2026-04-17T04:09:53Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/66662025-10-24T10:58:02Zcom_2072_378068com_2072_378040col_2072_378090
RECERCAT
author
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
2025-10-24T10:58:02Z
2025-10-24T10:58:02Z
2021-12-09T12:16:37Z2021-12-09T12:16:37Z2021-12-04
http://hdl.handle.net/11351/6666
Health behaviour; Health promotion; Hybrid trialComportamiento de salud; Promoción de la salud; Prueba híbridaComportament de salut; promoció de la salut; Prova híbridaBackground
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.
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess
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
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion