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CDPS = chronic disease prevention and screening. PP = prevention practitioner.
↵ awhere possible
BETTER triala BETTER 2 Characteristic n = 209 Remotebn = 57 Ruralbn = 23 Urbanbn = 74 Totaln = 154 Female, n (%) 138 (66) 41 (72) 20 (87) 58 (78) 119 (77) Mean a ge , years (SD) 53 (6.7) 55 (6.7) 57 (6.7) 56 (7.0) 56 (6.8) Ethnic group, n (%) European 184 (88) 22 (39) 16 (94) 65 (88) 103 (67) Indigenous 2 (1) 28 (49) 0 (0) 0 (0) 28 (18) Other 23 (11) c c c 5 (3) Citizenship, n (%) Canadian 161 (77) 56 (98) 23 (100) 67 (91) 146 (95) Other 48 (23) c c 7 (10) 8 (5) Education, n (%) High school or lower 25 (12) 3 (5) 14 (61) 5 (7) 22 (14) Some college/university 144 (69) 46 (81) 8 (35) 46 (62) 100 (65) Graduate degree 40 (19) c c 21 (29) 29 (19) Employment, n (%) Fully employed 140 (67) 34 (60) 6 (26) 44 (60) 84 (55) Retired 10 (5) 10 (18) 7 (30) 17 (23) 34 (22) Other 59 (28) 13 (23) 9 (39) 12 (16) 34 (22) Married or c ommon l aw, n (%) 155 (74) 47 (82) 21 (91) 54 (73) 122 (79) Income, n (%) <$60 000 40 (19) 7 (12) 10 (53) 19 (26) 36 (23) $60 000–$99 999 65 (31) 17 (30) 7 (37) 15 (20) 39 (25) ≥$100 000 104 (50) 23 (40) 2 (11) 30 (41) 55 (36) Current s moker , n (%) 31 (15) 10 (18) 1 (4) 6 (8) 17 (11) Alcohol c onsumption , n (%) Never 31 (15) 8 (14) 5 (23) 13 (18) 26 (17) Less than weekly 100 (48) 36 (63) 10 (43) 27 (37) 73 (47) Weekly or more 77 (37) 13 (23) 7 (30) 33 (45) 53 (35) Exercise, n (%): <150 minutes/week 169 (81) 39 (68) 12 (52) 33 (45) 84 (55) ≥150 minutes/week 40 (19) 18 (32) 11 (48) 41 (55) 70 (45) Mean BMI (SD) 26 (5.8) 33 (6.2) 31 (4.2) 30 (5.6) 31 (5.7) BMI ≥30, n (%) 52 (25) 35 (61) 13 (57) 34 (46) 82 (53) Mean w aist c irc , cm (SD) 108 (4) 102 (14) 108 (10) 99 (13) 101 (13) Diabetes m ellitus , n (%) 15 (7) 11 (19) 1 (4.8) 10 (14) 14 (9) Coronary a rtery d is ease , n (%) 10 (5) 11 (19) 11 (48) 9 (12) 32 (21) Family h istory of…, n (%) Breast cancer 31 (15) c c c 9 (6) Colorectal cancer 23 (11) c c 2 (1) Circ = circumference. Dis = disease. SD = standard deviation.
aBETTER trial demographics for patients receiving the prevention practitioner intervention are presented for comparison purposes. bSee Method section for an expanded description of study sites. cSuppressed for privacy reasons because of small numbers.
- Table 2. Prevention and screening actions by study (BETTER trial, BETTER 2) and randomisation groupa
BETTER trial BETTER 2 Control PP Patients, n 183 209 154 Eligible actions, mean (SD)b 9.1 (3.4) 8.9 (3.2) 12.3 (2.8) Achieved actions, mean (SD)c 1.9 (1.8) 4.7 (2.7) 6.0 (3.1) Actions achieved, % (SD) 21.0 (17.5) 53.6 (26.0) 49.3 (25.0) PP = prevention practitioner.
aRandomisation group applies only to the BETTER trial.
bThe number of actions patients were eligible to improve at baseline.
cThe number of eligible actions achieved at follow-up.
