The influence of partner's behavior on health behavior change: the English Longitudinal Study of Ageing. Helping Chinese Fathers Quit Smoking through Educating Their Nonsmoking Spouses: A Randomized Controlled Trial The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials Physical activity and nutrition programs for couples: a randomized controlled trial. A breast feeding education and promotion program: Effects on knowledge, attitudes, and support for breast feeding Efficacy of a partner assistance intervention designed to increase skin self-examination performance. The FAST study: Fertility ASsessment and advice Targeting lifestyle choices and behaviours: a pilot study. Health promotion in couples adapting to a shared lifestyle. A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples The effect of a couples intervention to increase breast cancer screening among korean americans. Prenatal and postpartum smoking abstinence a partner-assisted approach. A randomized, controlled trial of the influence of prenatal parenting education on postpartum anxiety and marital adjustment. Spouse-assisted coping skills training in the management of osteoarthritic knee pain. Effects of a smoking cessation program for pregnant women and their partners attending a public hospital antenatal clinic Change in coronary risk and coronary risk factor levels in couples following lifestyle intervention. The British Family Heart Study. Building strong and ready Army families: a multirisk reduction health promotion pilot study. The effect of a household partner and home urine monitoring on adherence to a sodium restricted diet. A randomized controlled trial to evaluate the effectiveness of CouPLES: a spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol. Effects of a cognition-oriented breast self-examination intervention for Korean women and their spouses. A "family-based" approach to the treatment of obese type II diabetic patients. Married to M. tuberculosis: risk of infection and disease in spouses of smear-positive tuberculosis patients.
IMPORTANCE Couples are highly concordant for unhealthy behaviors , and a change in one partner 's health behavior is often associated with a change in the other partner 's behavior . However , no studies have explicitly compared the influence of having a partner who takes up healthy behavior ( eg , quits smoking ) with one whose behavior is consistently healthy ( eg , never smokes ) . OBJECTIVE To examine the influence of partner 's behavior on making positive health behavior changes . DESIGN , SETTING , AND PARTICIPANTS We used prospect i ve data from married and cohabiting couples ( n , 3722 ) participating in the English Longitudinal Study of Ageing , a large population -based cohort of older adults ( ≥50 years ) . Study ing men and women who had unhealthy behaviors in 3 domains at baseline ( ie , smoking , physically inactive , or overweight/obese ) , we used logistic regression analysis to examine the influence of the partner 's behavior in the same domain on the odds of positive health behavior change over time . MAIN OUTCOMES AND MEASURES Smoking cessation , increased physical activity , and 5 % weight loss or greater . RESULTS Across all domains , we found that when one partner changed to a healthier behavior ( newly healthy ) , the other partner was more likely to make a positive health behavior change than if their partner remained unhealthy ( smoking : men 48 % vs 8 % , adjusted odds ratio [ OR ] , 11.82 [ 95 % CI , 4.84 - 28.90 ] ; women 50 % vs 8 % , OR , 11.23 [ 4.58 - 27.52 ] ) ( physical activity : men 67 % vs 26 % , OR , 5.28 [ 3.70 - 7.54 ] ; women 66 % vs 24 % , OR , 5.36 [ 3.74 - 7.68 ] ) ( weight loss : men 26 % vs 10 % , OR , 3.05 [ 1.96 - 4.74 ] ; women 36 % vs 15 % , OR , 3.08 [ 1.98 - 4.80 ] ) . For smoking and physical activity , having a consistently healthy partner also predicted positive change , but for each domain , the odds were significantly higher in individuals with a newly healthy partner than those with a consistently healthy partner ( smoking : men OR , 3.08 [ 1.43 - 6.62 ] ; women OR , 5.45 [ 2.44 - 12.16 ] ) ( physical activity : men OR , 1.92 [ 1.37 - 2.70 ] ; women OR , 1.84 [ 1.33 - 2.53 ] ) ( weight loss : men OR , 2.28 [ 1.36 - 3.84 ] ; women OR , 2.86 [ 1.55 - 5.26 ] ) . CONCLUSIONS AND RELEVANCE Men and women are more likely to make a positive health behavior change if their partner does too , and with a stronger effect than if the partner had been consistently healthy in that domain . Involving partners in behavior change interventions may therefore help improve outcomes Purpose . Assess the effectiveness of a two-step health education