The Effects of Preventive Counseling Followed by Remote Support Via Telephone on the Motivation to Change Lifestyle in Patients With High and Very High Cardiovascular Risk
https://doi.org/10.18087/cardio.2020.5.n1009
Abstract
Aim To evaluate effectiveness of preventive telephone counseling with a nutritional component and distance support for three months with respect of motivation for lifestyle modification in patients with high and very high cardiovascular risk (CVR).
Material and methods This prospective, controlled, randomized clinical study in two parallel groups included patients with high and very high CVR (5–9 % and ≥10 % according to the SCORE scale) who had at least two criteria of metabolic syndrome. Patients were randomized to the main and control groups in a 1:1 ratio with age and gender stratification. The main group received comprehensive preventive counseling with a nutritional component and distant support via telephone once in two weeks for three months (total 6 consultations). Patients of the control group received standard counseling by a health center physician. Patients’ motivation for lifestyle changes was evaluated with a questionnaire at baseline and at 6 and 12 months.
Results The study included a total of 100 patients (mean age, 59.85±4.47 years, 80 % females). At baseline, 81 % of patients had high and 19% of patients had very high CVR. Patients of the study groups did not differ in major demographic and clinical characteristics. At 6 month of follow-up, the main group showed a significantly more pronounced positive changes in motivation and healthier lifestyle (50 % in the main group vs. 12% in the control group, р<0.01). At 12 months of follow-up, the number of such patients somewhat decreased to 38%. In this process, a vast majority of patients in the control group (82 %) continued theoretically considering the expediency of lifestyle modification.
Conclusions Preventive counseling with nutritional component and further distance support via telephone for three months for patients with high and very high CVR provided increased motivation for healthier lifestyle and positive behavioral changes.
About the Authors
N. V. PogosovaNational Medical Research Center of Cardiology, Moscow, Russia
Russian Federation
professor, MD, Deputy General Director for research work and preventive cardiology
A. I. Yusubova
Russian Federation
cardiologist
Yu. M. Yufereva
Russian Federation
Chief scientific researcher, MD
A. K. Ausheva
Russian Federation
Chief scientific researcher, MD
A. V. Karpova
Russian Federation
Senior researcher
V. A. Vygodin
Russian Federation
Senior researcher
References
1. Bassi N, Karagodin I, Wang S, Vassallo P, Priyanath A, Massaro E et al. Lifestyle Modification for Metabolic Syndrome: A Systematic Review. The American Journal of Medicine. 2014;127(12):1242.e1-1242.e10. DOI: 10.1016/j.amjmed.2014.06.035
2. Rutten GM, Meis JJ, Hendriks MR, Hamers FJ, Veenhof C, Kremers SP. The contribution of lifestyle coaching of overweight patients in primary care to more autonomous motivation for physical activity and healthy dietary behaviour: results of a longitudinal study. International Journal of Behavioral Nutrition and Physical Activity. 2014;11(1):86. DOI: 10.1186/s12966-014-0086-z
3. Boytsov S.A., Pogosova N.V., Bubnova M.G., Drapkina O.M., Gavrilova N.E., Yeganyan R.A. et al. Cardiovascular prevention 2017. National guidelines. Russian Journal of Cardiology. 2018;23(6):7–122. DOI: 10.15829/1560-4071-2018-6-7-122
4. Goodpaster BH, DeLany JP, Otto AD, Kuller L, Vockley J, South-Paul JE et al. Effects of Diet and Physical Activity Interventions on Weight Loss and Cardiometabolic Risk Factors in Severely Obese Adults: A Randomized Trial. JAMA. 2010;304(16):1795–802. DOI: 10.1001/jama.2010.1505
