People with multiple unhealthy habits like smoking, high sodium intake and less physical activity, have a better chance to change these habits together than those who deal with these one at a time. Researchers from the Baylor College of Medicine, Houston studied the behaviour modification pattern in 289 participants in the age group of 45–64 years, among which two-thirds were women. All were smokers, and had high blood pressure. The goal was to make them quit smoking, reduce the amount of sodium in their diet, and increase physical activity by at least 10,000 pedometer steps per week. The patients were randomly assigned to one of the three groups. The first received an in-clinic counselling session on all three behaviours every 6 months, as well as motivational telephone calls for 18 months. The second group's intervention was similar, but a different behaviour was addressed every 6 months. The third group received usual care that consisted of a one-time referral to existing group classes. Overall, 230 of the participants completed the study. The findings suggest that the goal of changing two of the three behaviours was achieved in 6.5 per cent of the simultaneous group, 5.2 per cent of the sequential group and 6.5 per cent of the usual care group. Nevertheless, when single behaviours were assessed at 18 months, the simultaneous group did better. Reduction in smoking was achieved by 20 per cent in the simultaneous group, 17 per cent of the sequential group and 10 per cent of the control group. More participants in the simultaneous group also reached the goal of increased physical activity (33 per cent), followed by the sequential group (27 per cent) and the control group (23 per cent). While the simultaneous group was more successful at reducing sodium levels in 6 months, this was not the case by 18 months. However, studies also reveal that although simultaneous counselling appears more successful than sequential counselling, treatment success with the simultaneous approach is likely to be limited to a single behaviour.
Archives of Internal Medicine,
June 2007