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Primary prevention of diabetes mellitus type 2 and cardiovascular diseases using a cognitive behaviour programme aimed at lifestyle changes in subjects with abdominal obesity

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Partly because of the ageing population, and partly due to changes in lifestyle and the resulting epidemic of obesity, the percentage of people with cardiovascular diseases (CVD) and diabetes mellitus type 2 (DM2) is growing rapidly. The high prevalence and increasing incidence of CVD and DM2 show that these diseases are an important health problem that imposes a significant burden to society. CVD and DM2 are to a large extent caused by lifestyle dependent risk factors, such as overweight, reduced physical activity, and an unhealthy diet. Changing these risk factors has the potential to postpone or prevent the development of CVD or DM2. The objective of the study is to assess the effects and cost-effectiveness of a cognitive behaviour intervention in subjects at risk for CVD or DM2. All inhabitants aged 30-50 living in several municipalities in the semi-rural region of West-Friesland will be invited in a two-step screening procedure. In the first step subjects will receive an invitation to measure their own waist circumference with a tape measure. Subjects with abdominal obesity (based on the waist circumference) are invited for the second step of the screening, including blood pressure, taking a blood sample and anthropometric measurements. With these measurements subjects with a moderate or high risk of CVD or a high risk of DM2 can be identified. These subjects will be randomly assigned to an intervention group and a control group. The intervention group will receive a cognitive behaviour programme (CBP) consisting of motivational interviewing and problem solving therapy, a programme that in particular is focussed on motivation and the self-management of the subjects. The CBP will be given by nurse practitioners at general practices and consists of six individual sessions of 30 minutes. It aims to increase the subjects' motivation and ability to change their lifestyle. A manual will be used to guide the treatment, which included worksheets that will be used during the visits at the general practice and also by the subjects at home. The CBP will be followed by 3-monthly booster sessions by phone or e-mail, to provide a reminder, to the subjects, to reinforce what is learned and to give support and feedback. The subjects in the control group will receive written information about their risk of CVD and/or DM2, and existing brochures on health guidelines regarding physical activity and diet, and on smoking cessation. Baseline measurements and different follow-up measurements (after 6, 12 and 24 months) are used to explore short-term and long-term effects. Effects will be assessed in terms of changes in cardiovascular risk profile and changes in risk of developing diabetes. Furthermore, changes in dietary, physical activity, and smoking behaviour will be assessed. An economic evaluation will be performed after 24 months from the societal perspective and from the perspective of the health insurer.

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Projectnummer:
62300041
Looptijd: 100%
Looptijd: 100 %
2007
2011
Onderdeel van programma:
Projectleider en penvoerder:
Verantwoordelijke organisatie:
Amsterdam UMC - locatie VUmc