Physical activity and nutrition programs for couples: a randomized controlled trial.

Diet and physical activity habits may deteriorate after cohabitation, leading to weight gain and increased risk of lifestyle diseases. We carried out a 4-month, randomized controlled trial of a diet and physical activity program for couples with a 1-year follow-up, comparing two methods of delivery. The program used six modules, which, after an initial group session, were mailed to the low-level intervention group. In the high-level intervention group, half of the modules were mailed, and the others were delivered at interactive group sessions. A control group received no intervention. Postintervention and at follow-up, physical fitness improved in the high-level group, saturated fat intake decreased in both intervention groups, and low-density lipoprotein cholesterol fell in the high-level group. Fewer participants in the high-level group became overweight or obese. Health promotion for couples can improve health behaviors and potentially lower the risk of lifestyle diseases in participants and their future families.

Changes in cognitive measures in a randomized controlled trial of a health promotion program for couples targeting diet and physical activity.

PURPOSE: To examine cognitive responses to a 4-month health promotion program targeting diet and physical activity in recently cohabiting couples. DESIGN: A three-group randomized controlled trial: no intervention (Controls), interactive group sessions and mail-outs (Interactive), and one group session followed by mail-outs (Mail). SETTING: Australian research studies unit. SUBJECTS: Seventy-eight of 137 couples cohabiting for < 2 years, recruited by advertising, completed the study. MEASURES: Stages of change; health beliefs; self-efficacy; and perceived barriers to change evaluated by questionnaires at baseline, postintervention, and 1-year follow-up. Data were analyzed using mixed models, factor analysis, and linear regression. RESULTS: In the Mail group, the perceived importance of barriers to dietary change decreased by 19% at postintervention and 16% at 1-year follow-up; dietary self-efficacy increased by 9% and 3%, respectively. In the Interactive group, the perceived importance of barriers to dietary change decreased by 26% and 20%, and dietary self-efficacy increased by 14% and 12%, respectively. Similar trends for physical activity were not statistically significant. However, changes in self-efficacy and perceived barriers to change significantly predicted dietary and physical activity behaviors. A preponderance of higher socio-economic groups and the proportion of drop-out may have biased results. CONCLUSIONS: Health promotion using partners' support and targeting diet and physical activity improves associated cognitive variables in couples. Most improvements were greater and more sustained with interactive group sessions.

An innovative program for changing health behaviours.

Health-related behaviours affecting diet, weight control and physical activity are important for long-term cardiovascular health but behaviour change is difficult to initiate and even more difficult to maintain. We have developed a health promotion program, in which social support has a key role, to encourage a prudent diet, weight control and physical activity. Behaviour change is based on evaluating initial behaviour, weighing up costs and benefits, assessing barriers to change and goal-setting. We first evaluated the program in couples beginning to live together, a group chosen because of the risk of weight gain and decreased physical activity after marriage, readiness to change behaviour at that time in the life course and the opportunity to use partner's support in achieving behaviour change. In an initial short-term study with 39 couples, intake of fat and take-away foods decreased and consumption of fruit, vegetables and reduced fat foods increased. Physical activity increased and there was a 6% fall in blood cholesterol. Further evaluation in 137 couples included assessment after 12 months. A decrease in fat intake and increase in physical activity and fitness seen at the end of the program persisted 1 year later. Lower cholesterol and a trend to lower weight gain and lower blood pressure were also maintained after 12 months. We have modified the program aiming for weight loss, improved dietary habits and increased physical activity in overweight treated hypertensives, supported by their partners. Decreased intake of energy, total and saturated fat, and weight loss seen at the end of the 16 week program was significantly greater in the intervention group than with usual care. Blood pressure fell in the program group at the end of intervention and, in men, withdrawal of antihypertensive drugs was significantly associated with the intervention. Weight loss and a decrease in waist circumference were maintained in the program group up to 16 months after entering the study. This program has the potential for wider application in other at-risk groups.