This proposal to test the effectiveness of Health and Wellness Coaching (HWC) for primary prevention of stroke is particularly relevant to the ageing population where most strokes occur.
There is accumulating evidence suggesting that stroke and CVD prevention strategies should be aimed at reducing absolute risk and not individual risk factors in isolation. An important recommendation of current NZ Guidelines The Assessment and Management of Cardiovascular Risk32 is that people at >10% 5-year CVD risk should receive individual advice on healthy lifestyle modifications (e.g., healthy diet, regular physical activity, smoking cessation if relevant) by means of behaviour modification techniques. For people at >15% 5-year CVD risk, these guidelines additionally recommend aspirin, BP lowering medication and lipid modifying therapy.
However, management of CVD risk factors remains suboptimal, and although up to 80% of all acute CVD events occur in people with low to moderate CVD risk the majority are not included in high-risk preventative strategies. Moreover, low participant adherence to recommended medications and healthy lifestyle modifications seems the main obstacle to effective CVD prevention. This project is a phase III, prospective, randomised, open-treatment, blinded end-point trial. Aim: to determine the effectiveness of HWC for primary stroke prevention in Māori, Pasifika, Asians and NZ Europeans.