The effect of personalized pictorial-based information about atherosclerosis on adherence to lifestyle recommendations: results from the VIPVIZA study
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: Background/introduction Promoting a healthy lifestyle is regarded as the most important way to prevent atherosclerotic cardiovascular disease (CVD) [1]. Lifestyle interventions have the potential to reduce CVD incidence by at least 50% [2]. However, low adherence to lifestyle recommendations constitutes a major barrier to effective prevention [3]. In a recent consensus statement from the European Association of Preventive Cardiology, the need to develop new communication strategies to improve adherence to lifestyle recommendations was emphasized [4]. Lifestyle indices provide a comprehensive and multidimensional approach to the assessment of health-influencing habits, encompassing the interrelations between various lifestyle factors [5]. Purpose We aimed to evaluate the effect of communicating pictorial based information about subclinical atherosclerosis on individuals´ adherence to lifestyle recommendations, as measured by a lifestyle index. Methods VIPVIZA (Vasterbotten Intervention Programme - VIsualiZation of asymptomatic Atherosclerotic disease for optimum cardiovascular prevention) is a pragmatic, open-label, randomized controlled trial within the Vasterbotten Intervention Programme (VIP). VIPVIZA and VIP have been described [6,7,8]. In VIP, residents of Vasterbotten county in northern Sweden are invited to a health survey and a health-promoting dialogue with a primary care nurse at the age of 40, 50 and 60 years. 3532 VIP participants were included in VIPVIZA during 2013-2016. In addition to the VIP intervention, the study subjects underwent a carotid ultrasound examination. They were randomized 1:1 to intervention (personalized pictorial information about carotid atherosclerosis (fig 1) to participants and their primary care physicians), or control group (no information about the ultrasound result). A flow chart of the study is presented in fig. 2. We created a lifestyle index based on self-reported physical activity, smoking habits, diet and alcohol consumption from the VIP questionnaire, cathegorised in three levels for each habit. Lifestyle index thus ranged from 4-12, with higher levels corresponding to healthier lifestyles. We compared lifestyle index in the intervention and control groups at 3-year follow-up using ordinal regression. Results In the intervention group, mean lifestyle index increased from 9.9 at baseline to 10.2 after three years. In a model adjusted for age, sex, education and lifestyle index at baseline, the odds ratio of having a healthier lifestyle index at three-year follow-up, was 1.20 (95% CI 1.01-1.42) for the intervention group compared to the control group. We found no interactions for age or sex. Conclusion Our findings provide evidence for the contributory role of ultrasound-based personalized pictorial information about subclinical atherosclerosis to promote sustained adherence to lifestyle recommendations.Pictorial informationFlow chart of the study
Authors: A Wennstig, A Hult, S Sjalander, M Norberg, P Wester, P Wennberg
Institution: Umeå University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410499913