The COVID-19 Crisis as a Teachable Moment for Lifestyle Change in Dutch Cardiovascular Disease Patients

Abstract

Objective: When lifestyle changes are needed, life events or crises such as COVID-19 may function as “teachable moments”. This study aimed to explore whether the pandemic can provoke a teachable moment regarding lifestyle change in cardiovascular disease patients.Method: In this cross-sectional survey study, 830 cardiovascular disease patients reported their intentions to change lifestyle, instigated by the corona crisis, together with risk perception, affective impact, and changed self-concept, based on a “teachable moments” framework.Results: Between 8 and 28% of the sample reported increased intentions to optimize lifestyle behaviors, particularly related to general lifestyle (28%), physical activity (25%), and diet (21%). Multivariate regression analyses revealed that changed self-concept was associated with higher intentions to improve general lifestyle (B = 0.26; CI = 0.19–0.33), physical activity (B = 0.23; CI = 0.16–0.30), and smoking (B = 0.29; CI = 0.01–0.57). In addition, changed self-concept and affective impact were both significantly associated with higher intentions to improve diet (resp. B = 0.29; CI = 0.21–0.36 and B = 0.12; CI = 0.04–0.21) and to limit alcohol consumption (resp. B = 0.22; CI = 0.13–0.30 and B = 0.11; CI = 0.01–0.20). We did not find evidence for an important role of risk perception on behavior change intentions.Conclusion: The COVID-19 crisis evoked a potential teachable moment for lifestyle change in cardiovascular disease patients, driven by a change in a patient's self-concept and to a lesser extent by an affective impact of the COVID-19 crisis. These results suggest an important window of opportunity for healthcare professionals to utilize the pandemic to promote a healthy lifestyle to their patients.

The development and validation of scales to measure the presence of a teachable moment following a cardiovascular disease event

“…Someone’s health behaviors can thus be influenced by an assessment of the importance of social roles to a person ( Stets, 2020 ). We also found evidence for this phenomenon in the high association between Changed self-concept and Event-related lifestyle change in the current study, as well as in our previous work ( Brust et al, 2021 ).…”

“…The KMO (0.84) and significant Bartlett’s test of sphericity (χ2(1378, N = 300) = 6617;p < 0.001) indicated that data from the first half of the dataset were acceptable for factor analysis ( Watkins, 2018 ). Next, seventeen items ( McBride et al, 2003 , Lawson and Flocke, 2009 , Brust et al, 2021 , Karvinen et al, 2015 , Kim, 2013 , Watkins, 2018 , Bandura, 1998 , Stets, 2020 , Becker, 1974 , Olson, 2010 , Nagy et al, 2017 , Lt and Bentler, 1999 , Kline, 2015 , Cohen, 1988 , Fotuhi et al, 2013 , Chiou and Wan, 2007 , Oliveira et al, 2019 ) were removed from the dataset because they consistently showed communities below < 0.30, indicating that they possibly not load sufficiently on any factor. The new EFA showed that nine factors had eigenvalues over Kaiser’s criterion 1.…”

“…Within the field of health behavior change, research has identified life situations that may help instigate risk-reducing changes in behavior. These situations, referred to as ‘teachable moments’ (TMs), often occur in the time window following an important life or health event, and individuals may be more willing to optimize their lifestyle following a TM ( McBride et al, 2003 , Lawson and Flocke, 2009 , Flocke et al, 2014 , Brust et al, 2021 ). Because CVD events have been linked to lifestyle changes such as quitting smoking ( Tofler et al, 2015 ), scholars suggest that a potential TM following a cardiac event may induce the adoption of healthier lifestyle behaviors among affected patients ( Tofler et al, 2015 , Coull and Pugh, 2021 ).…”

Changes in Brain-Health Related Modifiable Risk Factors in Older Adults After One Year of COVID-19-Restrictions

“…It has been suggested that the COVID-19 pandemic provides an opportunity for healthcare professionals to promote lifestyle change ( 43 , 44 ). When regarding dementia risk, the general population is mostly unaware of its relation with lifestyle ( 45 , 46 ).…”

A qualitative exploration of women's perspectives and acceptability of including new cancer awareness information in all‐clear breast or cervical screening results

“…Described as an event or circumstance that motivates an individual to take positive actions regarding their health, ‘teachable moments’ have been examined across an array of settings over the years to assess whether health events can motivate risk‐reducing behaviours. For example, HIV treatment initiation and smoking cessation (Vidrine et al, 2018 ), antenatal care visits and screening for sickle cell and thalassemia (Brown et al, 2011 ; Tsianakas et al, 2012 ), COVID‐19 crisis and lifestyle change in cardiovascular disease patients (Brust et al, 2021 ), ‘cancer worry’ and smoking cessation (McBride et al, 2008 ) and cancer screening, diagnosis, care and survivorship (Gray et al, 2021 ; Karvinen et al, 2015 ; Kathuria et al, 2020 ; McBride et al, 2017 ; Neumann et al, 2021 ).…”