Stages of Change Across Ten Health Risk Behaviors for Older Adults

Nigg, Claudio R.; Burbank, Patricia M.; Padula, Cindy; Dufresne, Robert L.; Rossi, Joseph S.; Velicer, Wayne F.; Laforge, Robert G.; Prochaska, James O.

doi:10.1093/geront/39.4.473

Cited by 211 publications

(161 citation statements)

References 31 publications

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“…During each call (≈30 minutes), the stage of change for adherence to diet, medication, and exercise was assessed separately using the validated stage of change questions 18 and tailored counseling based on this assessment. The stages of change were precontemplation or no plans to adhere in <6 months; contemplation or plans to adhere in 1 to 6 months; preparation or plans to adhere within 1 month; action or adherence for <6 months; and maintenance or adherence for ≥6 months.…”

Section: Interventionmentioning

confidence: 99%

Effectiveness of a Tailored Behavioral Intervention to Improve Hypertension Control

et al. 2015

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M ore than 65 million American adults have hypertension.1 Diet, exercise, and drugs are mainstays of hypertension management. 2 The efficacy of hypertension treatment in preventing cardiovascular events is established.2 Although the system and provider interventions have improved blood pressure (BP) control rates from the previous low rate (27% 3 ) to more respectable rates (51% 1 to 79% 4,5 ), the substantial proportion remains uncontrolled. However, we may have reached the maximum control achievable with nontailored interventions targeting clinics or hospitals with growing concerns that such interventions may lead to overtreatment and adverse outcomes. 4,6 To optimize hypertension control further, approaches to identify and target patients at risk, to whom appropriately tailored therapy can then be offered, are needed.Suboptimal adherence is a common, but modifiable, problem leading to inadequate hypertension control. Fewer than 10% of adults with hypertension adhere fully to diet recommendations, 7 ≈35% exercise regularly, 8 and only 50% to 60% are fully medication adherent.9 In-person counseling to improve adherence requires time and is labor-intensive and costly. Telephone counseling offers a promising alternate approach, 10 and such counseling can be delivered at a convenient time and setting. 11Telephone interventions have improved medication adherence, 12,13 physical activity, 14 and diet, 15 all key to lowering BP. It is not known, however, whether novel theory-based behavioral interventions can be delivered by telephone and whether they are effective in busy, clinical settings.We conducted a randomized controlled trial to evaluate the effectiveness of targeting patients with repeated uncontrolled hypertension with either a tailored or a nontailored intervention in improving hypertension control and systolic blood pressure (SBP). Methods Design, Setting, and ParticipantsThe study was a randomized controlled trial to evaluate whether a telephone-delivered, behavioral stage-matched intervention (SMI) or a nontailored health education intervention (HEI) would lead to better BP control than usual care (UC) in patients with uncontrolled BP.The study was approved by the institutional review board. All participants provided written informed consent. Procedures were See Editorial Commentary, pp 273-275Abstract-Blood pressure (BP) control rates are suboptimal. We evaluated the effectiveness of 2 behavioral interventions to improve BP control via a 3-arm, randomized controlled trial of 533 adults with repeated uncontrolled BP, despite antihypertensive drug treatment for ≥6 months. The interventions were a tailored stage-matched intervention (SMI) or a nontailored health education intervention (HEI) of 6 monthly calls targeting diet, exercise, and medication. Control was usual care (UC). There were no baseline group differences.

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Section: Interventionmentioning

confidence: 99%

Effectiveness of a Tailored Behavioral Intervention to Improve Hypertension Control

et al. 2015

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“…For this substudy, we selected 3995 participants recruited in primary health centers affiliated with the Hospital Clinic of Barcelona, University of Valencia, University of Malaga, Department of Family Medicine (Sevilla), and University of Navarra (Pamplona) in Spain. Eligible participants were communitydwelling men aged 55e80 years and women aged 60e80 years, who were free of cardiovascular disease at baseline and fulfilled at least one of the following two criteria: (1) type-2 diabetes mellitus and/or (2) three or more coronary heart disease (CHD) risk factors: hypertension (systolic BP !140 mm Hg or diastolic BP !90 mm Hg or treatment with antihypertensive medication), dyslipidemia (LDL cholesterol !160 mg/dl; HDL cholesterol 40 mg/dl in men or 50 mg/dl in women; or under lipid-lowering therapy), obesity or overweight, smoking or family history of earlyonset CHD [19]. This trial has been registered with the International Standard Randomised Controlled Trial Number (ISRCTN of London, England) 35739639.…”

