referrals, offering counseling, and providing lifestyle interventions organized separately from the care process. In total, 102 lifestyle interventions were reported. Forty-five interventions were developed by researchers, of which 30 were developed by the Dutch Expert Center on Tobacco Control. Providers did not know the source of 31 interventions. Eighteen interventions were developed by the providers themselves, and eight were based on evidence-based guidelines.
  
  
  CONCLUSIONS
  Health promotion activities seemed to be widely present in Dutch health care, in particular smoking cessation interventions. Although health care providers use many different interventions, replacing nontested for evidence-based interventions is required.
authors.affiliation: IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands irene.vandeglind@radboudumc.nl.
authors.forename: Irene M
authors.initials: IM
authors.lastname: van de Glind
authors.affiliation: IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Maud M
authors.initials: MM
authors.lastname: Heinen
authors.affiliation: IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Wytske W
authors.initials: WW
authors.lastname: Geense
authors.affiliation: Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.affiliation: IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.affiliation: IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.
authors.forename: Theo
authors.initials: T
authors.lastname: van Achterberg
mesh_terms: D000428:Alcohol Drinking / Q000517:prevention & control; D003153:Community Health Services / Q000379:methods; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data*; D000072001:Diet, Healthy; D015444:Exercise; D058006:General Practice / Q000379:methods; D006293:Health Promotion / Q000379:methods; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D009426:Netherlands; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D000074606:Smoking Prevention
keywords: dissemination; health care providers; health promotion; implementation; lifestyle