Get Involved Reach Top Health (GIRTH): A community-based, peer-led group lifestyle modification program for men – A quasi-randomised trial

Abstract

Men are underrepresented in community-based lifestyle modification programs (LMP). A quasi-randomised trial was undertaken to assess the efficacy of GIRTH, a peer-led, group-based LMP for men, in reducing cardiometabolic risk factors. One-hundred-seventy-eight men (mean age 58 yrs, waist circumference 110 cm) in 11 groups, were allocated 1:3 to either a control group receiving healthy lifestyle information only (n = 45) or a GIRTH group involving 12, weekly, face-to-face sessions focused on health literacy, goal setting, problem solving and self-monitoring (n = 133). The primary outcome was waist circumference (WC) change over 12-weeks. Secondary outcomes included changes in body mass index (BMI), blood pressure, grip strength, lipid profile and glucose, diet, physical activity, and diet, exercise, coping, and sleep self-efficacy scores. The retention was 68 % and 88 % for the control and GIRTH groups respectively. WC decreased in both groups (p < 0.001), but the decrease was greater in the GIRTH group (intention-to-treat: −4.2 cm, −5.1 to −3.3 vs −1.9 cm, −3.1 to −0.7; p = 0.002; as-treated: −5.3 cm, −6.1 to −4.4 vs −3.0 cm, −4.6 to −1; p = 0.009). Men in both groups had improvements in weight, BMI, blood pressure, in coping, sleep and regulate eating self-efficacy scores, and physical activity (p < 0.05). Men in the GIRTH group also had improvements in high density lipoprotein (HDL), triglyceride (TC)/HDL ratio, and exercise self-efficacy score (p < 0.05). Reduction in WC correlated with changes in weight, BMI, systolic blood pressure, lipids, and increased fruit and vegetable consumption (p < 0.05). The GIRTH program was more effective than information alone in reducing WC and cardiometabolic disease risk factors in men.