Population-wide use of behavioural prevention and counselling programmes for lifestyle-related cardiovascular risk factors in Germany

Background: Behavioural prevention and counselling programmes for lifestyle-related cardiovascular risk factors are widely offered. However, their population-wide use is largely unexplored, particularly in high-risk persons with known CVD or diabetes. Methods: Data were collected within GEDA 2009, a national health survey covering a representative sample of 21,262 adults in Germany. Standardised structured computer-assisted telephone interviews included self-reported physician-diagnosed coronary heart disease, myocardial infarction, heart failure, stroke, diabetes as well as height, weight, usual diet, physical activity, and the use of programmes for weight reduction, healthy diet and improvement of fitness or mobility in the last twelve months. Results: Participation in prevention programmes was lowest for weight reduction (men 2.1% (95%-CI 1.8–2.5), women 3.5% (3.1–3.9)), somewhat higher for healthy diet (men 3.2% (2.8–3.7), women 4.7% (4.2–5.2)), and highest for improvement of fitness or mobility (men 8.6% (7.9–9.3), women 16.1% (15.3–16.9)). Among individuals with the respective risk factor, programme participation was still low: 5.5% (3.9–7.2) in obese men (women 7.2% (5.7–8.7)), for weight reduction. 2.8% (2.3–3.3) in men who did not eat fruits or vegetables daily (women 3.7% (3.1–4.2)), for healthy diet, and 7.9% (7.0–8.9) in physically inactive men (women 15.7% (14.5–16.8)) for improvement of fitness or mobility. In the presence of known CVD or diabetes, participation increased inconsistently and only moderately. Conclusion: Our results show low participation in behavioural prevention measures for lifestyle-related risk factors even in individuals with known CVD or diabetes. Further studies should investigate the knowledge about potential programme benefit, availability and reimbursement in both, patients and health care providers.