Long-Term Effectiveness of Health and Wellness Coaching (BRNZ CoRE)

20 Nov 2019

Current international evidence clearly demonstrates that at least 80% of strokes are preventable, with adequate control of modifiable risk factors. [1] However, despite the continuous decline in stroke incidence and mortality rates, the number of people (predominately older adults) affected by, and dying from, stoke is increasing in New Zealand and worldwide. [2] This study builds on an ongoing study, “Primary Prevention of Stroke in the Community Study” (PreventS), also funded by Ageing Well National Science Challenge, which investigates the effectiveness of Health and Wellness Coaching (HWC) to reduce absolute risk of 5-year Cardiovascular Disease (CVD) with Māori, Pacific Island, New Zealand European, and Asian participants. Participants were randomised to receive either 15 sessions of HWC over a 9-month period or usual care, the length of follow-up in this study was limited to 9 months. The current project “Long-Term Effectiveness of Health and Wellness Coaching” extends the length of follow-up to include an additional assessment at three years post-randomisation.

The aim of this study is to determine the long-term effectiveness of the HWC intervention in reducing CVD risk and prevention of cognitive impairment compared to usual care. The longer-term follow-up of participants in a trial of primary CVD prevention will inform on the suitability and sustainability of the HWC intervention once the intervention ceases. This approach has the potential of a 4-8% reduction in stroke risk, translating into 300-500 fewer strokes every year. This study will contribute further to the evidence obtained from the primary study that the benefits of the intervention are sustained long term. The data will provide the first evidence of any association of cognitive decline with cardiovascular risk factors in diverse ethnic groups in New Zealand.

[1] O’Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, Rao-Melacini P, Zhang X, Pais P, Agapay S, Lopez-Jaramillo P, Damasceno A, Langhorne P, McQueen MJ, Rosengren A, Dehghan M, Hankey GJ, Dans AL, Elsayed A, Avezum A, Mondo C, Diener HC, Ryglewicz D, Czlonkowska A, Pogosova N, Weimar C, Iqbal R, Diaz R, Yusoff K, Yusufali A, Oguz A, Wang X, Penaherrera E, Lanas F, Ogah OS, Ogunniyi A, Iversen HK, Malaga G, Rumboldt Z, Oveisgharan S, Al Hussain F, Magazi D, Nilanont Y, Ferguson J, Pare G, Yusuf S. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet (London, England). 2016;388:761-775 2.
[2] Feigin V, Forouzanfar M, Krishnamurthi R, Mensah G, Connor M, Bennett D, Moran A, Sacco R, Anderson L, Truelsen T, O’Donnell M, Venketasubramanian N, Barker-Collo S, Lawes C, Wang W, Shinohara Y, Witt E, Ezzati M, Naghavi M, Murray C. Global and regional burden of stroke during 1990& 2013; 2010: findings from the Global Burden of Disease Study 2010. The Lancet. 2014;383:245-255