program by nurses delivered through nonsmoking mothers to help fathers of sick children quit smoking . Design . R and omized , controlled trial . Setting . General pediatric wards of four major hospitals in Hong Kong . Subjects . Nonsmoking mothers who had a live-in smoking spouse were recruited when they brought sick children to the hospital . A total of 752 mothers were r and omized into the intervention arm and 731 into the control arm . Intervention . The intervention group received st and ardized health advice , behavior modification booklets , and a 1–week telephone reminder . The control group received usual care . Measurements . The main outcome measure was the quit rate ( 7–day point prevalence ) of smoking fathers as determined by telephone follow-up with mothers at 3 and 12 months . Quit attempts and smoking reduction were secondary outcome measures . Results . At 3 months , more fathers in the intervention group had quit smoking ( 7.4 % vs. 4.8 % ; p = .03 ) , reduced daily cigarette consumption by 50 % or more ( 30.6 % vs. 22.6 % ; p < .001 ) , and reported quit attempts ( 6.5 % vs. 3.6 % ; p = .01 ) . The differences were not statistically significant by 12 months . Conclusion . A simple health education intervention provided by nurses to mothers of sick children has a short-term effect in helping smoking fathers  quit , reduce consumption , and trigger quit attempts . Future studies should confirm the longer-term sustainability of the effect Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Diet and physical activity habits may deteriorate after cohabitation , leading to weight gain and increased risk of lifestyle diseases . We carried out a 4-month , r and omized controlled trial of a diet and physical activity program for couples with a 1-year follow-up , comparing two methods of delivery . The program used six modules , which , after an initial group session , were mailed to the low-level intervention group .  In the high-level intervention group , half of the modules were mailed , and the others were delivered at interactive group sessions . A control group received no intervention . Postintervention and at follow-up , physical fitness improved in the high-level group , saturated fat intake decreased in both intervention groups , and low-density lipoprotein cholesterol fell in the high-level group . Fewer participants in the high-level group became overweight or obese . Health promotion for couples can improve health behaviors and potentially lower the risk of lifestyle diseases in participants and their future families This study was undertaken to determine the effects of a partner-support , incentive-baed educational program on breast feeding knowledge , attitudes and support and to examine the relationship between feeding intentions and feeding behavior among low-income women . Women who expressed a willingness to participate in the intervention were r and omly assigned to “ intervention ” and “ usual breast feeding ” ( control ) groups . Sixty-eight primipara women , with expected due date s between May and December , 1992 , volunteered to participate in the study . Of these , 34 were r and omly assigned to each of the two groups . Approximately 81 percent of the women completed the study , leaving n=29 in the control group and n-26 in the intervention group . The intervention consisted of special incentives ( prizes ) for women and their partners to participate in several breast feeding education and promotion activities . Intervention group women and their partners experienced positive changes in breast feeding knowledge and attitudes . Furthermore , the intervention seemed to have influenced more women in the treatment group to breast feed despite their prenatal feeding intentions . In addition , the partners of intervention group women were perceived to be more supportive of , breast feeding than control group partners . These findings suggest that incentives , such as donated prizes , can be used to attract lower socioeconomic group women and their partners to breast feeding promotion interventions . Participation in such interventions can produce positive changes in breast feeding knowledge , attitudes , and support , and can have a dramatic effect in promoting breast feeding OBJECTIVE To examine the role of  partner assistance in learning and implementation of an intervention design ed to promote skin self-examination ( SSE ) behaviors in persons at risk of developing melanoma . DESIGN R and omized controlled trial with immediate and 4-month follow-up visits . SETTING Clinical offices in the ambulatory care area of a hospital . Patients The study included 130 