Lifestyle risk management in the 45 year old health check in general practice

Project Status

Project Coordinator
Cheryl Amoroso

Chief Investigators
Mark Harris, Gawaine Powell Davies, Nick Zwar

Associate Investigators
Mandy Ampt, Rachel Laws, Anna Williams, McKenzie S

Other Team Members
Chris Daniels


The SNAP risk factors – Smoking, Nutrition, Alcohol and Physical activity, have been identified by the Australian Government Department of Health and Ageing as a primary care intervention priority for the prevention of chronic disease. There is evidence that general practice can play an effective role in addressing these risk factors.

Following on from the NSW GP SNAP Trial which examined the feasibility of implementation through Divisions of General Practice, this research project will examine the implementation of this approach as part of the 45 year old health check to be implemented through general practice in November 2006, and the impact on patient lifestyle. The aim of the health check is to assist general practices with detection and and prevention of chronic disease and enable early intervention strategies where appropriate. The learnings will make an important contribution to the development of the 45 year old health check and the capacity building required to implement lifestyle modification.


This study will compare the change in lifestyle behaviour of general practice patients at risk of chronic disease before and 3 months after being recalled around age 45 years for a health check by their general practitioner.

The study will also explore what is required to support general practice and other services in providing lifestyle intervention for patients.

This study will inform implementation of policy from the Council of Australian Governments on a preventive health check in general practice for people around the age of 45 years.

Design and Method

Participants: Eight practices from two Divisions of General Practice are participating in the study. Each practice has recalled 80 patients between 45-49 years and at risk of developing chronic disease to have a health check. These patients were invited by the practice to attend for the health check and to give consent to participate in the study.

Intervention: The study's intervention officer from the Division provided support and training to participating practices. Practices were supported to identify patients to call in for the Health Check, as well as screen for and manage behavioural risk factors that are identified at the health check.

Data collection: GPs and practice nurses completed a questionnaire to determine their knowledge, confidence and reported practices in the identification of patients at risk, conduct of the health check, assessment of risk factors and their management including referral. They are being interviewed after the trial regarding the acceptability of the 45-49 year old health check and to identify those factors which acted as a facilitator/barrier to implementation and patient behaviour change. We will compare the number of patients identified and recalled against those who present for screening. We will also collect data on the number of patients referred to other services and survey referral services to determine change in demand. Consenting patients have completed a questionnaire at baseline and are also completing this questionnaire three months after the health check. Using validated questions based on the NSW Health Survey these will identify practice attendance, assessment and management of SNAP risk factors, SNAP risk factor behaviours. and readiness to change risk factors.

Data analysis: We will examine the study variables before and after interventions and compare the difference in outcomes. Qualitative data will be analysed thematically to identify issues that impact on the successful implementation of risk factor management in this context.

Key Publications

Amoroso C, Harris M, Ampt A, Laws R, McKenzie S, Williams A, Powell Davies G, Zwar N. 45-to-49 year old chronic disease prevention health checks in general practice: ultilisation, acceptability and effectiveness. Research Centre for Primary health Care and Equity UNSW and Australian Primary Health Care Research Institute, ANU. 2008.