Section: Study Subjectsmentioning

confidence: 99%

Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial

Medina‐Remón

Vallverdú‐Queralt

Arranz

et al. 2013

Nutrition, Metabolism and Cardiovascular Diseases

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(R.M. Lamuela-Raventos). 1 On behalf of the PREDIMED Study Investigators. + MODELPlease cite this article in press as: Medina-Remón A, et al., Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Abstract Background and aim: Hypertension is a major public health problem and a leading cause of death and disability in both developed and developing countries, affecting onequarter of the world's adult population. Our aim was to evaluate whether the consumption of gazpacho, a Mediterranean vegetable-based cold soup rich in phytochemicals, is associated with lower blood pressure (BP) and/or reduced prevalence of hypertension in individuals at high cardiovascular risk. Methods and results:We selected 3995 individuals (58% women, mean age 67 y) at high cardiovascular risk (81% hypertensive) recruited into the PREDIMED study. BP, weight, and dietary and physical activity data were collected. In multivariate linear regression analyses, after adjustment, moderate and high gazpacho consumption categories were associated with reduced mean systolic BP of À1.9 mm Hg [95% confidence interval (CI): À3.4; À0.6] and À2.6 mm Hg (CI: À4.2; À1.0), respectively, and reduced diastolic BP of À1.5 mm Hg (CI: À2.3; À0.6) and À1.9 mm Hg (CI: À2.8; À1.1). By multiple-adjusted logistic regression analysis, gazpacho consumption was associated with a lower prevalence of hypertension, with OR Z 0.85 (CI: 0.73; 0.99) for each 250 g/week increase and OR Z 0.73 (CI: 0.55; 0.98) for high gazpacho consumption groups compared to the no-consumption group. Conclusions: Gazpacho consumption was inversely associated with systolic and diastolic BP and prevalence of hypertension in a cross-sectional Mediterranean population at high cardiovascular risk. The association between gazpacho intake and reduction of BP is probably due to synergy among several bioactive compounds present in the vegetable ingredients used to make the recipe. ª

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“…Segundo Nigg et al (1999), a manutenção de dieta pobre em gorduras e rica em fibras aumenta com o avançar da idade, sugerindo que os idosos são mais preocupados com seu comportamento alimentar do que os mais jovens. No entanto, os cuidados com a alimentação eram delegados pelos participantes, em grande parte, a suas esposas e a restrição a certos tipos de alimentos era consequência frequente da necessidade de conter o avanço de doenças.…”

Section: Discussionunclassified

“…As intervenções são planejadas de acordo com as necessidades psicológicas relacionadas ao estágio em questão e buscam aumentar a consciência do indivíduo sobre causas e consequências do comportamento de risco mediante feedback e estratégias educativas (Prochaska & Velicer, 1997). Entre idosos, Nigg et al (1999) identificaram a pré-contemplação como o principal estágio a ser alvo de intervenções quando a meta era perder peso, usar protetor solar e praticar exercícios. Por outro lado, uma parcela expressiva dos 1.615 idosos entrevistados neste estudo revelou encontrar-se no estágio de manutenção em relação a importantes comportamentos de saúde.…”

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Healthy Lifestyles in Old Age: Effects of Psycho Educational Intervention With Older Men

Borges¹,

Seidl²

2014

Psic., Saúde & Doenças

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Este artigo está licenciado sob uma licença Creative Commons Atribuição-NãoComercial 4.0 Internacional. Você tem direito de:Compartilhar -copiar e redistribuir o material em qualquer suporte ou formato.Adaptar -remixar, transformar, e criar a partir do material. De acordo com os termos seguintes:Atribuição -Você deve dar o crédito apropriado, prover um link para a licença e indicar se mudanças foram feitas. Você deve fazê-lo em qualquer circunstância razoável, mas de maneira alguma que sugira ao licenciante a apoiar você ou o seu uso Não Comercial -Você não pode usar o material para fins comerciais.Sem restrições adicionais -Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita. This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. You are free to:Share -copy and redistribute the material in any medium or format.Adapt -remix, transform, and build upon the material. Under the following terms:Attribution -You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.NonCommercial -You may not use the material for commercial purposes.No additional restrictions -You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.PSICOLOGIA, SAÚDE & DOENÇAS, 2014, 15(2) ABSTRACT-The present study aimed to investigate the effects of a psycho educational intervention designed to strengthen self-care in older men. Participated thirteen men of an social center for elderly in operation at a private university located in Brasilia, Brazil, ages 62 to 78 years (M = 69.5). All of them were married, literate, retired and with chronic diseases. Data relating to the habits of life of the elderly were obtained through individual interviews conducted before and after the engagement of these in nine thematic group meetings grounded in cognitive-behavioral model. The results showed the strengthening of physical exercise, healthy eating and assertive behaviors by participants, as well as greater emphasis on beliefs about the benefits of health-promoting behaviors. The intervention was useful to maximize healthy habits, although it has larger effects to sensitize and maintain than to change behaviors.

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Stages of Change Across Ten Health Risk Behaviors for Older Adults

Cited by 211 publications

References 31 publications

Effectiveness of a Tailored Behavioral Intervention to Improve Hypertension Control

Effectiveness of a Tailored Behavioral Intervention to Improve Hypertension Control

Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial

Healthy Lifestyles in Old Age: Effects of Psycho Educational Intervention With Older Men

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