5. Spiller V, Scaglia M, Meneghini S, Vanzo A. Assessing motivation for change toward healthy nutrition and regular physical activity. Validation of two sets of instruments. Mediterranean Journal of Nutrition and Metabolism. 2009;2(1):41–7. DOI: 10.1007/s12349-009-0044-5
6. Livia B, Elisa R, Claudia R, Roberto P, Cristina A, Emilia ST et al. Stage of Change and Motivation to a Healthier Lifestyle before and after an Intensive Lifestyle Intervention. Journal of Obesity. 2016;2016:6421265. DOI: 10.1155/2016/6421265
7. Silva MN, Markland D, Carraça EV, Vieira PN, Coutinho SR, Minderico CS et al. Exercise Autonomous Motivation Predicts 3-yr Weight Loss in Women. Medicine & Science in Sports & Exercise. 2011;43(4):728–37. DOI: 10.1249/MSS.0b013e3181f3818f
8. Shaikh AR, Vinokur AD, Yaroch AL, Williams GC, Resnicow K. Direct and Mediated Effects of Two Theoretically Based Interventions to Increase Consumption of Fruits and Vegetables in the Healthy Body Healthy Spirit Trial. Health Education & Behavior. 2011;38(5):492–501. DOI: 10.1177/1090198110384468
9. Teixeira PJ, Silva MN, Mata J, Palmeira AL, Markland D. Motivation, self-determination, and long-term weight control. International Journal of Behavioral Nutrition and Physical Activity. 2012;9(1):22. DOI: 10.1186/1479-5868-9-22
10. Pogosova N.V., Yufereva Yu.M., Yusubova A.I., Allenov A.M., Karpova A.V., Ausheva A.K. et al. Preventive Counselling With the Use of Remote Technologies Provides Effective Control of Metabolic Risk Factors in Patients With High and Very High Cardiovascular Risk. Kardiologiia. 2018;58(10):34–44. DOI: 10.18087/cardio.2018.10.10183
11. Pogosova N.V., Yufereva Yu.M., Yusubova A.I., Ausheva A.K., Starodubova A.V., Allenov A.M. et al. The effectiveness of preventive counseling with the use of remote technologies on medical awareness of cardiovascular risk factors in patients with high and very high cardiovascular risk. Kardiologiia. 2019;59(10S):31–40. DOI: 10.18087/cardio.n472
12. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE et al. International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise. 2003;35(8):1381–95. DOI: 10.1249/01.MSS.0000078924.61453.FB
13. Oganov R.G., Pogosova G.V., Koltunov I.E., Belova Yu.S., Vygodin V.A., Sokolova Ya.V. RELIPH - REgularnoye Letcheniye I ProPHylaktika (Regular Treatment and Prevention) – The Key to Improvement of Situation With Cardiovascular Diseases in Russia: Results of Multicenter Study. Part I. Kardiologiia. 2007;47(5):58–66.
14. Lawlor ER, Bradley DT, Cupples ME, Tully MA. The effect of community-based interventions for cardiovascular disease secondary prevention on behavioural risk factors. Preventive Medicine. 2018;114:24–38. DOI: 10.1016/j.ypmed.2018.05.019
15. Schwingshackl L, Dias S, Hoffmann G. Impact of long-term lifestyle programmes on weight loss and cardiovascular risk factors in overweight/obese participants: a systematic review and network metaanalysis. Systematic Reviews. 2014;3(1):130. DOI: 10.1186/2046-4053-3-130
16. Digenio AG. Comparison of Methods for Delivering a Lifestyle Modification Program for Obese Patients: A Randomized Trial. Annals of Internal Medicine. 2009;150(4):255–62. DOI: 10.7326/0003-4819-150-4-200902170-00006
Review
For citations:
Pogosova N.V., Yusubova A.I., Yufereva Yu.M., Ausheva A.K., Karpova A.V., Vygodin V.A. The Effects of Preventive Counseling Followed by Remote Support Via Telephone on the Motivation to Change Lifestyle in Patients With High and Very High Cardiovascular Risk. Kardiologiia. 2020;60(5):41–46. https://doi.org/10.18087/cardio.2020.5.n1009