Evaluation of a 4-week interdisciplinary primary care cardiovascular health programme: impact on knowledge, Mediterranean Diet adherence and biomarkers

Abstract

BackgroundCardiovascular disease (CVD) is the second-leading cause of death among Canadians. Clinical practice guidelines suggest that improvements to lifestyle, including dietary intake, can reduce the risk of CVD.ObjectivesThe primary aim of the study was to evaluate patient changes in adherence to the Mediterranean Diet (Medi-Diet) from baseline to 4-week and 6-month follow-up after participating in a 4-week, group-based, interdisciplinary cardiovascular health programme run by healthcare professionals (HCPs) in a primary care setting. Secondary outcomes included changes in blood pressure, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein cholesterol (HDL-c), triglycerides, non-HDL-c and haemoglobin A1c% from baseline to 6 months, and changes in knowledge scores from baseline to 4 weeks and 6 months. This study further aimed to compare outcomes between in-person programme delivery and virtual programme delivery during the COVID-19 pandemic.MethodsParticipants (n=31) attended the Get Heart Smart (GHS) group-based educational and lifestyle behaviour change programme at the East Elgin Family Health Team for 4 weeks. Participants were 18 years or older and were referred by a HCP or self-referred to the GHS programme. Changes in the above-mentioned outcomes were evaluated. Due to the COVID-19 pandemic, the programme moved to a virtual mode of delivery, with 16 participants completing the programme in a virtual environment. Two-way repeated-measures analyses of variance were performed to explore if there were significant differences from baseline to 4-week and/or 6-month follow-up between groups (in-person compared with virtual) and within the pooled sample.ResultsAt baseline and 4-week follow-up, there were significant between-group differences in knowledge scores. After 6-month follow-up, there were statistically significant within-group improvements in Medi-Diet scores and knowledge scores in the pooled sample (n=31), in-person sample (n=15) and virtual sample (n=16). Apart from triglycerides, changes in biomarkers were all non-significant.ConclusionsThe GHS programme effectively facilitated long-term (6-month) improved cardiovascular/lifestyle knowledge and adherence to the Medi-Diet. Transitioning to a virtual programme delivery did not impact the program’s ability to motivate nutrition-related behaviour change.