participants and their cohabiting partners drawn from a melanoma registry . Intervention The subjects were r and omly assigned to receive the intervention either as solo learning or as dyadic learning . The intervention consisted of a 10-minute demonstration of the ABCDE ( asymmetry of shape , border irregularity , color variegation , diameter > or = 6 mm , and evolution of the lesion ) rule and skills training . MAIN OUTCOME MEASURES Behavioral measures included self-reported performance of SSE and use of a body map design ed to record areas of concern found during SSE . Intentions , along with attitudinal measures such as perceived importance of SSE and self-efficacy in performing SSE , were also assessed at the 4-month follow-up visit . RESULTS The participants in the dyadic learning group were significantly more likely to report engaging in SSE behaviors ( P<.05 ) . The dyadic learning group also exhibited greater intentions to perform future SSE ( P<.01 ) , higher perceived importance of SSE ( P<.01 ) , and higher perceived self-efficacy ( P<.01 ) . CONCLUSION Dyadic learning may be more effective than solo learning in regard to interventions design ed to teach and promote health behaviors , such as SSE BACKGROUND Lifestyle has been shown to affect fertility in both males and females , with compelling evidence that smoking and being under or overweight impairs natural and assisted fertility , and other factors such as stress and caffeine have also been implicated . The objective of this study was to determine whether providing infertile couples with individualized lifestyle assessment s and ongoing support facilitates positive lifestyle changes enhancing healthy fertility . METHODS We conducted a prospect i ve cohort pilot study of 23 infertile couples attending an Adelaide-based fertility clinic for advice and treatment relating to infertility . The intervention was a comprehensive assessment interview with the couple , focused on health and lifestyle . Motivational interviewing techniques were used and ongoing support provided . The assessment was repeated after 4 months and included an exit question naire . The main outcome measure(s ) was self-reported lifestyle changes , including increased exercise , modified diet , reduced caffeine and alcohol consumption , ceased or reduced smoking and decreased psychological stress . RESULTS Following the initial lifestyle assessment interview , all participants reported adverse lifestyle behaviour . CONCLUSIONS The results suggest that the FAST ( Fertility ASsessment and advice Targeting lifestyle choices and behaviours ) approach of an individualized assessment of current lifestyle practice followed by ongoing one to two weekly telephone support is effective in promoting healthy lifestyle change . Larger studies using this methodology are now required In a pilot health promotion program for couples , we aim ed to build on re-evaluation of attitudes to health occurring early in marriage , and social support provided by partners , to address the weight gain and physical inactivity which may follow marriage . A r and omized controlled trial lasting 16 weeks used six modules focusing on nutrition and physical activity but including information about alcohol and smoking . Thirty-four of 39 couples enrolled completed the study .  Self-efficacy for diet and physical activity increased significantly in the program group while ranking of barriers to healthy behaviours decreased and ranking of beliefs about the benefits of health behaviours increased relative to controls . Intake of fat , take-away foods and alcohol decreased , and consumption of fruit , vegetables and reduced-fat foods increased significantly in the program group .  Physical activity  in the program group increased by the equivalent of 50 min of brisk walking weekly but did not differ significantly from controls . Cholesterol fell significantly by 6 % more in the program group than controls . In focus groups , participants unanimously found the program valuable . Health promotion programs design ed for couples can achieve short-term changes in behaviour and risk factors . Larger trials with longer-term monitoring , incorporating feedback from focus groups and cost-benefit analysis , are in progress The objective of this study was to evaluate the efficacy of a couple-tailored print ( CTP ) intervention on  colorectal cancer screening ( CRCS ) , CRCS intentions , and on knowledge and attitudes among couples in which neither partner is on schedule with regard to CRCS . A total of 168 married couples with both members non-adherent with CRCS were r and omly assigned to receive either a CTP pamphlet