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Table 4 Details of actions included in BETTER HEALTH: Durham study outcome composite index. Adapted from composite index used in original BETTER trial [6, 8]

From: Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial

   Eligible for: Met if:
1 FBS or A1C screen A) All non-diabetics with at least one risk factor or self-report as pre-diabetic that haven’t had a Fasting Blood Sugar (FBS) or A1C in the past year
OR
B) All non-diabetics without risk factors (see Section B) that haven’t had an FBS or A1C in the past 3 years
OR
C) All non-diabetics with pre-diabetes who haven’t had a FBS/A1C in past 6 months
Had a fasting blood test to check for diabetes or had an A1C test since the first survey interview
2 BP screen A) All patients without CVD and Non-hypertensive and Non-diabetic > 12 months since BP check
OR
B) All patients without CVD and Non-hypertensive and Diabetic > 6 months since BP check
Had a nurse or doctor check blood pressure since the first survey interview
3 BP monitor All patients without CVD with hypertension with no BP check in past 6 months Had a nurse or doctor check blood pressure since the first survey interview
4 LDL measured A) All non-diabetic Men ≥ 40 without CVD without a cholesterol test reported < 1 year ago
OR
B) All non-diabetic Women ≥ 50 without CVD without a cholesterol test reported < 1 year ago
Had a fasting blood test to check for high cholesterol since the first survey interview
5 Breast screening A) All women ≥ 50-65 without a personal history of breast cancer AND without family history risk of breast or ovarian cancer:
Routine mammogram not done within 2 years OR
OR
B) All women 40-65 without personal history of breast cancer but with a family history risk of breast or ovarian cancer:
Routine mammogram not done within 1 year
Had a mammogram since the first survey interview
6 Colorectal screening A) All patients ≥50-65 without personal history CRC and without family history of CRC with the following:
 ◦ FOBT not done within 2 years
 ◦ Sigmoidoscopy not done within 5 years
 ◦ Colonoscopy not done within 10 years
OR
B) All patients 40-65 with a family history of CRC with the following:
 ◦ FOBT not done within 2 years
 ◦ Sigmoidoscopy not done within 5 years
 ◦ Colonoscopy not done within 10 years
Had an FOBT or colonoscopy or sigmoidoscopy since the first survey interview
7 Pap screening All women without personal history of cervical cancer with no pap tests within the past 3 years Had a Pap test since the first survey interview
8 BMI screening BMI not measured in past 2 years Had a nurse or doctor measure height and weight since the first survey interview
9 Waist circumference Waist circumference not measured in past 2 years Had a nurse or doctor measure waist circumference since the first survey interview
10 Weight Control BMI ≥ 25 No increase in BMI since the first survey interview
11 Referral for BMI >= 25 BMI ≥ 25 Been referred to an exercise program, been referred to a dietician/nutrition program, had a discussion with a health professional about exercise, had a discussion with a health professional about diet/nutrition, initiated a referral to a diet/nutrition program, or initiated a referral to an exercise program since the first survey interview
12 Smoking cessation Smoker Not smoking cigarettes at all at time of 6-month survey interview
13 Cessation referral Smoker Prescribed medication for smoking cessation, been referred to a smoking cessation program, had a discussion with a health professional about smoking cessation, or initiated a referral to a smoking cessation program since the first survey interview
14 Alcohol control A) ≥ 7 drinks per week for Women or AUDIT-C (Alcohol Use Disorders Identification Test) [35] score >3
OR
B) ≥ 14 drinks per week for Men or AUDIT-C score ≥ 4
AUDIT-C score from 6-month survey interview less than on first survey interview, or number of drinks per week at 6-moth survey interview less than on first survey interview
15 Alcohol referral A) ≥ 14 drinks per week or AUDIT-C score >4 for Men
OR
B) ≥ 7 drinks per week or AUDIT-C score >3 for Women*
OR
C) Identified as a binge drinker (>6 drinks on one occasion)
Prescribed medication for alcohol cessation, been referred to an alcohol cessation program, had a discussion with a health professional about alcohol cessation, or initiated a referral to an alcohol cessation program since the first survey interview
16 Physical activity improved < 150 minutes of vigorous physical activity per week OR
General Practice Physical Activity Questionnaire (GPPAQ) score is other than “active” [36]
Increase in the number of minutes spent exercising per week since the first survey interview or GPPAQ score improved on 6-month survey interview compared to first survey interview
17 Activity referral < 150 minutes of vigorous physical activity per week OR
General Practice Physical Activity Questionnaire (GPPAQ) score is other than “active”
Been referred to an exercise program, had a discussion with a health professional about exercise, or initiated a referral to an exercise program since the first survey interview
18 Healthy diet score Starting the Conversation diet score ≥ 4 Decrease in diet score on 6-month survey interview from first survey interview
19 Nutrition referral Starting the Conversation diet score ≥ 4 [37] Been referred to a dietician/nutrition program, had a discussion with a health professional about diet/nutrition, or initiated a referral to a diet/nutrition program since the first survey interview