van den Brekel-Dijkstra Karolien, Rengers Antonia H, Niessen Maurice A J, de Wit Niek J, Kraaijenhagen Roderik A
Leidsche Rijn Julius Gezondheidscentra, Utrecht, The Netherlands Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
Leidsche Rijn Julius Gezondheidscentra, Utrecht, The Netherlands.
Eur J Prev Cardiol. 2016 Mar;23(5):544-51. doi: 10.1177/2047487315591441. Epub 2015 Jun 16.
The aim of this prospective implementation study is to evaluate feasibility of a personalized prevention approach with use of a web-based health risk assessment for cardiovascular diseases combined with tailored lifestyle feedback and interventions in the community setting.
A random sample of 800 inhabitants of Leidsche Rijn (a newly built residential area in the city of Utrecht) between 45 and 70 years old was invited by their general practitioner to participate in this study and sent a web-based health risk assessment containing a questionnaire, covering socio-demographic variables, family and personal medical history, lifestyle behaviour and psychological variables. The system generates an individual cardiovascular risk based on prognostic modelling. In the case of increased risk further biometric and laboratory evaluation is advised. All participants received tailored web-based feedback with an electronic referral to available medical, psychological and lifestyle interventions in the neighbourhood, or online interventions, and a follow-up questionnaire after six months.
The participation rate was 29% (230/800) of which 39% (89/230) were at increased risk for cardiovascular disease and were advised to perform biometric measures, of which 36% (32/89) actually did. Of these respondents 25% (8/32) had increased blood pressure (≥140/90), 56% (18/32) increased total cholesterol (>6.0 mmol/l).One-third of the participants started changing their lifestyle, 20% indicated planning to do this later; 32% (41/129) increased their physical activity and 28% (36/129) were eating healthier. Seventy-nine per cent of the responders stated their participation was 'meaningful'.
The personalized prevention approach offers a system for integrated risk profiling and individualized health management that was well received in general practice. The client-centred approach, which was embedded in a local community setting, using a web-based health risk assessment with tailored feedback and linkage to regional health management and lifestyle providers proved feasible, and successful. Participating in the health risk assessment elicited actual behaviour change among follow-up survey respondents.
这项前瞻性实施研究的目的是评估在社区环境中，使用基于网络的心血管疾病健康风险评估，并结合量身定制的生活方式反馈和干预措施的个性化预防方法的可行性。
乌得勒支市一个新建住宅区莱德施莱茵的800名年龄在45至70岁之间的居民被他们的全科医生随机抽样邀请参与这项研究，并收到一份基于网络的健康风险评估问卷，涵盖社会人口统计学变量、家庭和个人病史、生活方式行为和心理变量。该系统基于预后模型生成个体心血管风险。如果风险增加，建议进一步进行生物特征和实验室评估。所有参与者都收到了量身定制的基于网络的反馈，包括电子转诊到附近可用的医疗、心理和生活方式干预措施或在线干预措施，以及六个月后的随访问卷。
参与率为29%（230/800），其中39%（89/230）心血管疾病风险增加，并被建议进行生物特征测量，其中36%（32/89）实际进行了测量。在这些受访者中，25%（8/32）血压升高（≥140/90），56%（18/32）总胆固醇升高（>6.0 mmol/l）。三分之一的参与者开始改变他们的生活方式，20%表示计划稍后改变；32%（41/129）增加了体育活动，28%（36/129）饮食更健康。79%的受访者表示他们的参与“有意义”。
个性化预防方法提供了一个综合风险评估和个性化健康管理系统，在全科医疗中得到了广泛认可。以客户为中心的方法，嵌入当地社区环境，使用基于网络的健康风险评估，并提供量身定制的反馈，以及与区域健康管理和生活方式提供者的联系，被证明是可行且成功的。参与健康风险评估在随访调查受访者中引发了实际的行为改变。
