Evaluation of a 4-week interdisciplinary primary care cardiovascular health programme: impact on knowledge, Mediterranean Diet adherence and biomarkers.

Background: Cardiovascular disease (CVD) is the second-leading cause of death among Canadians. Clinical practice guidelines suggest that improvements to lifestyle, including dietary intake, can reduce the risk of CVD.

Objectives: The primary aim of the study was to evaluate patient changes in adherence to the Mediterranean Diet (Medi-Diet) from baseline to 4-week and 6-month follow-up after participating in a 4-week, group-based, interdisciplinary cardiovascular health programme run by healthcare professionals (HCPs) in a primary care setting. Secondary outcomes included changes in blood pressure, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein cholesterol (HDL-c), triglycerides, non-HDL-c and haemoglobin A1c% from baseline to 6 months, and changes in knowledge scores from baseline to 4 weeks and 6 months. This study further aimed to compare outcomes between in-person programme delivery and virtual programme delivery during the COVID-19 pandemic.

Methods: Participants (n=31) attended the Get Heart Smart (GHS) group-based educational and lifestyle behaviour change programme at the East Elgin Family Health Team for 4 weeks. Participants were 18 years or older and were referred by a HCP or self-referred to the GHS programme. Changes in the above-mentioned outcomes were evaluated. Due to the COVID-19 pandemic, the programme moved to a virtual mode of delivery, with 16 participants completing the programme in a virtual environment. Two-way repeated-measures analyses of variance were performed to explore if there were significant differences from baseline to 4-week and/or 6-month follow-up between groups (in-person compared with virtual) and within the pooled sample.

Results: At baseline and 4-week follow-up, there were significant between-group differences in knowledge scores. After 6-month follow-up, there were statistically significant within-group improvements in Medi-Diet scores and knowledge scores in the pooled sample (n=31), in-person sample (n=15) and virtual sample (n=16). Apart from triglycerides, changes in biomarkers were all non-significant.

Conclusions: The GHS programme effectively facilitated long-term (6-month) improved cardiovascular/lifestyle knowledge and adherence to the Medi-Diet. Transitioning to a virtual programme delivery did not impact the program's ability to motivate nutrition-related behaviour change.