Waste the waist:

A pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk

Colin Greaves, Fiona Gillison, Afroditi Stathi, Paul Bennett, Prasuna Reddy, Rachel Perry, Daniel Messom, Roger Chandler, Margaret Francis, Mark Davis, Colin Green, Philip Evans, Gordon Taylor

Research output: Contribution to journalArticle

9 Citations (Scopus)
80 Downloads (Pure)

Abstract

Background
In the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight.

Methods
Patients aged 40–74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months.

Results
108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: −4.8 to −0.3, p = 0.025). No significant differences were found in physical activity.

Conclusions
The Waste the Waist intervention is deliverable in UK primary care, has acceptable recruitment and retention rates and produces promising preliminary weight loss results. Subject to refinement of the physical activity component, it is now ready for evaluation in a full-scale trial.
Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume12
Issue number1
DOIs
Publication statusPublished - 16 Jan 2015

Keywords

  • weight loss
  • behaviour change
  • diet
  • physical activity
  • randomised controlled trial
  • pilot trial

Cite this

Waste the waist: A pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk. / Greaves, Colin; Gillison, Fiona; Stathi, Afroditi; Bennett, Paul; Reddy, Prasuna; Perry, Rachel; Messom, Daniel; Chandler, Roger; Francis, Margaret; Davis, Mark; Green, Colin; Evans, Philip; Taylor, Gordon.

In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 12, No. 1, 16.01.2015, p. 1-13.

Research output: Contribution to journalArticle

Greaves, Colin ; Gillison, Fiona ; Stathi, Afroditi ; Bennett, Paul ; Reddy, Prasuna ; Perry, Rachel ; Messom, Daniel ; Chandler, Roger ; Francis, Margaret ; Davis, Mark ; Green, Colin ; Evans, Philip ; Taylor, Gordon. / Waste the waist: A pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk. In: International Journal of Behavioral Nutrition and Physical Activity. 2015 ; Vol. 12, No. 1. pp. 1-13.
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T2 - A pilot randomised controlled trial of a primary care based intervention to support lifestyle change in people with high cardiovascular risk

AU - Greaves, Colin

AU - Gillison, Fiona

AU - Stathi, Afroditi

AU - Bennett, Paul

AU - Reddy, Prasuna

AU - Perry, Rachel

AU - Messom, Daniel

AU - Chandler, Roger

AU - Francis, Margaret

AU - Davis, Mark

AU - Green, Colin

AU - Evans, Philip

AU - Taylor, Gordon

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N2 - BackgroundIn the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight.MethodsPatients aged 40–74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months.Results108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: −4.8 to −0.3, p = 0.025). No significant differences were found in physical activity.ConclusionsThe Waste the Waist intervention is deliverable in UK primary care, has acceptable recruitment and retention rates and produces promising preliminary weight loss results. Subject to refinement of the physical activity component, it is now ready for evaluation in a full-scale trial.

AB - BackgroundIn the UK, thousands of people with high cardiovascular risk are being identified by a national risk-assessment programme (NHS Health Checks). Waste the Waist is an evidence-informed, theory-driven (modified Health Action Process Approach), group-based intervention designed to promote healthy eating and physical activity for people with high cardiovascular risk. This pilot randomised controlled trial aimed to assess the feasibility of delivering the Waste the Waist intervention in UK primary care and of conducting a full-scale randomised controlled trial. We also conducted exploratory analyses of changes in weight.MethodsPatients aged 40–74 with a Body Mass Index of 28 or more and high cardiovascular risk were identified from risk-assessment data or from practice database searches. Participants were randomised, using an online computerised randomisation algorithm, to receive usual care and standardised information on cardiovascular risk and lifestyle (Controls) or nine sessions of the Waste the Waist programme (Intervention). Group allocation was concealed until the point of randomisation. Thereafter, the statistician, but not participants or data collectors were blinded to group allocation. Weight, physical activity (accelerometry) and cardiovascular risk markers (blood tests) were measured at 0, 4 and 12 months.Results108 participants (22% of those approached) were recruited (55 intervention, 53 controls) from 6 practices and 89% provided data at both 4 and 12 months. Participants had a mean age of 65 and 70% were male. Intervention participants attended 72% of group sessions. Based on last observations carried forward, the intervention group did not lose significantly more weight than controls at 12 months, although the difference was significant when co-interventions and co-morbidities that could affect weight were taken into account (Mean Diff 2.6Kg. 95%CI: −4.8 to −0.3, p = 0.025). No significant differences were found in physical activity.ConclusionsThe Waste the Waist intervention is deliverable in UK primary care, has acceptable recruitment and retention rates and produces promising preliminary weight loss results. Subject to refinement of the physical activity component, it is now ready for evaluation in a full-scale trial.

KW - weight loss

KW - behaviour change

KW - diet

KW - physical activity

KW - randomised controlled trial

KW - pilot trial

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DO - 10.1186/s12966-014-0159-z

M3 - Article

VL - 12

SP - 1

EP - 13

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

SN - 1479-5868

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