Objectives: This study sought to identify elements that influence behavioral change in a patient population with chronic cardiovascular disease (CVD). Our objective was to: identify the multifaceted elements that influence behavioral change; organize the information to facilitate the development of a cost-effective behavioral change guideline; and review current efforts in this field. Methods: A literature review was performed to identify key components of behavioral change. Topics explored are: behavioral change theories, aspects of CVD, patient perspective, clinician perspective and financial ramifications. A brainstorming session was conducted with healthcare researchers and clinicians to explore aspects of behavior change that are not in the literature. An Ishikawa Cause and Effect Diagram was used to classify and graphically display all of the possible variables influencing the problem statement “Behavioral Change in Chronic Illness.” Several programs that reported their results of behavioral change interventions were investigated in detail. Results: The literature review revealed 156 articles, which demonstrated four main components (bones) affecting behavior change in chronic illness. These components are demonstrated on the C&E diagram and include “Patient”, “Provider”, “Finances” and “Techniques & Tools.” Each bone is defined by subcategories (twigs), and supported by annotated references. Three current programs were identified and reviewed. They were the Stanford Five-City Project, the Food for Heart program, and the Smoking Cessation program. Each reported one single-issue intervention, i.e. community education, smoking cessation and educational referrals. Conclusion: Clinical practice guidelines must include methods for assessing and changing the behavior of both patients with chronic cardiovascular disease and those providing care.
Learning Objectives: 1. Develop cause and effect diagrams for behavior change. 2. Evaluate disease management programs based on the key components of behavior change in patients with cardiovascular disease. 3. Create guidelines for behavior change using the cause and effect diagram.
Keywords: Behavior Modification, Heart Disease
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Thomas Jefferson University, Office of Health Policy and Clinical Outcomes
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.