Coronary risk factor intervention: Characteristics associated with change

Abstract

Predicting change in coronary heart disease (CHD) risk factors (cigarette smoking, hypertension, and cholesterol) was undertaken in participants randomized to the treatment group of the Harvard Center of the Multiple Risk Factor Intervention Trial. The predictor variables of interest were psychosocial characteristics, responses to the initial group sessions intervention strategy, and change in weight. The Harvard sample consists of 652 men identified at high risk of death from CHD. Fifty percent were randomized into an intervention group, and 50% were referred to their usual source of medical care. For the analyses, men were stratified by their baseline smoking status and whether they were taking medication for hypertension. The analyses revealed that there was no single model that explained changes in all three risk factors. For example, cigarette smokers were significantly more likely to stop smoking if they attended the group sessions (p ≤ 0.001). An internal locus of control predicted a lower blood pressure by the end of the first year independent of medication (p ≤ 0.05). If a participant entered the trial with serum cholesterol as the only risk factor of concern, attending the group sessions was associated with a significant decrease by the end of the first year (p ≤ 0.05).

Changes in smoking behavior after a myocardial infarction.

“…Preillness psychological adjustment has been related to smoking cessation in medical patients (Burns, 1969; Dudley et al, 1977; Eaker, Benfari, & Reed, 1982; Lloyd & Crawley, 1980). In our study, however, only lower levels of preinfarction marital conflicts were related to short-term quitting.…”

Promoting Adherence to Transplant Medication Regimens: A Review of Behavioral Analysis

“…11 Failure to adhere to treatment regimens has been a significant and long-standing problem in healthcare. 12 Over the years, many books and articles have been written on the complex issue of behavioral regimen adherence. 11 One approach to adherence, often called behavioral analysis, focuses on the individual, his or her interactions with the environment, and how the environment affects one's well-being.…”

“…One of the primary premises of Social Learning Theory is that behavior is not simply a product of personal and environmental influences, but that instead the components interact as mutual determinants of each other. 12 For the purpose of this review, the operational definition of behavioral analysis will be as follows: the process by which behavior is observed, documented, and analyzed. Behavior is usually analyzed from 3 perspectives: the antecedent events that precede and serve as stimuli for the behavior, components of the actual behavior, and consequences that follow the behavior.…”

“…3 Research with other patient groups support Bandura's 13 beliefs. 6,12,17,18 One of the specific contentions of behavioral research is that having multiple recommendations-compared to having only 1leads to greater nonadherent behaviors. 6,11 Because most transplant recipients take multiple medications at various times throughout the day, their adherence to this complex regimen must be analyzed carefully.…”

Perceptions of participants regarding the long-term impact of an education and support program for heart attack and heart surgery patients and their partners

“…Several independent studies have concluded that for cardiovascular patients, social support is an important determinant in successful attempts at smoking cessation (Eaker, Benfari, & Reed, 1982; Giannetti, Reynolds, & Rihn, 1985;Powell & Arnold, 1982; Sirota, Curran, & Habif, 1985), weight loss (Finnegan & Suler, 1985), and maintenance of exercise programs (Daltroy & Godin, 1989). Highlighting the importance of social support, Marmot (1983) and Carmody, Istvan, Matarazzo, and Connor (1986) stressed the need for involving the family unit as a mechanism for implementing specific guidance and advice in the promotion of healthy-heart diets.…”