The Impact of Behavioral Counseling on Stage of Change in Fat Intake, Physical Activity, and Cigarette Smoking in Adults at Increased Risk of Coronary Heart Disease

Overview

Journal Am J Public Health

Specialty Public Health

Date 2001 Feb 24

PMID 11211636

Citations 43

Authors

A Steptoe

S Kerry

E Rink

S Hilton

Affiliations

Soon will be listed here.

Abstract

Objectives: This study assessed stages of change in fat intake, physical activity, and cigarette smoking during a randomized controlled trial of behavioral counseling.

Methods: Twenty general practices (primary health care centers) were randomized to lifestyle counseling by behavioral methods or to usual health promotion. A total of 883 patients were selected for the presence of 1 or more of the following risk factors: cigarette smoking, high cholesterol, or a combination of a high body mass index and low physical activity. Stage of change (precontemplation, contemplation, preparation, and action/maintenance) was assessed at baseline and after 4 and 12 months.

Results: The odds of moving to action/maintenance for behavioral intervention vs control patients at 4 months were 2.15 (95% confidence interval [CI] = 1.30, 3.56) for fat reduction, 1.89 (95% CI = 1.07, 3.36) for increased physical activity, and 1.77 (95% CI = 0.76, 4.14) for smoking cessation. The likelihood of achieving action/maintenance was related to baseline stage for all 3 behaviors.

Conclusions: Brief behavioral counseling based on advice matched to stage of readiness for change may be valuable in encouraging healthy lifestyles among patients in primary care at raised risk of cardiovascular disease.

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References

Glanz K, Patterson R, Kristal A, Feng Z, Linnan L, HEIMENDINGER J . Impact of work site health promotion on stages of dietary change: the Working Well Trial. Health Educ Behav. 1998; 25(4):448-63. DOI: 10.1177/109019819802500404. View

Pinto B, Goldstein M, Marcus B . Activity counseling by primary care physicians. Prev Med. 1998; 27(4):506-13. DOI: 10.1006/pmed.1998.0335. View

Marcus B, Bock B, Pinto B, Forsyth L, Roberts M, Traficante R . Efficacy of an individualized, motivationally-tailored physical activity intervention. Ann Behav Med. 1999; 20(3):174-80. DOI: 10.1007/BF02884958. View

Doherty S, Steptoe A, Rink E, Kendrick T, Hilton S . Readiness to change health behaviours among patients at high risk of cardiovascular disease. J Cardiovasc Risk. 1999; 5(3):147-53. View

Little P, Barnett J, Margetts B, Kinmonth A, Gabbay J, Thompson R . The validity of dietary assessment in general practice. J Epidemiol Community Health. 1999; 53(3):165-72. PMC: 1756848. DOI: 10.1136/jech.53.3.165. View

Steptoe A, Doherty S, Rink E, Kerry S, Kendrick T, Hilton S . Behavioural counselling in general practice for the promotion of healthy behaviour among adults at increased risk of coronary heart disease: randomised trial. BMJ. 1999; 319(7215):943-7; discussion 947-8. PMC: 28246. DOI: 10.1136/bmj.319.7215.943. View

DiClemente C, Prochaska J, Fairhurst S, Velicer W, Velasquez M, Rossi J . The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991; 59(2):295-304. DOI: 10.1037//0022-006x.59.2.295. View

Marcus B, Rakowski W, Rossi J . Assessing motivational readiness and decision making for exercise. Health Psychol. 1992; 11(4):257-61. DOI: 10.1037//0278-6133.11.4.257. View

Prochaska J, DiClemente C, Norcross J . In search of how people change. Applications to addictive behaviors. Am Psychol. 1992; 47(9):1102-14. DOI: 10.1037//0003-066x.47.9.1102. View

10.

Marcus B, Rossi J, Selby V, Niaura R, Abrams D . The stages and processes of exercise adoption and maintenance in a worksite sample. Health Psychol. 1992; 11(6):386-95. DOI: 10.1037//0278-6133.11.6.386. View

11.

Curry S, Kristal A, Bowen D . An application of the stage model of behavior change to dietary fat reduction. Health Educ Res. 1992; 7(1):97-105. DOI: 10.1093/her/7.1.97. View

12.

Campbell M, DeVellis B, Strecher V, Ammerman A, DeVellis R, Sandler R . Improving dietary behavior: the effectiveness of tailored messages in primary care settings. Am J Public Health. 1994; 84(5):783-7. PMC: 1615043. DOI: 10.2105/ajph.84.5.783. View

13.

Strecher V, Kreuter M, Den Boer D, Kobrin S, Hospers H, Skinner C . The effects of computer-tailored smoking cessation messages in family practice settings. J Fam Pract. 1994; 39(3):262-70. View

14.

Pate R, Pratt M, Blair S, Haskell W, Macera C, Bouchard C . Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995; 273(5):402-7. DOI: 10.1001/jama.273.5.402. View

15.

Roe L, Strong C, Whiteside C, Neil A, Mant D . Dietary intervention in primary care: validity of the DINE method for diet assessment. Fam Pract. 1994; 11(4):375-81. DOI: 10.1093/fampra/11.4.375. View

16.

Calfas K, Long B, Sallis J, Wooten W, Pratt M, Patrick K . A controlled trial of physician counseling to promote the adoption of physical activity. Prev Med. 1996; 25(3):225-33. DOI: 10.1006/pmed.1996.0050. View

17.

Beresford S, Curry S, Kristal A, Lazovich D, Feng Z, Wagner E . A dietary intervention in primary care practice: the Eating Patterns Study. Am J Public Health. 1997; 87(4):610-6. PMC: 1380841. DOI: 10.2105/ajph.87.4.610. View

18.

Bland J, Kerry S . Statistics notes. Weighted comparison of means. BMJ. 1998; 316(7125):129. PMC: 2665397. DOI: 10.1136/bmj.316.7125.129. View

19.

Marcus B, Emmons K, Linnan L, Taylor E, Bock B, Roberts M . Evaluation of motivationally tailored vs. standard self-help physical activity interventions at the workplace. Am J Health Promot. 1998; 12(4):246-53. DOI: 10.4278/0890-1171-12.4.246. View

20.

King A, Sallis J, Dunn A, Simons-Morton D, Albright C, Cohen S . Overview of the Activity Counseling Trial (ACT) intervention for promoting physical activity in primary health care settings. Activity Counseling Trial Research Group. Med Sci Sports Exerc. 1998; 30(7):1086-96. DOI: 10.1097/00005768-199807000-00011. View