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Published in: BMC Primary Care 1/2010

Open Access 01-12-2010 | Study protocol

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area

Authors: Juan José Rodríguez Cristóbal, Josefa Ma Panisello Royo, Carlos Alonso-Villaverde Grote, José Ma Pérez Santos, Anna Muñoz Lloret, Francisca Rodríguez Cortés, Pere Travé Mercadé, Francisca Benavides Márquez, Pilar Martí de la Morena, Ma José González Burgillos, Marta Delclós Baulies, Domingo Bleda Fernández, Elida Quillama Torres, representing the IMOAP group

Published in: BMC Primary Care | Issue 1/2010

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Abstract

Background

The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity.

Methods

This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months.

Discussion

By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting.

Trial Registration

ClinicalTrials.gov Identifier: NCT01006213
Appendix
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Literature
1.
go back to reference Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Technical report series n.° 894. 2000, Geneva WHO Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Technical report series n.° 894. 2000, Geneva WHO
2.
go back to reference National Institutes of Health: National Heart, Lung and Blood Institute. Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults. The evidence report. Bethesda. 1999 National Institutes of Health: National Heart, Lung and Blood Institute. Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults. The evidence report. Bethesda. 1999
3.
go back to reference Bonow RO, Eckel RH: Diet, obesity, and cardiovascular risk. N Engl J Med. 2003, 348: 2057-8. 10.1056/NEJMp030053.CrossRefPubMed Bonow RO, Eckel RH: Diet, obesity, and cardiovascular risk. N Engl J Med. 2003, 348: 2057-8. 10.1056/NEJMp030053.CrossRefPubMed
4.
go back to reference Ridker PM, Stampfer MJ, Rifai N: Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001, 285: 2481-5. 10.1001/jama.285.19.2481.CrossRefPubMed Ridker PM, Stampfer MJ, Rifai N: Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA. 2001, 285: 2481-5. 10.1001/jama.285.19.2481.CrossRefPubMed
5.
go back to reference Cañizo FJ, Aguilar M, Carral F, Conget I, Costa A, Esteve E: Diabetes Mellitus tipo 2 y factores de riesgo cardiovascular. Nilo industria gráfica S.A. 2003, 103-104. Cañizo FJ, Aguilar M, Carral F, Conget I, Costa A, Esteve E: Diabetes Mellitus tipo 2 y factores de riesgo cardiovascular. Nilo industria gráfica S.A. 2003, 103-104.
6.
go back to reference Dotevall A, Johansson S, Wilhelmsen L: Association between fibrinogen and other risk factors for cardiovascular disease in men and women. Results from the Göteborg MONICA survey 1985. Ann Epidemiol. 1994, 4: 369-74.CrossRefPubMed Dotevall A, Johansson S, Wilhelmsen L: Association between fibrinogen and other risk factors for cardiovascular disease in men and women. Results from the Göteborg MONICA survey 1985. Ann Epidemiol. 1994, 4: 369-74.CrossRefPubMed
7.
go back to reference Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group: Obesity in adulthood and its consequences for life expectancy: A life-table file analysis. Ann Intern Med. 2003, 138: 24-32.CrossRefPubMed Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group: Obesity in adulthood and its consequences for life expectancy: A life-table file analysis. Ann Intern Med. 2003, 138: 24-32.CrossRefPubMed
8.
go back to reference Aranceta J, Foz M, Gil B, Jover E, Mantilla T, Millán J, Monereo S, Moreno B: Documento de consenso: Obesidad y riesgo cardiovascular. Clin Invest Arterioscl. 2003, 15: 196-233. Aranceta J, Foz M, Gil B, Jover E, Mantilla T, Millán J, Monereo S, Moreno B: Documento de consenso: Obesidad y riesgo cardiovascular. Clin Invest Arterioscl. 2003, 15: 196-233.
9.
go back to reference Gutiérrez-Fisac JL, Banegas-Banegas JR, Rodríguez Artalejo F, Regidor E: Increasing prevalence of overweight and obesity among Spanish adults, 1987-1997. Int J Obesity. 2000, 24: 1677-82. 10.1038/sj.ijo.0801445.CrossRef Gutiérrez-Fisac JL, Banegas-Banegas JR, Rodríguez Artalejo F, Regidor E: Increasing prevalence of overweight and obesity among Spanish adults, 1987-1997. Int J Obesity. 2000, 24: 1677-82. 10.1038/sj.ijo.0801445.CrossRef
