Issue: December 2015
November 10, 2015
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Fifty-Fifty Study: Peer group support proves beneficial for CV health

Issue: December 2015
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ORLANDO, Fla. — A peer group-based lifestyle management program had a beneficial impact on CV risk factors, according to data from the Fifty-Fifty Program.

Participants of the peer group-based program exhibited significant improvement in the Fuster-BEWAT score, a composite score related to BP, exercise, weight, alimentation and tobacco [use], with particular benefit seen on smoking cessation, Valentin Fuster, MD, PhD, physician-in-chief at Mount Sinai Medical Hospital and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, N.Y., reported at the American Heart Association Scientific Sessions.

Valentin Fuster, MD

Valentin Fuster

The multicenter trial, conducted in seven communities in Spain, included 543 participants (mean age, 42 years; 71% women) with at least one CV risk factor, including overweight (82%), lack of physical activity (81%), smoking (31%) and hypertension (20%). All participants attended six workshops on lifestyle modifications and CV risk factors during a run-in phase and were then randomly assigned to a peer group-based intervention (n = 277) or self-management (n = 266; control group).

The intervention groups included 10 participants each, with two members elected by the group to serve as peer leaders. The peer leaders received additional education on health information related to lifestyle modifications and held monthly meetings lasting 60 to 90 minutes with their groups, with the goal of reducing CVD risk by promoting physical activity, improved dietary behavior and smoking cessation.

“Peer support is a proven beneficial strategy for substance abuse. Why not consider a similar peer support strategy to modify CV global risk factors and behavior?” Fuster said during a presentation here.

The primary outcome was mean change in the Fuster-BEWAT score at 1 year. The mean Fuster-BEWAT score was 8.42 ± 2.35 at baseline.

In an intention-to-treat analysis at 1 year, the peer group-based intervention group had a significantly higher mean Fuster-BEWAT score compared with the control group (8.84 vs. 8.17; P = .02). The increase in the overall score was also significantly greater among those who participated in the intervention (difference, 0.75; P = .02). Analysis of individual components of the Fuster-BEWAT score indicated greater improvement in all five components in the intervention group, with a significant difference for tobacco use.

Fuster reported that a per-protocol analysis of 456 participants with evaluable 1-year follow-up data yielded similar results, with a significantly greater overall score and a greater mean increase in the peer group-based intervention group compared with the control group.

“Wider adoption of such a program may have a meaningful impact on CV health promotion,” Fuster concluded. “A follow-up assessment will be performed 1 year after these final results … to determine long-term sustainability of the improvements.” – by Adam Taliercio

References:

Fuster V, et al. Late-Breaking Clinical Trials 2. Presented at: American Heart Association Scientific Sessions; Nov. 7-11, 2015; Orlando, Fla.

Gomez E, et al. J Am Coll Cardiol. 2015;doi:10.1016/j.jacc.2015.10.033.

Disclosure: Fuster reports no relevant financial disclosures.