Five-year effect of community-based intervention Hartslag Limburg on quality of life: A longitudinal cohort study
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RESEARCH
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Five-year effect of community-based intervention Hartslag Limburg on quality of life: A longitudinal cohort study Saskia PJ Verkleij1*, Marcel C Adriaanse1, WM Monique Verschuren2, Eric C Ruland3, Gerrie CW Wendel-Vos2, Albertine J Schuit1,2
Abstract Background: During the past decade, quality of life (QoL) has become an accepted measure of disease impact, therapeutic outcome, and evaluation of interventions. So far, very little is known about the effects of communitybased interventions on people’s QoL. Therefore, the effect of an integrative cardiovascular diseases communitybased intervention programme ‘Hartslag Limburg’ on QoL after 5-years of intervention is studied. Methods: A longitudinal cohort study comparing 5-year mean change in QoL between the intervention (n = 2356) and reference group (n = 758). QoL outcomes were the physical and mental health composite scores (PCS and MCS) measured by the RAND-36. Analyses were stratified for gender and socio-economic status (SES). Results: After 5-years of intervention we found no difference in mean change in PCS and MCS between the intervention and reference group in both genders and low-SES. However, for the moderate/high SES intervention group, the scales social functioning (-3.6, 95% CI:-6.1 to -1.2), physical role limitations (-5.3, 95% CI:-9.6 to -1.0), general mental health (-3.0, 95% CI:-4.7 to -1.3), vitality (-3.2, 95% CI:-5.1 to -1.3), and MCS (-1.8, 95% CI:-2.9 to -0.6) significantly changed compared with the reference group. These differences were due to a slight decrease of QoL in the intervention group and an increase of QoL in the reference group. Conclusion: Hartslag Limburg has no beneficial effect on people’s physical and mental QoL after 5-years of intervention. In fact, subjects in the intervention group with a moderate/high SES, show a decrease on their mental QoL compared with the reference group.
Introduction During the past decade there has been growing interest in measuring people’s quality of life (QoL). Traditionally, outcome measurements in health care have mostly been determined by objective medical evaluation [1]. The interest in assessing QoL stems from recognition of the importance of patients’ own perception of their health status and well-being. QoL has become an accepted measure of disease impact, therapeutic outcome, and evaluation of interventions. Chronic diseases often affect people’s QoL. Research shows that people with diabetes mellitus type 2, obesity, and cardiovascular diseases (CVD) have an decreased * Correspondence: [email protected] 1 Department of Health Sciences VU University, Amsterdam, the Netherlands Full list of author information is available at the end of the article
QoL [2-5]. Moreover, people with favourable levels of CVD risk factors have greater longevity and tend to have a better QoL [2]. Therefore, health promotion may not only stimulate a healthy lifestyle but may also improve people’s QoL. A widely advocated strategy in public health is community-based health promotion. In
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