ArticleBMC family practice2015
The implementation and sustainability of a combined lifestyle intervention in primary care: mixed method process evaluation.
Article in BMC family practice, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Systematic review of process evaluations of interventions in trials investigating sedentary behaviour in adults.BMJ open · 2022Pooled it
- A systematic review of the use and reporting of evaluation frameworks within evaluations of physical activity interventions.The international journal of behavioral nutrition and physical activity · 2020Pooled it
- Sustainability of implementation of health-promotion practice in primary healthcare: a non-randomized parallel group study.BMC health services research · 2026Trial
- Intervention Mapping: A Framework to Co-Design the ALAPAGE Programme to Simultaneously Improve Dietary Diversity and Physical Fitness Among Older People.Health expectations : an international journal of public participation in health care and health policy · 2026Trial
- The Effect and Cost-Effectiveness of Offering a Combined Lifestyle Intervention for the Prevention of Cardiovascular Disease in Primary Care: Results of the Healthy Heart Stepped-Wedge Trial.International journal of environmental research and public health · 2023Trial
- Trial
- The coaching on lifestyle (CooL) intervention for obesity, a study protocol for an action-oriented mixed-methods study.BMC public health · 2018Trial
- Process evaluation of a randomised controlled trial of a diabetes prevention intervention in Dutch primary health care: the SLIMMER study.Public health nutrition · 2016Trial
- Trial
- Exploring working mechanism of an implementation strategy bundle on the implementation of a lifestyle intervention for community-dwelling older adults: process evaluation of a stepped wedge trial.Implementation science communications · 2026Article
- Implementing a multimodal lifestyle intervention for depression and overweight in primary and secondary care: protocol for an implementation study exploring what works, how, and under what conditions.Implementation science communications · 2026Article
- Community-Based Combined Lifestyle Interventions for Children with Overweight or Obesity: Exploring the Professional Teams Composition and Approach to Collaboration.Children (Basel, Switzerland) · 2026Article
- Proactive health behaviour intervention strategies for older T2DM patients with multimorbidity: protocol for a cluster randomised controlled trial with hybrid type 2 effectiveness-implementation design.BMC primary care · 2026Article
- Article
- Promoting the implementation of a computer-tailored physical activity intervention: development and feasibility testing of an implementation intervention.Implementation science communications · 2024Article
- Implementation of a group-based lifestyle intervention programme (Healthy Heart) in general practices in The Netherlands: a mixed-methods study.BJGP open · 2023Article
- Implementation of Combined Lifestyle Interventions for Children with Overweight or Obesity: Experiences of Healthcare Professionals in Multiple Communities.International journal of environmental research and public health · 2023Article
- Identifying existing approaches used to evaluate the sustainability of evidence-based interventions in healthcare: an integrative review.Systematic reviews · 2022Review
- Barriers and facilitators on the implementation of physical activity in Primary Health Care: A systematic review.Preventive medicine reports · 2022Review
- [Health promotion initiatives aimed at young adults. Qualitative study].Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of physical inactivity and unhealthy diet on health is increasingly profound. Lifestyle interventions targeting both behaviors simultaneously might decrease the prevalence of overweight and comorbidities. The Dutch 'BeweegKuur' is a combined lifestyle intervention (CLI) in primary care, to improve physical activity and dietary behavior in overweight people. In a cluster randomized controlled trial, the (cost-) effectiveness of an intensively guided program has been compared to a less intensively guided program. This process evaluation aimed to assess protocol adherence and potential differences between clusters. In addition, sustainability (i.e. continuation of the CLI in practice after study termination) was evaluated.
methodsExisting frameworks were combined to design the process evaluation for our intervention and setting specifically. We assessed reach, fidelity, dose delivered and received, context and implementation strategy. Both qualitative and quantitative data were used for a comprehensive evaluation. Data were collected in semi-structured interviews with health care providers (HCPs, n = 25), drop-out registration by HCPs, regular questionnaires among participants (n = 411) and logbooks kept by researchers during the trial.
resultsProtocol adherence by professionals and participants varied between the programs and clusters. In both programs the number of meetings with all HCPs was lower than planned in the protocol. Participants of the supervised program attended, compared to participants of the start-up program, more meetings with physiotherapists, but fewer with lifestyle advisors and dieticians. The 'BeweegKuur' was not sustained, but intervention aspects, networks and experiences were still utilized after finalization of the project. Whether clusters continued to offer a CLI seemed dependent on funding opportunities and collaborations.
conclusionsProtocol adherence in a CLI was problematic in both HCPs and participants. Mainly the amount of dietary guidance was lower than planned, and decreased with increasing guidance by PT. Thus, feasibility of changing physical activity and dietary habits simultaneously by one intervention in one year was not as high as expected. Also the sustainability of CLI was poor. When a CLI program is started, re-invention should be allowed and maximum effort should be taken to guarantee long term continuation, by planning both implementation and sustainability carefully.
trial registrationCurrent Controlled Trials ISRCTN46574304 . Registered 23 December 2010.
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