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]
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 |