10.
go back to reference Vázquez R, López JMa: Obesidad: La epidemia del siglo XXI. Rev Esp Econ Sal. 2002, 1: 34-42. Vázquez R, López JMa: Obesidad: La epidemia del siglo XXI. Rev Esp Econ Sal. 2002, 1: 34-42.
11.
go back to reference Sociedad Española para el Estudio de la Obesidad (SEEDO): Consenso SEEDO'2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica. Med Clin (Barc). 2000, 115: 587-597.CrossRef Sociedad Española para el Estudio de la Obesidad (SEEDO): Consenso SEEDO'2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica. Med Clin (Barc). 2000, 115: 587-597.CrossRef
12.
go back to reference Brownell KD, ed: The LEARN program for weight control. 1998, Dallas: American Health Publishing, 7 Brownell KD, ed: The LEARN program for weight control. 1998, Dallas: American Health Publishing, 7
13.
go back to reference Brownell KD, Rodin J: The weight maintenance survival guide. 1990, Dallas:Brownell&Hager Brownell KD, Rodin J: The weight maintenance survival guide. 1990, Dallas:Brownell&Hager
14.
go back to reference Gortmaker SL, Must A, Perrin JM: Social and economic consequences of overweigh in adolescence and young adulthood. New Engl J Med. 1993, 329: 1008-12. 10.1056/NEJM199309303291406.CrossRefPubMed Gortmaker SL, Must A, Perrin JM: Social and economic consequences of overweigh in adolescence and young adulthood. New Engl J Med. 1993, 329: 1008-12. 10.1056/NEJM199309303291406.CrossRefPubMed
15.
go back to reference Barr SI, Yarker KV, Levy-Milne R, Chapman GE: Canadian dietitians' views and practices regarding obesity and weight management. J Hum Nutr Diet. 2004, 17: 503-12. 10.1111/j.1365-277X.2004.00562.x.CrossRefPubMed Barr SI, Yarker KV, Levy-Milne R, Chapman GE: Canadian dietitians' views and practices regarding obesity and weight management. J Hum Nutr Diet. 2004, 17: 503-12. 10.1111/j.1365-277X.2004.00562.x.CrossRefPubMed
16.
go back to reference Steptoe A, Kerry S, Rink E, Hilton S: The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. Am J Public Health. 2001, 91: 265-9. 10.2105/AJPH.91.2.265.CrossRefPubMedPubMedCentral Steptoe A, Kerry S, Rink E, Hilton S: The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. Am J Public Health. 2001, 91: 265-9. 10.2105/AJPH.91.2.265.CrossRefPubMedPubMedCentral
17.
go back to reference Wadden TA, Berkowitz RI, Womble LG, Sarwer DB, Phelan S, Cato RK, Hesson LA, Osei SY, Kaplan R, Stunkard AJ: Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity. N Engl J Med. 2005, 353: 2111-20. 10.1056/NEJMoa050156.CrossRefPubMed Wadden TA, Berkowitz RI, Womble LG, Sarwer DB, Phelan S, Cato RK, Hesson LA, Osei SY, Kaplan R, Stunkard AJ: Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity. N Engl J Med. 2005, 353: 2111-20. 10.1056/NEJMoa050156.CrossRefPubMed
19.
go back to reference Duenas Herrero RM, Aleu Bover M, Gonzalez Tejon I, San Molina L, Salavert Jimenez J, Arranz Marti B: Impact of medical counseling to quit smoking during the process of dehabituation in patients with mental illness. Actas Esp Psiquiatr. 2004, 32: 287-92.PubMed Duenas Herrero RM, Aleu Bover M, Gonzalez Tejon I, San Molina L, Salavert Jimenez J, Arranz Marti B: Impact of medical counseling to quit smoking during the process of dehabituation in patients with mental illness. Actas Esp Psiquiatr. 2004, 32: 287-92.PubMed
20.
go back to reference Wakefield M, Olver I, Whitford H, Rosenfeld E: Motivational interviewing as a smoking cessation intervention for patients with cancer: randomized controlled trial. Nurs Res. 2004, 53: 396-405. 10.1097/00006199-200411000-00008.CrossRefPubMed Wakefield M, Olver I, Whitford H, Rosenfeld E: Motivational interviewing as a smoking cessation intervention for patients with cancer: randomized controlled trial. Nurs Res. 2004, 53: 396-405. 10.1097/00006199-200411000-00008.CrossRefPubMed
21.
go back to reference McCambridge J, Strang J: The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction. 2004, 99: 39-52. 10.1111/j.1360-0443.2004.00564.x.CrossRefPubMed McCambridge J, Strang J: The efficacy of single-session motivational interviewing in reducing drug consumption and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized trial. Addiction. 2004, 99: 39-52. 10.1111/j.1360-0443.2004.00564.x.CrossRefPubMed
