The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57699

Niraj L. Sehgal, MD, MPH, Brain Oliviera, PhD, William Haskell, PhD, and Randall S. Stafford, MD, PhD. Stanford Prevention Research Center, Stanford University, Hoover Pavilion, Room N401, 211 Quarry Road, Stanford, CA 94305-5705, 650-725-9930, nsehgal23@hotmail.com

This study evaluated the role of specific patient characteristics and intermediate outcomes on successful changes in blood pressure and cholesterol for 740 participants in a one-year multiple risk factor reduction intervention. Baseline risk assessments selected intervention participants at highest risk for cardiovascular disease. Participants underwent specific counseling and education to promote healthy behaviors. Signal detection methodology predicted one-year changes in blood pressure and cholesterol from the following baseline characteristics and intermediate outcomes: age, gender, BMI, change in BMI, family history of heart disease, smoking status, level of physical activity, change in physical activity, and intake of high fat foods and fruits or vegetables. In separate analyses, systolic blood pressure (SBP) successes were defined as a decrease of 10%, diastolic blood pressure (DBP) as a decrease of 5%, and cholesterol as a decrease of 10%. Of the participants with successful outcomes in blood pressure, those who experienced a decrease in BMI > 0.4 were more successful in reducing their SBP and DBP (SBP: 35% vs. 25%, p<.01; DBP: 54% vs. 42%, p<.001). In addition, of those decreasing their BMI, the participants who increased heavy activity 97.5 minutes per week were more successful in reducing their SBP (55% vs. 32%, p<.01). Of those participants with successful outcomes in cholesterol, those who reported daily light physical activity were more successful in reducing their cholesterol (44% vs. 34%, p<.01). Tailoring risk factor reduction interventions to specific mediators of change such as a change in BMI or physical activity may improve outcomes in high-risk individuals.

Learning Objectives:

• Describe the difference between a moderator and mediator of a given outcome
• Identify moderators and mediators of a successful multiple risk factor reduction program
• Discuss the best statistical methods (signal detection vs. regression) to use in answering questions about moderators and mediators of change

Keywords: Chronic (CVD), Health Education

Presenting author's disclosure statement:
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.