Preventive counseling (PC) in behavioral risk factors (BRF) of chronic diseases development should consider the complex of personal and behavioral features as well as environmental factors, that is especially important in combined multiple BRF.
OBJECTIVE
To formulate conceptual principles of the relationship of multiple behavioral risk factors for increase of the effectiveness of personalized preventive counseling.
MATERIALS AND METHODS
Comparative dynamics of BRF depending on the presence of targeted comprehensive intervention (in-depth PC and remote control) was investigated in a cohort preventive study on the reduction of excessive body mass (EBM).
RESULTS
Cohort included 546 persons, mean age 42.8±9.4 years, majority of patients — women (88.3%), median BM index was 31.0 [29.0; 35.0] kg/m2, waist circumference — 96.0 [88.0; 104.0] cm. Most patients (82.2%) experienced a decrease in BM by an average of 4 kg under the influence of targeted comprehensive intervention, 42.5% — achievement of the target level of BM reduction, patients changed their dietary habits according to recommendations and increased physical activity. Against this background, positive dynamics of accompanying BRF that were not under targeted intervention has been also obtained. Thus, the proportion of patients who do not drink alcohol doubled (p<0.001), and the frequency of alcohol consumption decreased (p<0.021). The proportion of smokers decreased by a quarter among patients who achieved the target BM reduction (24.8%, p=0.035).
CONCLUSIONS
The obtained results are consistent with publications on the study of combined behavioral risk factors, mainly at the population level. The relationship and unidirectionality of dynamics of multiple behavioral risk factors at the individual level have been shown as well, that can be characterized as a linked interference (according to the «domino effect» principle) of multiple risk factors in patient’s behavior changes, that is important to consider in preventive counselling of such patients.