accompanied by a generic print ( GP ) pamphlet or a GP pamphlet only . Couples completed measures of CRCS , intentions , relational perspective on CRCS , discussion s about CRCS , spouse support for CRCS , spouse influence strategies , CRC knowledge , perceived CRC risk , and CRCS benefits and barriers . Results indicated there was no significant benefit of CTP vs. GP on CRCS , but there was a significant increase in CRCS intentions in CTP compared with GP . There was also a significant increase in relationship perspective on CRCS , a significant increase in husb and s ’ support of their wives ’ CRCS , and a significant increase in CRCS benefits in CTP . In summary , CTP did not increase CRCS practice s but increased intentions and perceived benefits of CRCS as well as improving couples ’ ability to view CRCS as having benefit for the marital relationship PURPOSE / OBJECTIVES To assess the efficacy of  Korean Immigrants and Mammography-Culture-Specific Health Intervention ( KIM-CHI ) , an educational program for Korean American ( KA ) couples design ed to improve  mammography uptake among KA women . DESIGN A two-group cluster r and omized , longitudinal , controlled design . SETTING 50 KA religious organizations in the Chicago area . SAMPLE 428 married KA women 40 years of age or older who had not had a mammogram in the past year . The women and their husb and s were recruited from 50 KA religious organizations . METHODS Couples were r and omly assigned to intervention or attention control groups . Those in the KIM-CHI program ( n = 211 couples ) were compared to an attention control group ( n = 217 couples ) at baseline , as well as at 6 and 15 months postintervention on mammogram uptake . MAIN RESEARCH VARIABLES Sociodemographic variables and mammography uptake were measured . Level of acculturation was measured using the Suinn-Lew Asian Self-Identity Acculturation Scale . Research ers asked questions about healthcare re sources and use , health insurance status , usual source of care , physical examinations in the past two years , family history of breast cancer , and history of mammography . FINDINGS The KIM-CHI group showed statistically significant increases in mammography uptake compared to the attention control group at 6 months and 15 months postintervention . CONCLUSIONS The culturally targeted KIM-CHI program was effective in increasing mammogram uptake among nonadherent KA women . IMPLICATION S FOR NURSING Nurses and healthcare providers should consider specific health beliefs as well as inclusion of husb and s or significant others . They also should target education to be culturally relevant for KA women to effectively improve frequency of breast cancer screening BACKGROUND A partner 's provision of support and smoking status has been consistently associated with women 's likelihood of smoking cessation during pregnancy and relapse in postpartum . DESIGN A three-group r and omized controlled intervention trial was conducted in 1996 to 2001 , with 583 women and their partners r and omized to usual care ( UC ) , woman-only ( WO ) , or partner-assisted ( PA ) intervention .  Follow-ups occurred at 28 weeks of pregnancy , and 2- , 6- , and 12-months postpartum . SETTING Womack Army Medical Center ( WAMC ) at Fort Bragg in Fayetteville , North Carolina . INTERVENTION Women in the UC condition received provider advice to quit and a self-help guide . The WO condition received UC components plus a late-pregnancy relapse prevention kit ( booklet and gift items ) and six counseling calls ( three in pregnancy and three postpartum ) initiated by a health advisor . Women in the PA condition received the WO intervention , and their partners received telephone counseling and a support guide emphasizing skills to help the woman build and maintain her confidence to quit smoking . Partners who smoked also received cessation aids and related counseling . MAIN OUTCOME MEASURE Seven-day self-reported abstinence from smoking at each follow-up . RESULTS Intent-to-treat analyses showed no significant differences by condition in women 's reports of abstinence at any follow-up . In late pregnancy , more partners were abstinent in the PA condition ( 15 % ) than in the UC condition ( 5 % ) , p = 0.02 . CONCLUSIONS Partner-assisted smoking-cessation interventions need further refinement . Influencing young couples ' support patterns may require more intensive and conjoint intervention . Partners who smoke could benefit from support for their cessation efforts OBJECTIVE The aim of this study was to measure the impact of two middle-trimester parenting communication classes on postpartum anxiety , marital adjustment , and