Study title

We explored the processes of establishing and conducting healthy living activities and measured outcome on process, health behavior and health. The HLCs offer programs of physical activity, diet, smoking- and snuff cessation, obesity treatment among adults and children, alcohol problems and mastering of depression for adults and adolescents. We used Intervention Mapping as a processing tool to facilitate research activity that takes into account that the activities in the HLCs should be based on best practice, grounded in a local community´s needs and resources, and be sustainable over time. The programs specifically target the underlying causes of chronic disease. We mapped the distribution of lifestyle habits among individuals and families. We also explored how lifestyle habits relate to known determinants of social health inequality, such as adverse previous experiences, participation in working life and low income. We explored effects of the interventions delivered in HLCs by short time (6 months) controlled trial methodology with waiting list control group, and also explore long term effects by longitudinal observational study design and follow up during 2 years or more. Data from the study was also communicated with the HLCs and was used in continuous planning and improvement of interventions. HLCs base their clinical interventions on motivational interviewing (MI) approach, a directive and client centred method aiming at promoting autonomy and self-determination. The research group´s theoretical framework included Self-determination theory (SDT). This theory is strongly linked to the clinical practice of MI. The SDT research community has developed concepts, questionnaires and research methods that are feasible for studying human behaviour and motivation. We also studied if socioeconomic differences are of importance for entering or dropping out of HLC interventions, and the ability to sustain lifestyle changes.