Preventive Medicine

HAPA-based interventions produce modest, significant post-intervention behavior change.

Meta-analysis of 74 randomized trials (9,115 intervention vs 8,858 control) found an overall post-intervention effect size d = 0.459 on health behaviours. Effects were largest for physical activity (d = 0.504) and fruit/vegetable intake (d = 0.636), and for other dietary behaviours (d = 0.776). Dual-phase (motivational+volitional), approach-focused, hybrid-delivery, and 12–24 week interventions showed larger effects than single-component or avoidance designs. Findings support using structured HAPA frameworks in clinical populations, but durability beyond post-intervention needs further study. 1

Disclosing proteomic RCVR scores increased cardioprotective prescribing in type 2 diabetes.

Open-label randomized trial (n=377) showed higher cardioprotective prescribing when SomaScan RCVR scores were shared: 32.1% vs 9.6% (OR 5.45; p<0.001). Per-risk-bin prescribing rose across elevated risk strata, indicating risk-concordant treatment escalation after disclosure. Among 173 with paired scores, initiation of cardioprotective therapy corresponded to a 3.9% reduction in proteomic-predicted CV risk at follow-up. Results suggest proteomic risk disclosure can change clinician and patient behavior but require evaluation of clinical outcomes, cost, and workflow integration. 2

Intensive lifestyle reduced long-term multimorbidity risk; metformin did not.

Long-term DPP/DPPOS follow-up in 1,173 participants using CMS data found lifestyle vs placebo reduced multimorbidity risk (HR 0.79; 95% CI 0.68–0.93). Metformin showed no significant difference versus placebo (HR 0.91; 95% CI 0.78–1.07). Lifestyle effects persisted when excluding diabetes and were stronger for the costliest condition dyads (HR 0.57; 95% CI 0.38–0.85). These data support prioritizing intensive lifestyle programs for adults with prediabetes to lower long-term multimorbidity burden. 3