22.
go back to reference Burke BL, Arkowitz H, Menchola M: The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003, 71: 843-61. 10.1037/0022-006X.71.5.843.CrossRefPubMed Burke BL, Arkowitz H, Menchola M: The efficacy of motivational interviewing: a meta-analysis of controlled clinical trials. J Consult Clin Psychol. 2003, 71: 843-61. 10.1037/0022-006X.71.5.843.CrossRefPubMed
23.
go back to reference Lugoboni F, Quaglio G, Mezzelani P, Pajusco B, Casari R, Lechi A: Improving compliance in internal medicine: the motivational discussion. Ann Ital Med Int. 2004, 19: 155-62.PubMed Lugoboni F, Quaglio G, Mezzelani P, Pajusco B, Casari R, Lechi A: Improving compliance in internal medicine: the motivational discussion. Ann Ital Med Int. 2004, 19: 155-62.PubMed
24.
go back to reference Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la Fuente L: Valores poblacionales de referencia de la versión española del Cuestionario de Salud SF-36. Med Clin (Barc). 1998, 111: 410-416. Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la Fuente L: Valores poblacionales de referencia de la versión española del Cuestionario de Salud SF-36. Med Clin (Barc). 1998, 111: 410-416.
25.
go back to reference Burke BSR: The diet history as a tool in research. J Am Diet Assoc. 1947, 23: 1041-1046. Burke BSR: The diet history as a tool in research. J Am Diet Assoc. 1947, 23: 1041-1046.
26.
go back to reference Bion WR: Experiencias en grupos. Ed Piadós. Barcelona. 1985 Bion WR: Experiencias en grupos. Ed Piadós. Barcelona. 1985
27.
go back to reference Grinberg L, Langer M, Rodrigué E: Psicoterapia del grupo, Buenos Aires, 1961. Ed Paidós. 1961 Grinberg L, Langer M, Rodrigué E: Psicoterapia del grupo, Buenos Aires, 1961. Ed Paidós. 1961
28.
go back to reference Doyle M, Siegel R, Supe K: Stages of change and transitioning for adolescent patients with obesity and hypertension. Adv Chronic Kidney Dis. 2006, 13: 386-93. 10.1053/j.ackd.2006.07.006.CrossRefPubMed Doyle M, Siegel R, Supe K: Stages of change and transitioning for adolescent patients with obesity and hypertension. Adv Chronic Kidney Dis. 2006, 13: 386-93. 10.1053/j.ackd.2006.07.006.CrossRefPubMed
29.
go back to reference Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, Fiore C, Harlow LL, Redding CA, Rosenbloom D: Stages of change and decisional balance for 12 problems behaviors. Health Psichology. 1994, 13: 39-46. 10.1037/0278-6133.13.1.39.CrossRef Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski W, Fiore C, Harlow LL, Redding CA, Rosenbloom D: Stages of change and decisional balance for 12 problems behaviors. Health Psichology. 1994, 13: 39-46. 10.1037/0278-6133.13.1.39.CrossRef
30.
go back to reference Formiguera i Sala X: Moreno Esteban y el grupo de investigadores del Estudio OBESO. Rev Esp de Obesidad. 2003, S1: 10-19. Formiguera i Sala X: Moreno Esteban y el grupo de investigadores del Estudio OBESO. Rev Esp de Obesidad. 2003, S1: 10-19.
31.
go back to reference Omar RZ, Thompson SG: Analysis of a cluster randomised trial with binary outcome data using a multilevel model. Stat Med. 2000, 19: 2675-88. 10.1002/1097-0258(20001015)19:19<2675::AID-SIM556>3.0.CO;2-A.CrossRefPubMed Omar RZ, Thompson SG: Analysis of a cluster randomised trial with binary outcome data using a multilevel model. Stat Med. 2000, 19: 2675-88. 10.1002/1097-0258(20001015)19:19<2675::AID-SIM556>3.0.CO;2-A.CrossRefPubMed
32.
go back to reference Machin D, Campbell M, Fayers P, Pinol A: Sample Size Tables files for Clinical Studies. 1997, Blackwell Science. Oxford Machin D, Campbell M, Fayers P, Pinol A: Sample Size Tables files for Clinical Studies. 1997, Blackwell Science. Oxford
Metadata
Title
Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area
Authors
Juan José Rodríguez Cristóbal
Josefa Ma Panisello Royo
Carlos Alonso-Villaverde Grote
José Ma Pérez Santos
Anna Muñoz Lloret
Francisca Rodríguez Cortés
Pere Travé Mercadé
Francisca Benavides Márquez
Pilar Martí de la Morena
Ma José González Burgillos
Marta Delclós Baulies
Domingo Bleda Fernández
Elida Quillama Torres
representing the IMOAP group
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2010
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-11-23

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