Choosing Health

Choosing Health: Making healthy choices easier (Department of Health, 2004) is a White Paper which sets out an agenda to 'support people in making better choices for their health and the health of their families' Full details can be found on http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanceArticle/
fs/en?CONTENT_ID=4094550&chk=aN5Cor

It provides a key set of principles to inform that choice. Six priorities for action have been identified;

• Smoking prevention and smoking cessation

Feenstra TL, Hamberg-van Reenen HH, Hoogenveen RT et al. Cost-effectiveness of face-to-face smoking cessation interventions: a dynamic modeling study. Value in Health. 2005; 8(3); 178-190.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15877590&dopt=Abstract

Feenstra et al (2005) undertook a CEA and a CUA to compare 5 face-to-face smoking cessation interventions, managed by either medical professionals or educated smoking cessation counsellors, with current practice in the authors' setting.

A full abstract for this study is available on the following website;
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=22006008066

• Reduction of obesity and improved diet and nutrition

Raftery JP, Yao GL, Murchie P et al. Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial. British Medical Journal. 2005; 330: 707-710.
http://www.bmj.com/cgi/content/abstract/330/7493/707

Raftery et al (2005) examined a nurse-led clinic for patients with coronary heart disease (CHD) which was aimed at promoting medical and lifestyle components of secondary prevention. This was compared to usual care based on a CUA.

A full abstract for this study is available on the following website;
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=22005008126

• Increased physical activity levels

Wang LY, Yang Q, Lowry R et al. Economic analysis of a school-based obesity prevention program. Obesity Research. 2003; 11(11): 1313-1324.
http://www.obesityresearch.org/cgi/content/abstract/11/11/1313

Wang et al (2003) undertook a CEA to compare a school-based intervention designed to reduce obesity in youth of middle-school age with a no intervention alternative, whereby students received the usual curricula and physical education classes.

A full abstract for this study is available on the following website;
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=22004006125

The NICE physical activity public health intervention guidance covers 4 methods commonly used to increase the population's physical activity levels:
1. brief interventions in primary care
2. exercise referral schemes
3. pedometers
4. community-based walking and cycling programmes.
http://www.nice.org.uk/guidance/PHI2

• Encouragement of sensible drinking and preventing alcohol misuse

Sobell LC, Sobell MB, Leo GI et al. Promoting self-change with alcohol abusers: a community-level mail intervention based on natural recovery studies. Alcoholism: Clinical and Experimental Research. 2002; 26(6): 936-948.
http://www.alcoholism-cer.com/pt/re/alcoholism/abstract.00000374-200206000-00025.htm;
jsessionid=FVtH0FgkQGJRGmnWdsHwZn8147y1JWsL4jp14mVxLwx2yxy3Qvyd!736553971!-949856145!8091!-1

Sobell et al (2002) undertook a CCA to compare motivational enhancement/personalised feedback (MEPF), consisting of advice describing their drinking levels, high-risk situations and motivation for change with bibliotherapy/drinking guidelines (BDG), another comparator group of alcohol abusers were given two pamphlets with information on alcohol and guidelines for low-risk drinking, also by post.

A full abstract for this study is available on the following website;
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=22002001181

• Improved sexual health

Wang LY, Davis M, Robin L et al. Economic evaluation of safer choices: a school-based human immunodeficiency virus, other sexually transmitted diseases, and pregnancy prevention program. Archives of Pediatrics and Adolescent Medicine. 2000: 154(10): 1017-1024.
http://archpedi.ama-assn.org/cgi/content/abstract/154/10/1017

Wang et al (2000) compared the use of a school-based programme, Safer Choices, which was aimed at preventing human immunodeficiency virus (HIV), infection by other sexually transmitted diseases (STDs) such as chlamydia, gonorrhoea infections and pelvic inflammatory disease, and unintended pregnancy among adolescents with a standard information-based programme. The evaluation was based on a CEA.

A full abstract for this study is available on the following website;
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=22000001649

• Improved mental health

Kominski G, Andersen R, Bastani R et al. UPBEAT: the impact of a psychogeriatric intervention in VA medical centers. Medical Care. 2001; 39(5): 500-512.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11317098&dopt=Abstract

Kominski et al (2001) undertook a CCA to compare a package of in depth psychogeriatric assessment and mental health care co-ordination by a multidisciplinary team, termed the Unified Psychogeriatric Biopsychosocial Evaluation and Treatment (UPBEAT) programme with usual care.

A full abstract for this study is available on the following website;
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?View=Full&ID=22001008118