2026-04-13T04:23:48Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/66662025-10-24T10:58:02Zcom_2072_378068com_2072_378040col_2072_378090

00925njm 22002777a 4500 dc Zabaleta-del-Olmo, Edurne author Casajuana-Closas, Marc author López-Jiménez, Tomàs author Pombo-Ramos, Haizea author Pujol-Ribera, Enriqueta author Cabezas-Peña, Carmen author Ramos, Rafel author Bolíbar-Ribas, Bonaventura author Martí Lluch, Ruth author Jacques Aviñó, Constanza author Pons-Vigués, Mariona author 2021-12-09T12:16:37Z 2021-12-09T12:16:37Z 2021-12-04 Health behaviour; Health promotion; Hybrid trial Comportamiento de salud; Promoción de la salud; Prueba híbrida Comportament de salut; promoció de la salut; Prova híbrida Background This study aimed to evaluate the effectiveness of a) a Multiple Health Behaviour Change (MHBC) intervention on reducing smoking, increasing physical activity and adherence to a Mediterranean dietary pattern in people aged 45–75 years compared to usual care; and b) an implementation strategy. Methods A cluster randomised effectiveness-implementation hybrid trial-type 2 with two parallel groups was conducted in 25 Spanish Primary Health Care (PHC) centres (3062 participants): 12 centres (1481 participants) were randomised to the intervention and 13 (1581 participants) to the control group (usual care). The intervention was based on the Transtheoretical Model and focused on all target behaviours using individual, group and community approaches. PHC professionals made it during routine care. The implementation strategy was based on the Consolidated Framework for Implementation Research (CFIR). Data were analysed using generalised linear mixed models, accounting for clustering. A mixed-methods data analysis was used to evaluate implementation outcomes (adoption, acceptability, appropriateness, feasibility and fidelity) and determinants of implementation success. Results 14.5% of participants in the intervention group and 8.9% in the usual care group showed a positive change in two or all the target behaviours. Intervention was more effective in promoting dietary behaviour change (31.9% vs 21.4%). The overall adoption rate by professionals was 48.7%. Early and final appropriateness were perceived by professionals as moderate. Early acceptability was high, whereas final acceptability was only moderate. Initial and final acceptability as perceived by the participants was high, and appropriateness moderate. Consent and recruitment rates were 82.0% and 65.5%, respectively, intervention uptake was 89.5% and completion rate 74.7%. The global value of the percentage of approaches with fidelity ≥50% was 16.7%. Eight CFIR constructs distinguished between high and low implementation, five corresponding to the Inner Setting domain. Conclusions Compared to usual care, the EIRA intervention was more effective in promoting MHBC and dietary behaviour change. Implementation outcomes were satisfactory except for the fidelity to the planned intervention, which was low. The organisational and structural contexts of the centres proved to be significant determinants of implementation effectiveness. http://hdl.handle.net/11351/6666 Promoció de la salut Atenció primària Assaigs clínics PUBLIC HEALTH::Health Care (Public Health)::Health Promotion PUBLICATION CHARACTERISTICS::Study Characteristics::Clinical Study::Clinical Trial::Controlled Clinical Trial::Randomized Controlled Trial PUBLIC HEALTH::Health Care (Public Health)::Health Care Levels::Health Care (Public Health)::Primary Health Care SALUD PÚBLICA::atención a la salud (salud pública)::promoción de la salud CARACTERÍSTICAS DE PUBLICACIONES::características del estudio::estudio clínico::ensayo clínico::ensayo clínico controlado::ensayo clínico controlado aleatorizado SALUD PÚBLICA::atención a la salud (salud pública)::niveles de atención a la salud::atención a la salud (salud pública)::atención primaria de la salud Multiple health behaviour change primary care intervention for smoking cessation, physical activity and healthy diet in adults 45 to 75 years old (EIRA study): a hybrid effectiveness-implementation cluster randomised trial