Prevention and screening actionsa Eligibleb Achievedc n % n % 95% CI Screening 1. FBS or HbA1c monitoring (n = 145) 3 2.1 1 33.3 0.8 to 90.6 2. BP monitor (n = 153) 6 3.9 1 16.7 0.4 to 64.1 3. Cervical cancer screen (n = 90) 8 8.9 6 75 34.9 to 96.8 4. Breast cancer screen (n = 115) 16 13.9 12 75 47.6 to 92.7 5. BP screen (n = 153) 26 17.0 15 57.7 36.9 to 76.7 6. CRC screen (n = 154) 36 23.4 14 38.9 23.1 to 56.5 7. LDL measured (n = 153) 40 26.1 25 62.5 45.8 to 77.3 8. FBS or HbA1c screen (n = 154) 45 29.2 20 44.4 29.6 to 60.0 9. Smoking screen (n = 154) 65 42.2 24 36.9 25.3 to 49.8 10. Alcohol use screen (n = 154) 99 64.3 48 48.5 38.3 to 58.8 11. Physical activity screen (n = 154) 104 67.5 63 60.6 50.5 to 70.0 12. Nutrition screen (n = 154) 129 83.8 53 41.1 32.5 to 50.1 13. BMI screen (n = 154) 131 85.1 108 82.4 74.8 to 88.5 14. Waist circumference recorded (n = 154) 147 95.5 123 83.7 76.7 to 89.3 Treatment i nitiation or r eferral 15. Cholesterol treatment (n = 121) 2 1.7 2 100 15.8 to 100.0 16. Referral smoking cessation (n = 154) 22 14.3 5 22.7 7.8 to 45.4 17. Referral alcohol cessation (n = 154) 104 67.5 4 3.9 1.1 to 9.6 18. Referral nutrition (n = 154) 123 79.9 44 35.8 27.3 to 44.9 19. Referral physical activity (n = 153) 130 85.0 36 27.7 20.2 to 36.2 20. Referral weight control (n = 151) 132 87.4 58 43.9 35.3 to 52.8 Risk m odification 21. LDL improvement (n = 121) 18 14.9 11 61.1 35.8 to 82.7 22. Smoking cessation (n = 154) 22 14.3 8 36.4 17.2 to 59.3 23. Hypertension control (n = 153) 29 19.0 24 85.7 67.3 to 96.0 24. At risk alcohol improvement (n = 154) 79 51.3 32 60.4 46.0 to 73.4 25. Diet score improvement (n = 154) 123 79.9 54 62.1 51.0 to 72.3 26. Physical activity improvement (n = 153) 130 85.0 61 67 56.4 to 76.5 27. Overweight stabilisation (n = 151) 132 87.4 67 50.8 41.9 to 59.6 BMI = body mass index. BP = blood pressure. CI = confidence intervals. CRC = colorectal cancer. FBS = fasting blood sugar. HbA1c = haemoglobin A1C. LDL = low-density lipoprotein.
aComplete description of each item available from the authors on request. This column includes the number of participants for whom this CDPS action was assessable at follow-up. Action items intended for women were only assessed for female participants (n = 119). bIndicates the patients who were eligible to improve the action at baseline. cOf the patients who were eligible at baseline, indicates the patients who accomplished the action at follow-up.
- Table 4. Demographic and clinical characteristics associated with differences in composite outcome score
Bivariate models Multivariate modela Δ Outcome (95% CI)b P value Δ Outcome ( 95% CI) b P value Female -7.3 (-13.3 to -1.3) 0.02 -13.8 (-18.9 to -8.7) <0.001 Age, years 0.5 (0.1 to 0.9) 0.02 0.0 (-0.5 to 0.5) 0.99 Ethnicity: European reference — reference — Indigenous -0.8 (-10.9 to 9.3) 0.87 -4.9 (-12.2 to 2.5) 0.20 Other 7.1 (-9.4 to 23.7) 0.40 6.1 (-7.0 to 19.1) 0.36 Citizenship: Canadian reference — reference — Non-Canadian 10.9 (2.4 to 19.4) 0.01 5.3 (-5.3 to 15.9) 0.33 Education: ≤High school reference — reference — Some college/university 12.1 (3.7 to 20.5) 0.005 13.7 (0.3 to 27.0) 0.04 Graduate degree 18.0 (11.6 to 24.4) <0.001 21.6 (6.1 to 37.0) 0.006 Employment: Fully employed reference — reference — Retired 2.8 (-2.5 to 8.2) 0.30 -3.7 (-11.0 to 3.5) 0.31 Other 0.1 (-5.9 to 6.0) 0.98 -2.1 (-9.9 to 5.6) 0.59 Relationship: Partnered reference — reference — Non-partnered 3.0 (-3.8 to 9.8) 0.39 -2.2 (-9.1 to 4.6) 0.52 Income: $0–$60 000 reference — reference — $60 000–$100 000 -2.3 (-9.0 to 4.5) 0.52 -7.0 (-17.0 to 2.9) 0.16 ≥$100 000 -6.1 (-12.4 to 0.1) 0.06 -11.5 (-20.7to -2.4) 0.01 Smoking status: Non-smoker reference — reference — Smoker -16.7 (-23.7 to -9.7) <0.001 -8.8 (-17.5 to -0.1) 0.05 Alcohol consumption: Never reference — reference — Less than weekly 9.6 (1.9 to 17.4) 0.02 3.4 (-3.5 to 10.3) 0.34 Weekly or more -1.2 (-6.5 to 4.2) 0.68 -11.5 (-22.3 to -0.6) 0.04 Exercise: <150 minutes/week reference — reference — >150 minutes/week -1.3 (-8.5 to 5.9) 0.73 -1.2 (-7.8 to 5.5) 0.73 CI = confidence intervals. aMultivariate models contain all listed variables, plus variables for study site. b Data are difference in composite outcome relative to the reference condition for the variable (for example, women achieved a mean of 7.3% less than men on the unadjusted analysis, and 13.8% less than men on the composite outcome after adjustment for the effect of other covariates)
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