Being overweight or obese increases the chance of a person developing chronic conditions such as diabetes and heart disease. Currently about 63% of Australians are overweight or obese. This study intervention aimed to help these people find and use relevant health information to improve their diet, increase the amount of physical activity they do, and generally improve their health, thereby preventing the development of chronic disease. While there are a large number of apps focused on lifestyle behaviours, few are tailored to the needs of older patients and those with low health and e-literacy and supported by clinicians in general practice.
HeLP GP supported practice nurses (PNs) to provide a smart phone/tablet app to patients to monitor their weight, BMI, waist circumference and blood pressure and to track changes over time. Patients received advice and support to set achievable lifestyle goals and to access ten free sessions of confidential advice via a professional telephone coaching service (Get Healthy). The evaluation showed some improvements in health literacy and diet, substantial differences in other outcomes were not achieved. There was a need to tailor the approach to the individual needs of the practice and for greater and more consistent engagement and support for staff (especially the PNs) in the intervention.
The lessons from this project have informed programs using mobile phone apps to support change in lifestyle behaviours. An important example of this is the Health Habits app developed by the RACGP to support change in physical activity and diet in general practice and allowing GPs to monitor this (https://healthyhabits.racgp.org.au/). Professor Harris is chair of the RACGP working group on this project which has allowed him to ensure that this development and evaluation has been informed by the HeLP-GP study.
Publications from this trial are still ongoing. Current publications and their associated metrics are:
Parker SM, Barr M, Stocks N, et al
Preventing chronic disease in overweight and obese patients with low health literacy using eHealth and teamwork in primary healthcare (HeLP-GP): a cluster randomised controlled trial
BMJ Open 2022;12:e060393. doi: 10.1136/bmjopen-2021-060393
Paine, K., Parker, S., Denney-Wilson, E. et al.
In it for the long haul: the complexities of managing overweight in family practice: qualitative thematic analysis from the Health eLiteracy for Prevention in General Practice (HeLP-GP) trial.
BMC Prim. Care 24, 57 (2023). https://doi.org/10.1186/s12875-023-01995-w
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Professor Mark Harris
Ms Sharon Parker
A/Professor Margo Barr
Mr A.Y.M Alamgir Kabir
Ms An Tran
Centre for Primary Health Care and Equity, UNSW Sydney
Professor Don Nutbeam
Professor Elizabeth Denney-Wilson
University of Sydney
Professor Nigel Stocks
Dr Carmel McNamara
Discipline of General Practice, University of Adelaide
Professor Nick Zwarr
Faculty of Health Sciences & Medicine, Bond University
Professor Richard Osborne
The study was conducted with the support of the South West Sydney, Adelaide and Nepean and Blue Mountains Primary Health Networks. Australian Institute of Health Innovation developed the mobile app. The Get Healthy Information and Coaching Service (NSW and SA) arranged access to telephone coaching. Dr Anton Knieriemen developed tailored version of the Doctors Control Panel (DCP) program which allowed us to recruit patients, conduct clinical audits and monitor and collect data for participating patients.