Effects of combining positive psychological intervention and lifestyle intervention on improving cardiovascular health for at-risk older adults: study protocol of a Chinese multicentric community-based randomised controlled trial (ACCOMPLI-CH).

Zhiwei Zheng, Xinyi Zhu, Chunbo Li, Tiemei Zhang, Lijuan Jiang, Xiaomei Liu, Deping Liu, Hui Zeng, Jing Yu, Yao Yao, Juan Li, Xiangjun Yin, Boyu Zhai, Baoxi Wang

Journal: BMJ open 2025;15(3):e090760

PMID: 40107697

Abstract

INTRODUCTION

Cardiovascular health is influenced by various factors, including not only physiological and behavioural ones but also psychological well-being. However, when developing comprehensive preventive approaches, psychological interventions often receive less attention, despite their possible multiple mechanisms on cardiovascular health. Incorporating both healthy behaviour and psychological well-being promotion would be a more efficacious preventive approach. This study aims to investigate the effects of a community-based multicomponent intervention combining positive psychological intervention and lifestyle intervention on improving cardiovascular health among older adults with risk factors of cardiovascular diseases.

METHODS AND ANALYSIS

This study is a multicentre, community-based, randomised controlled trial with 18 months of intervention and follow-up for community-dwelling older adults aged 60 years and above with risk factors for cardiovascular health. Intervention activities last 6 months and are composed of in-person group training sessions of 60-80 min led by trained group instructors and weekly self-monitoring homework. Participants are randomly assigned to a multicomponent intervention 'Harmony' group (24 sessions of positive psychology and lifestyle intervention delivered weekly), an active control 'Lifestyle' group (eight sessions of lifestyle intervention delivered every 3-4 weeks) or a waitlist control group (no intervention activities). Positive psychological training sessions are designed using well-known techniques derived from positive psychology theories with adaptations to Chinese culture, and lifestyle training sessions are developed according to national guidelines. The primary outcome includes the change of a composite score of systolic blood pressure, total cholesterol, high-density lipoprotein and low-density lipoprotein levels, as well as psychological well-being measured from three perspectives, including hedonic, eudaimonic and evaluative well-being. Secondary assessments include other measures for physical and biological indicators, psychological well-being, health behaviours, social connection factors and overall cognitive functions. Primary data analyses will follow the intention-to-treat principle. To examine the effects of intervention, multilevel mixed models will be performed. In case of any differences in baseline participant characteristics, they will be adjusted for as covariates.

ETHICS AND DISSEMINATION

A centralised ethics review process was conducted, and the study protocol was approved by the ethics committee of the Institutional Review Board of the Institute of Psychology, Chinese Academy of Sciences in April 2022. A signed written informed consent form will be obtained from all participants. On completion, the trial results will be disseminated through published manuscripts and presentations at scientific conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2200062929.

© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.

Address: Center on Aging Psychology, State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology Chinese Academy of Sciences, Beijing, China.; Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China.; Faculty of Psychology, Southwest University, Chongqing, China.; Key Laboratory of Jiangxi Province for Psychology and Cognition Science, School of Psychology, Jiangxi Normal University, Nanchang, China.; Xiangya School of Nursing, Central South University, Changsha, China.; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.; Department of Cardiology, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences Institute of Geriatric Medicine, Beijing, China.; Graduate School, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.; The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Beijing Hospital/National Center of Gerontology, National Health Commission of the People's Republic of China, Beijing, China.; China Center for Health Development Studies, Peking University, Beijing, China.; Division of Elderly Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.; Center on Aging Psychology, State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology Chinese Academy of Sciences, Beijing, China [email protected].; Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China.
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