Healthy recovery: results and reflections from a stepped wedge randomised controlled trial of a healthy lifestyle intervention within substance dependence treatment

Healthy Recovery: Results and reflections from a stepped wedge randomized controlled trial of a healthy lifestyle intervention within substance dependence treatment

Background: Cardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders. Smoking and other unhealthy lifestyle behaviours are the primary behavioural risk factors that contribute to the development of these diseases. Healthy Recovery is an 8-session group-based intervention that primarily targets smoking, but also addresses diet and physical inactivity as part of a healthy lifestyle approach. The presentation will report the primary smoking outcomes from the study. It will also report secondary analysis focused on diet quality (i.e. fruit and vegetable intake) and physical activity.

Methods: The project was conducted as a stepped wedge randomised controlled trial (N = 172; 89% follow-up at 8 months). Participants were attending residential substance dependence treatment provided by The Australian Salvation Army.

Results: Participants completing Healthy Recovery had a significantly lower rate of cigarettes smoked per day at 2 months follow-up than people in the control group (average of 5 cigarettes/day lower; p=0.001). At 8 months there was still a statistically significant difference between the two groups (p=0.05). When compared to treatment as usual, people completing Healthy Recovery demonstrated higher quit rates (21% v 9%). Participants of Healthy Recovery also demonstrated greater increases in intake of fruit and vegetables, compared to the control group. However, there were no between group differences for physical activity.

Conclusions:People attending substance dependence treatment are willing to engage in healthy lifestyle interventions. Interventions focusing on increasing individual’s self-efficacy to quit smoking during substance abuse treatment may lead to reductions in smoking. Future research should examine the implementation of Healthy Recovery within outpatient alcohol and other drug treatment services.