A randomized comparative effectiveness study of Healthy Directions 2-A multiple risk behavior intervention for primary care

Objective. To evaluate the effectiveness of the Healthy Directions 2 (HD2) intervention in the primary care setting. Methods. HD2 was a cluster randomized trial (conducted 3/09-11/11). The primary sampling unit was provider (n = 33), with secondary sampling of patients within provider (n = 2440). Study arms included: 1) usual care (UC); 2) HD2 a patient self-guided intervention. targeting 5 risk behaviors; and 3) HD2 plus 2 brief telephone coaching calls (HD2 + CC). The outcome measure was the proportion of participants with a lower multiple risk behavior (MRB) score by follow-up. Results. At baseline, only 4% of the participants met all behavioral recommendations. Both HD2 and HD2 + CC led to improvements in MRB score, relative to UC, with no differences between the two HD2 conditions. Twenty-eight percent of the UC participants had improved MRB scores at 6 months, vs. 39% and 43% in HD2 and HD2 + CC, respectively (ps