Improving health behaviors and outcomes after angioplasty: using economic theory to inform intervention

Patients who have been relieved of cardiac symptoms following angioplasty may not be sufficiently motivated to initiate behavior changes that can reduce risk of subsequent cardiac events. Finding an effective means to help patients modify their behavior thus presents a unique challenge. This paper describes an innovative behavioral intervention whose theoretical underpinning is net-present value economic theory. This intervention is being evaluated in a randomized controlled trial in which all patients complete a computerized baseline health assessment of 14 cardiovascular risk factors. Each patient is presented with an individualized risk-factor profile and asked to choose risk factors for modification. In the experimental group, each risk factor is presented with a corresponding numerical biologic age value that represents the relative potential to benefit from modifying each risk factor. Risk reduction for these patients is framed as the opportunity to reduce present biologic age (the net-present value), and improve current health status and quality of life. In the control group, risk reduction is framed in the standard risk-factor approach as the value of preventing future health problems. We hope to demonstrate that economic theory is a plausible perspective from which to design interventions aimed at communicating risk and facilitating change in health behaviors.