Risk Confrontation in Primary Care as a Possible Teachable Moment Toward Healthy Lifestyle Changes in Individuals with High Cardiovascular Risk

Objective. Cardiovascular diseases (CVD) are one of the most common causes of death. Healthy lifestyle changes are the focus of primary prevention of CVD. Naturally occurring health events that spontaneously urge behavior changes have been defined as Teachable Moments (TM). However, so far TMs have been explored in urgent life events, such as experiencing an acute coronary event. The present study aimed to explore whether a less urgent event, such as being confronted with an increased risk of CVD would be a TM, which psychosocial factors are predicting this, and whether experiencing a TM in turn leads to improved health outcomes. Method. The study included 114 patients from GP practices, who were informed about their increased risk for developing CVD. They were provided with “The Stevit Box”, an at-home self-monitoring device measuring blood pressure (BP) and weight. Participants further filled out the Cardiac Lifestyle Change Intention (LCI) scale. Univariate and multivariate...Show moreObjective. Cardiovascular diseases (CVD) are one of the most common causes of death. Healthy lifestyle changes are the focus of primary prevention of CVD. Naturally occurring health events that spontaneously urge behavior changes have been defined as Teachable Moments (TM). However, so far TMs have been explored in urgent life events, such as experiencing an acute coronary event. The present study aimed to explore whether a less urgent event, such as being confronted with an increased risk of CVD would be a TM, which psychosocial factors are predicting this, and whether experiencing a TM in turn leads to improved health outcomes. Method. The study included 114 patients from GP practices, who were informed about their increased risk for developing CVD. They were provided with “The Stevit Box”, an at-home self-monitoring device measuring blood pressure (BP) and weight. Participants further filled out the Cardiac Lifestyle Change Intention (LCI) scale. Univariate and multivariate regression analyses were used to investigate whether risk perception, affective impact, and a changed self-concept predicted LCI and reductions in BP and body mass index (BMI) at six months, controlling for BP and BMI at baseline. Further, univariate regressions were conducted with LCI as the predictor and BP and BMI as outcome variables, while controlling for baseline measurements. Results. Of our participants, 55.3% experienced increased lifestyle change intentions. A lower risk perception ((B= -0.27; CI = -0.39 - (-0.15)) and a higher change in self-concept (B = 0.34; CI= 0.23 - 0.44) were predictors of LCI. High risk perception (B= 0.23; CI= 0.06 - 0.42) and higher changes in self-concept (B= 0.54; CI= 0.37- 0.72) predicted a lower BMI reduction at six months. A higher change in self-concept predicted a higher reduction in BP (B=-3.32; CI= -6.55- (-0.09)). Lastly, LCI predicted higher reductions in BP (-5.04; CI= -9.08- (-0.29)). Conclusion. Results suggest that less urgent cardiac events, such as a confrontation with an increased risk for CVD, can be experienced as a potential TM that urges lifestyle change intentions and affects health outcomes. TMs may offer a unique opportunity to urge lifestyle changes in primary care.Show less

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Risk Confrontation in Primary Care as a Possible Teachable Moment Toward Healthy Lifestyle Changes in Individuals with High Cardiovascular Risk