Spielmann Marie, Krolo-Wicovsky Filipa, Tiede Anika, John Ulrich, Freyer-Adam Jennis
Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany.
Eur J Public Health. 2025 Aug 1;35(4):635-641. doi: 10.1093/eurpub/ckaf035.
Although behavior change interventions are highly recommended in health care, their reach, a core dimension of the public health impact of interventions, is rarely evaluated. This study aimed to investigate whether an individualized, computer-based brief intervention to reduce co-occurring health risk behaviors (HRBs), namely tobacco smoking, at-risk alcohol use, insufficient physical activity, and unhealthy diet, can reach and retain a sufficiently large part of general hospital patients (>75%) and whether patients with high need, that is with more HRBs, low school education or current unemployment may be sufficiently reached and retained. Over 6 weeks in 2022, all 18-64-year-old patients admitted to 11 wards of five medical departments of a university hospital in Germany were asked to participate in a computer-based HRB screening and in a pre-post intervention study with three further assessments and individualized computer-generated feedback. To investigate associations between intervention reach and retention and patient characteristics, a logistic and a Poisson regression analysis were used. Screening reached 78.9% of all eligible patients (225/285). Of those eligible for the intervention study, 81.8% (175/214) participated in the intervention. Among these, 76.0% (133/175) participated at least once more after hospitalization. Patients' lifestyle and socio-economic characteristics were not significantly associated with reach or retention, Ps ≥ .467. Proactive computer-based multiple-HRB change interventions may reach and retain a sufficiently large part of general hospital patients, including those most in need. When proven efficacious and adequately implemented, this is a promising approach concerning public health impact in the reduction non-communicable diseases. Trial registration: ClinicalTrials.gov NCT05365269, 9 May 2022.
尽管行为改变干预措施在医疗保健中受到强烈推荐，但作为干预措施对公共卫生影响的一个核心维度，其覆盖范围却很少得到评估。本研究旨在调查一种基于计算机的个性化简短干预措施，以减少同时出现的健康风险行为（HRB），即吸烟、危险饮酒、缺乏体育锻炼和不健康饮食，能否覆盖并留住足够多的综合医院患者（>75%），以及高需求患者，即有更多HRB、低学历或当前失业的患者是否能被充分覆盖并留住。在2022年的6周时间里，德国一家大学医院五个医学科室的11个病房收治的所有18 - 64岁患者被要求参与基于计算机的HRB筛查以及一项干预前后的研究，该研究还包括另外三次评估和个性化的计算机生成反馈。为了调查干预覆盖范围和留存率与患者特征之间的关联，使用了逻辑回归和泊松回归分析。筛查覆盖了所有符合条件患者的78.9%（225/285）。在符合干预研究条件的患者中，81.8%（175/214）参与了干预。其中，76.0%（133/175）在出院后至少再次参与了一次。患者的生活方式和社会经济特征与覆盖范围或留存率没有显著关联，P值≥0.467。基于计算机的主动式多HRB改变干预措施可能会覆盖并留住足够多的综合医院患者，包括那些最有需求的患者。当被证明有效并得到充分实施时，这是一种在减少非传染性疾病方面对公共卫生影响很有前景的方法。试验注册：ClinicalTrials.gov NCT05365269，2022年5月9日。
