More Effective Lifestyle Programs Through Better Reference by General Practitioners and Other Councils

This is demonstrated by the research of the scientist Adrie Bouma of the UMCG. She will defend her thesis at the University of Groningen on November 21st

. A significant proportion of the population is not active enough and does not adhere to the recommendations of a healthy diet. Lifestyle-oriented counseling programs seem to be suitable for a healthier lifestyle. Previous research has shown that interventions can lead to more exercise. But many people do not follow the advice or move too little. In her research, Adrie Bouma examined what can contribute to more effective interventions in practice. She followed the referral role of general practitioners in her study and developed a new way to guide participants in interventions more effectively.

Guidance Role of General Practitioners

His research shows that general practitioners do not have the opportunity to do objective screening of patients likely to follow a lifestyle-oriented program. General practitioners are often not motivated and do not have the right means to refer. They also have little knowledge of effective and successful interventions. Bouma shows that general practitioners primarily address patients who have a clear physical indication of a disease and who have few preventive references. General practitioners were more likely to refer if they had a healthy lifestyle, exercise and a healthy diet.

Obstacles and motivation of participants

The combination of motivation of a participant to move and obstacles that a participant puts against the exercise determine the success of it. Bouma's research shows that, up to now, the coaching of the participants relies mainly on their motivation, which is only effective in the short term. Bouma shows in his research that, in the long run, it is more efficient to guide the participants to the obstacles that hinder the movements. She has developed a new method of behavior change, the barrier approach. It involves four different strategies: 1) learn other ways to achieve lifestyle goals to overcome barriers; 2) change the goal of reducing participants' barriers; 3) change the perception of obstacles among participants; 4) Participants learn to accept the investments and the consequences to achieve their goal. Bouma followed participants in lifestyle interventions for two years. His research shows that participants who were guided with this new method to learn how to overcome their obstacles stayed active longer and enjoyed a higher quality of life.

Effectiveness of Programs

Bouma pleads in favor of a quick check of the lifestyle of patients to include in the protocol for general practitioners. Bouma also believes that lifestyle change should be seen by more clinicians as a treatment option, in addition to regular care. She supports the development of official guidelines and tools for the screening of appropriate patients. For this reason, general practitioners have an indication for a reference, so that more people can be reached. In addition, according to Bouma, information on lifestyle promotion programs should be offered to primary health care in the Netherlands, so as to improve their knowledge of these interventions. Finally, Bouma argues that general practitioners should work closely with other health professionals specializing in behavioral change, who oversee interventions.

Programs as of January 2019

According to Bouma, effective, lifestyle-based and evidence-based interventions contribute to increased life expectancy and quality of life. The programs reimbursed by the health insurers from January 2019 are based on the motivation of the participants. She thinks it's best to guide the instructions on removing obstacles. In VWS diets, overweight people are primarily selected for lifestyle programs; she thinks it's important that other people can follow the programs.

Curriculum vitae

Adrie Bouma (Stiens, 1978) studied the sciences of human movement at the University of Groningen. She did her research at the SHARE Research Institute of UMCG. The title of his thesis is "The barrier-belief approach, a new perspective of behavioral change in primary care". She has conducted her research as a professor-researcher at Sportkunde, at the Institute of Sports Studies of the Hanze University of Groningen. She is now working as a postdoctoral researcher at the UMCG's Department of Rehabilitation Medicine, where she conducts more in-depth research on referrals to lifestyle-enhancing interventions from second-line care and their effectiveness.