postpartum adjustment . METHODS Seventy primiparous , low-risk couples enrolled in prenatal classes in a large urban hospital were r and omized to experimental and control groups . An educational intervention consisting of two second-trimester classes was facilitated by two social workers . The classes were based on a previous assessment of the educational needs of postpartum couples and contained didactic sessions , role-playing sessions , and values clarification exercises . The Spielberger State-Trait Anxiety Inventory and the Dyadic Adjustment Scale were administered to both groups prenatally in the second trimester and at 6 weeks and 6 months postpartum . A modified version of the O'Hara Postpartum Adjustment Question naire was administered at 6 weeks and 6 months postpartum . RESULTS Both groups scored comparably in the prenatal period . The experimental group scored significantly lower on anxiety and higher on dyadic adjustment at both postpartum time periods than the control group . The experimental group also indicated a higher degree of postpartum adjustment . CONCLUSION Prenatal parenting communication classes had a significant impact on postpartum anxiety , postpartum marital satisfaction , and postpartum adjustment OBJECTIVE To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain , psychological disability , physical disability , pain-coping , and pain behavior in patients with osteoarthritis ( OA ) of the knees . METHODS Eighty-eight OA patients with persistent knee pain were r and omly assigned to 1 of 3 conditions : 1 ) spouse-assisted pain-coping skills training , ( spouse-assisted CST ) , 2 ) a conventional CST intervention with no spouse involvement ( CST ) , or 3 ) an arthritis education-spousal support ( AE-SS ) control condition . All treatment was carried out in 10 weekly , 2-hour group sessions . RESULTS Data analysis revealed that at the completion of treatment , patients in the spouse-assisted CST condition had significantly lower levels of pain , psychological disability , and pain behavior , and higher scores on measures of coping attempts , marital adjustment , and self-efficacy than patients in the AE-SS control condition . Compared to patients in the AE-SS control condition , patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies . CONCLUSION These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients This study aim ed to assess the effect of a hospital‐based smoking cessation intervention delivered by midwives during routine antenatal and postnatal care on the smoking habits of pregnant women and their partners . At the first antenatal visit , women in the intervention group ( n=110 ) were given a demonstration of the immediate effects of smoking on foetal heart rate , brief smoking cessation advice and smoking cessation booklets for themselves and their partners ; at delivery , they were given brief advice and a booklet about postpartum cessation . Compared with an historical control group who received usual care ( n=110 ) and assuming those lost to follow‐up continued to smoke , biochemically‐verified maternal cessation sustained from at least 24 weeks gestation to late pregnancy was 6.4 % in the intervention group and 1.8 % in the comparison group . However , there was no difference between maternal quit rates at six months postpartum . Partners were more likely to try to quit in the intervention group , but quit rates did not differ . Exposure to the intervention was not associated with increased levels of psychological distress , as measured by the 12‐item General Health Question naire . We conclude that this type of intervention , when implemented by staff during routine care , is probably associated with a small improvement in maternal cessation in pregnancy , similar to that produced by minimal advice to quit smoking OBJECTIVES To measure the extent to which changes in cardiovascular risk factors were correlated among married couples following a 1-year primary care , family-centered , cardiovascular lifestyle intervention program and to identify couples who benefited most from this prevention program . DESIGN Observational study . SETTING Thirteen primary care centers in 13 towns in Britain . PARTICIPANTS A total of 1477 men aged 40 to 59 years and their female partners who attended a family health checkup in 1991 to 1992 from r and omly ordered invitations to registered families . After 1 year , 1204 ( 82 % ) partner pairs were rescreened . MAIN OUTCOME MEASURES One-year changes in cigarette smoking , systolic blood pressure , serum cholesterol level , blood glucose level , and a total coronary risk score . RESULTS Comparing men and women partners , baseline values and 1-year changes in overall coronary risk score ( Pearson r = 0.27 and r = 0.20 , respectively ) , cigarette smoking , body mass index , systolic blood pressure , cholesterol levels , and glucose levels were all positively correlated ( all P < .001 except smoking cessation , P = .03 ) . Changes in cholesterol levels and systolic blood pressure were also associated with partner 's baseline measurement ( P < or = .01 in both men and women ) . CONCLUSIONS Men and women who benefit most from risk factor reductions have partners who also tend to benefit most . Conversely , men and women who enjoy little or no benefit have partners who tend to have similarly small benefits . It is likely that lifestyle intervention targeted at men and women as couples rather than as individuals may result in a greater reduction in cardiovascular risk factors , possibly through mutual reinforcement of lifestyle changes A quasi-experimental prospect i ve study was conducted to assess the stage of change progression and elimination of unhealthy behaviors among active duty Army soldiers and their spouses ( N = 245 ) before and after attending a community-based wellness program .  Significant differences in stage progression between the intervention group and a comparison group was seen in the fitness ( p = 0.05 ) and communication risk categories ( p = 0.03 ) immediately after the intervention ; significant differences in stage progression in fitness ( p = 0.05 ) and spirituality ( p = 0.005 ) risk categories 6 months after baseline . There was a significant increase in seat belt use ( p = 0.008 ) , a decrease in reported tobacco use ( p < 0.05 ) , and a reduction in family stress ( p = 0.06 ) and personal stress ( p < 0.02 ) in the intervention group . Targeting multiple behavior changes and risk reduction in a single intervention program presents several challenges . In this pilot study , there were many positive nonsignificant trends in risk reduction that might translate into significant changes with a larger sample To evaluate the effects of social support and home urine monitoring on success with  dietary sodium  reduction , 114 essential hypertensive adults and a household partner were recruited . One of the pair was required to be the food preparer . Patients with their partners were r and omly assigned to either an active or passive partner condition . During dietary counseling in the active condition , both patient and partner were involved in instructions to change their diet to reduce their daily sodium intake to 80 mmol or less . In the passive condition , the partners were present during the dietary counseling , but no effort was made to involve them directly in the instruction or to encourage them to make personal dietary changes . Patients and active partners collected two 24-hr urine collection s between each of the first two counseling sessions and received feedback on the sodium results by a telephone call . In the passive partner condition , only patients collected urine for feedback . At the end of the 6 week instructional period , all patients and partners collected a 24-hr urine and had their blood pressure assessed . Half of each group was also r and omly assigned to have access to a system for periodic home-monitoring of urine for sodium content during a 3-month period beginning at week 6 of the study ( immediate ) . The delayed feedback group received the home-monitoring three months after completion of the dietary instruction . All patients , but only active partners , used the feedback system during their assignment periods and collected a 24-hr urine monthly between 6 and 30 weeks of the study . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE This r and omized controlled trial evaluated the effectiveness of a telephone-delivered , spouse-assisted lifestyle intervention to reduce patient LDL-C.  METHOD From 2007 to 2010 , 255 out patients with LDL-C>76 mg/dL and their spouses from the Durham Veterans Affairs Medical Center were r and omized to intervention or usual care .  The intervention comprised nine monthly goal - setting telephone calls to patients and support planning calls to spouses . Outcomes were assessed at 11 months . RESULTS Patients were 95 % male and 65 % White .  