4.1. Comparison with Previous Literature
EIRA
HEART, DER
We assumed that introducing a lifestyle programme in primary practices would give lifestyle change a boost during the intervention period and participants would be stimulated to change their lifestyle through goalsetting and discussion of participating in the programme. However, a significant short-term or longer-term (24 months) effect on cardiovascular outcomes or lifestyle behaviours was not found.The most important difference between the current study and previous studies is that previous studies examined the actual participants of a lifestyle programme, while in our study, outcomes were measured on a population level, where participants had the possibility to participate in the programme—or not. It appeared that only 15 percent of the participants included in the intervention period were willing to participate in the Healthy Heart programme. In line with previous studies [In contrast, the comparable Spanish EIRA trial [Van der Bruggen et al. [Because intention supports behaviour change, participants in our study were challenged—either through questionnaires (control period) or by their GP/PN (intervention period)—to set a goal on lifestyle change at baseline [This study confirms that implementation of lifestyle programmes in primary care still faces large barriers [Time, effort and lack of knowledge about the effectiveness of the programme were barriers for care providers to promote participation in the Healthy Heart programme [