Feasibility of a lifestyle cardiovascular health promotion programme for 8--15-year-olds in irish general practice: results of the galway health project

Abstract

Health promotion initiatives in general practice suggest moderate benefit for adults, but little evidence in children. This study assessed the feasibility of a cardiovascular programme for 8-15-year-olds targeted at smoking, exercise and diet. Following an initial needs assessment of 56 general practitioners (response rare 69%), 12 practices were randomized to a I-year factorial intervention study based on nurse- or doctor-led clinics offered opportunistically at surgery attendance or by recall from age-sex register. A purpose-designed information programme was used by both doctors and nurses at a 10-min appointment session. All participants completed a baseline questionnaire and were followed up I year later As part of the intervention, 516 people were seen; half to nurse-led recall clinics (15% attendance rate). Doctors reported lack of time to organize recall clinics though attendance at both types of opportunistic clinics was similar. Families from higher socio-economic groups were significantly over-represented among attenders (Chi square 31.64, p < 0.0001); 29% of adults and 16% of 12-15-year-olds were current smokers at baseline. There were high satisfaction levels (98%) among attendees with the educational materials. There were significant gains in several nutrition and exercise knowledge indicators at follow-up among both children and adults. A survey of a 10% sample of non-attenders revealed that inconvenience of appointment was the largest obstacle to attendance (71 %). A survey of 35 local schools in the catchment area revealed that the target topics were covered in the curriculum, but no concerted life skills programme was in place. For programmes to have an impact, nurse clinic resources and an adequate age-sex register are needed; there are considerable economic implications. Association with skill-based schools programmes would facilitate action on advice received in line with a multi-sectoral approach.