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Spouse outcomes from a spouse-assisted intervention to lower patient cholesterol
King HA, Coffman CJ, McVay M, Voils CI. Spouse outcomes from a spouse-assisted intervention to lower patient cholesterol. Paper presented at: Society of Behavioral Medicine Annual Meeting and Scientific Sessions; 2013 Mar 22; San Francisco, CA.
Objective: In spouse-assisted interventions, the role of spouses is to encourage and reinforce patient behavior change. Unclear is whether spouses merely support behavior change or make similar behavior changes. In a telephone-delivered, spouse-assisted lifestyle intervention to improve patient cholesterol levels, patients improved diet and physical activity. We conducted secondary analyses to determine whether spouses demonstrated similar improvements in these health behaviors.
Method: 255 outpatient, married veterans with LDL-C > 76 mg/dL and their spouses were randomized to usual care or an intervention comprising eight monthly goal-setting telephone calls to patients and separate support planning calls to spouses. Outcomes for this analysis included spouse (1) frequency and duration of moderate intensity physical activity and (2) dietary intake (total calories, total fat, saturated fat, cholesterol, fiber, and percentage of calories from fat and saturated fat) at baseline and 6- and 11-month follow-up time points. For analysis of the food frequency questionnaire (FFQ) dietary outcomes, we fit linear mixed models (LMM). For the frequency and duration of physical activity outcomes, we fit generalized LMMs using a negative-binomial distribution with a log link function. Primary predictors included a common intercept, indicator variables for follow-up time points, and treatment group by time interaction.
Results: Spouses were 6% male, 64% White, and averaged 58.8 years in age. No significant differences were found at 11-months between intervention and usual care for moderate intensity physical activity frequency (p = .84) or duration (p = .92) or dietary intake (total calories, p = .65; total fat, p = .27; saturated fat, p = .31; cholesterol, p = .87; fiber, p = .69; % calories fat, p = .16; % calories saturated fat, p = .26).
Conclusion: To improve spouse outcomes, interventions need to be family-centered, focusing on spouse behavior change goals and including provision of support to spouses.