LDL-C did not differ between groups ( mean difference = 2.3 mg/dL , 95 % CI = -3.6 , 8.3 , p = 0.44 ) , nor did the odds of meeting goal LDL-C ( OR = 0.95 , 95 % CI = 0.6 , 1.7 ; p = 0.87 ) . Intakes of calories ( p = 0.03 ) , total fat ( p = 0.02 ) , and saturated fat ( p = 0.02 ) were lower for the intervention group . Cholesterol and fiber intake did not differ between groups ( p = 0.11 and 0.26 , respectively ) . The estimated rate of moderate intensity physical activity per week was 20 % higher in the intervention group ( IRR = 1.2 , 95 % CI = 1.0 , 1.5 , p = 0.06 ) . Most participants did not experience a change in cholesterol medication usage during the study period in the intervention ( 71.7 % ) and usual care ( 78.9 % ) groups . CONCLUSION This intervention might be an adjunct to usual primary care to improve adherence to lifestyle behaviors OBJECTIVE This study evaluated the effectiveness of a cognition-oriented breast self-examination ( BSE ) intervention program that is based on the Transtheoretical Model and reflects individual characteristics according to BSE stage among Korean women and their spouses . DESIGN A time-series nonequivalent control group design was used . SAMPLE AND MEASUREMENT : Twenty-four couples in each of 2 groups completed a preintervention test and were evaluated 1 , 3 , and 6 months later for their knowledge of breast cancer and BSE , spousal encouragement for BSE , perceived confidence in BSE methods , change in BSE stage , and perceived benefits and barriers to BSE . The intervention involved husb and s as well as women , and consisted of lectures on breast cancer and BSE , demonstrations and practice with models while being videotaped , and feedback . RESULTS There were significant differences between the control and experimental groups for all variables . Change of BSE stage in experimental group showed significantly advancement over time . CONCLUSIONS This intervention program was effective in promoting regular BSE practice and in enhancing confidence in BSE . The intervention also raised awareness among husb and s of the importance of breast health for their wives . Educational interventions for breast cancer prevention should be specified to an individual 's stage of BSE Forty-nine obese diabetic patients with obese spouses ( diabetic or nondiabetic ) were r and omly assigned to an alone or together condition . Patients in the alone group participated by themselves in a 20-week behavioral weight control program ; their spouses attended assessment sessions only . Patients in the together group attended the program with their spouses ; both were targeted for weight loss and taught social support strategies .  Weight losses of patients treated alone and together did not differ significantly at posttreatment ( 19.9 vs. 19.1 lb ) or 1-year follow-up ( 11.6 vs. 7.0 lb ) . However , there was a significant interaction of treatment and gender ; women did better when treated with their spouses , whereas men did better when treated alone . A " family-based " approach was not effective for these obese Type II diabetic patients as a whole but may be helpful for women OBJECTIVES To quantify the risk of infection and disease in spouses of tuberculosis patients and the extent to which intervention could reduce the risk in this highly exposed group . METHODS We compared HIV prevalence , TB prevalence and incidence and tuberculin skin test ( TST ) results in spouses of TB patients and community controls . HIV-positive spouses were offered isoniazid preventive therapy ( IPT ) , and TST was repeated at 6 , 12 and 24 months . RESULTS We recruited 148 spouses of smear-positive patients ascertained prospect ively and 3 % had active TB . We identified 203 spouses of previously diagnosed smear-positive patients , 11 had already had TB , and the rate of TB was 2.4 per 100 person years(py ) over 2 years ( 95 % CI 1.15 - 5.09 ) . 116 were found alive and recruited .  HIV prevalence was 37 % and 39 % in the prospect i ve and retrospective spouse groups and 17 % in controls . TST was ≥10 mm in 80 % of HIV negative and in 57 % of HIV-positive spouses ascertained retrospectively ; 74 % HIV negative and 62 % HIV-positive spouses ascertained prospect ively , and 48 % HIV negative and 26 % HIV-positive community controls . Of 54 HIV-positive spouses , 18 completed 6-month IPT . At 2 year follow-up , 87 % of surviving spouses had TST ≥10 mm and the rate of TB was 1.1 per 100 py ( 95 % CI 0.34 - 3.29 ) . CONCLUSIONS Spouses are a high-risk group who should be screened for HIV and active TB . TST prevalence was already high by the time the spouses were approached but further infections were seen to occur . Uptake and  adherence to IPT was disappointing , lessening the impact of short- duration therapy
OBJECTIVES Partners are a significant influence on individuals ' health , and concordance in health behaviours increases over time in couples .
Several theories suggest that couple-focused interventions for health behaviour change may therefore be more effective than individual interventions .