Readiness to Change Health Behaviours Among Patients at High Risk of Cardiovascular Disease

Doherty, Sheelagh; Steptoe, Andrew; Rink, Elizabeth; Kendrick, Tony; Hilton, Sean

doi:10.1177/174182679800500302

Cited by 29 publications

(4 citation statements)

References 35 publications

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“…However, in line with other researchers, we concur that it is more ''reasonable to recommend giving up smoking and promoting physical activity at the population level'' (Senti et al, 2001, p. 390) in order to reduce overall harm. Although evidence is inconsistent, becoming more physically active may serve as a ''gatekeeping'' function, increasing the likelihood of subsequent smoking cessation attempts (Bock, Marcus, Rossi, & Redding, 1998;Boudreaux, Francis, Carmack Taylor, Scarinci, & Brantley, 2003;Doherty, Steptoe, Rink, Kendrick, & Hilton, 1998;Emmons, Marcus, Linnan, Rossi, & Abrams, 1994;King et al, 1996;Nguyet, Beland, & Otis, 1998). As with harm reduction strategies in general (Fiore et al, 2000), further research is undoubtedly required to prove such a proposition and to ensure that increases in physical activity do not reduce the perceived need to quit smoking.…”

Section: Resultsmentioning

confidence: 94%

Tobacco harm reduction strategies: The case for physical activity

deRuiter¹,

Faulkner²

2006

Nicotine & Tobacco Research

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Since the effects of tobacco smoke are so detrimental to health, growing consideration has been given to the development of harm reduction strategies for those smokers who are unable or unwilling to stop using tobacco. The term harm reduction refers to a policy, strategy, or particular intervention that assumes continued use of an undesired behavior and aspires to lower the risk of adverse consequences associated with the continuation of this addictive behavior. Up to this point, tobacco harm reduction interventions have focused on reducing tobacco-related harm through the utilization of innovative tobacco products, reduced tobacco consumption, and pharmaceutical medications. With the possible exception of medicinal nicotine products, these strategies remain unproven and thus far no scientific or medical literature exists to suggest these harm reduction strategies reduce tobacco-related exposure, morbidity, or mortality. Consequently, a need exists for broadening the range of potentially effective harm reduction strategies. This preliminary review suggests that physical activity has the potential to become one such strategy. Of the eight principles that characterize a harm reduction strategy, all are at least partially satisfied by physical activity. Further, emerging evidence indicates that physical activity may delay the occurrence of disease and premature death initiated by tobacco consumption. Significant concerns remain regarding the practicality of physical activity as a harm reduction strategy and the extent to which participation in physical activity may be used to justify continued smoking.

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Section: Resultsmentioning

confidence: 94%

Tobacco harm reduction strategies: The case for physical activity

deRuiter¹,

Faulkner²

2006

Nicotine & Tobacco Research

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“…increased physical activity) were influenced by the approach. It has been suggested that people differ in their 'readiness to change' for various behaviors (Taylor et al, 2004;Boudreaux et al, 2003;Doherty et al, 1998) and that health behaviors are 'domain specific' (Persky et al, 2005). The intervention strategies targeting cessation behaviors may not affect adoptive behaviors if they do not address a common stimulus, provide explicit links between behaviors, or teach a common coping mechanism (Prochaska, 2011).…”

Section: Discussionmentioning

confidence: 98%

Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials

James

Freund

Booth

et al. 2016

Preventive Medicine

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There is limited evidence regarding the relative effectiveness of sequential and simultaneous approaches. Given only three of the six trials observed a difference in intervention effectiveness for one health behavior outcome, and the relatively consistent finding that the sequential and simultaneous approaches were more effective than a usual/minimal care control condition, it appears that both approaches should be considered equally efficacious. PROSPERO registration number: CRD42015027876.

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“…15 The 5 stages are precontemplation (patients are not eating a low-fat diet or currently exercising or are smokers, and they are not seriously considering changing behavior), contemplation (patients are considering a change in behavior but are not confident they will carry this out within the next month), preparation (patients are seriously planning to change behavior and are confident that they will make changes within the next month), action (patients have changed behavior within the last 6 months), and maintenance (patients have maintained the change for at least 6 months). The criterion for physical activity was exercising 3 or more times per week for at least 20 minutes on each occasion.…”

Section: Methodsmentioning

confidence: 99%

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

Steptoe

Kerry²,

Rink³

et al. 2001

Am J Public Health

155

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A B S T R A C TObjectives. 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. Encouraging smoking cessation, dietary fat reduction, and regular physical activity is a central element of cardiovascular disease prevention through lifestyle change. 1 The stage of change model has become increasingly influential as a framework for understanding healthrelated behavior and directing efforts in health promotion.2,3 The model postulates that individuals can be allocated to different stages of readiness for change (from precontemplation through contemplation, preparation, and action to maintenance of successful change) and that baseline stage is a predictor of behavior change. 4-6The stage of change framework suggests that intervention programs might be tailored to the individual's stage of readiness. The Change of Heart Study is a randomized controlled trial that compares brief behavioral counseling with usual health promotion advice among patients at increased risk of coronary heart disease in a primary care setting, 7 where there is limited evidence regarding the effects of stage-oriented programs.8-10 The behavioral and biological risk factor results of this study, which have been described elsewhere, show greater reductions in fat intake and the number of cigarettes smoked and greater increases in physical activity in the behavioral intervention group than in the control group at 4 and 12 months.11 In this article, we present stage of change outcomes in the study and address (1) whether behavioral intervention was more effective than normal practice in achieving the target stage (action/maintenance), (2) whether the likelihood of achieving the target stage for each behavior varied with initial stage, and (3) whether any advantage of behavioral intervention was equally evident for patients at different stages of readiness at baseline. Methods Study DesignThis randomized trial involved 20 general practices (primary care centers), half allocated to behavioral intervention and half to control conditions. 7 Patients with 1 or more of the following modifiable risk factors were recruited: regular cigarette smoking (more than 1 cigarette per day), high cholesterol (6.5-9.0 mmol/L), or a combination of high body mass index (BMI; 25-35 kg/m 2 ) and low physical activity (fewer than 12 episodes in the past 4 weeks of vigorous or moderate exercise lasting 20 minutes). Patients were excluded if they were on active follow-up or ...

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Readiness to Change Health Behaviours Among Patients at High Risk of Cardiovascular Disease

Cited by 29 publications

References 35 publications

Tobacco harm reduction strategies: The case for physical activity

Tobacco harm reduction strategies: The case for physical activity

Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials

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

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