Multiple Risk Factor Counseling to Promote Heart-healthy Lifestyles in the Chest Pain Observation Unit: Pilot...

Area of Science:

• Cardiology
• Public Health
• Behavioral Science

Background:

• The chest pain observation unit (CPOU) presents an opportunity to encourage heart-healthy lifestyle changes.
• Assessing the effectiveness of interventions targeting cardiovascular risk factors (CRFs) during CPOU admission is crucial.

Purpose of the Study:

• To evaluate a multiple risk factor intervention's impact on CPOU patients' health beliefs and readiness to change behaviors.
• To estimate the intervention's effect on diet, physical activity, and smoking.

Main Methods:

• A pilot randomized controlled trial involved 140 adult patients with at least one modifiable CRF admitted to the CPOU.
• Intervention included face-to-face counseling and telephone follow-ups versus minimal counseling.
• Health beliefs, stage of change, and CRF-related behaviors were measured over 6-month follow-up.

Main Results:

• No significant differences in health beliefs or behaviors were observed between the full and minimal counseling groups.
• Patients in both groups showed increased perceived benefits of healthy behaviors and readiness to change diet and exercise.
• Significant improvements were noted in readiness to change dietary fat intake, fruit/vegetable consumption, and regular exercise.

Conclusions:

• A comprehensive intervention did not significantly improve behavioral outcomes compared to minimal counseling.
• CPOU admission serves as a "teachable moment" for cardiovascular risk reduction, evidenced by sustained belief and behavior changes.
• Future research should explore emergency department-initiated counseling for cardiovascular risk behaviors in coordination with primary care.