This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. Primary support for the subproject and the subproject's principal investigator may have been provided by other sources, including other NIH sources. The Total Cost listed for the subproject likely represents the estimated amount of Center infrastructure utilized by the subproject, not direct funding provided by the NCRR grant to the subproject or subproject staff. In spite of overwhelming clinical research data and practice guidelines regarding the role of dietary and physical activity (D&PA) interventions in reducing cardiovascular (CV) mortality, the clinical practice has failed to successfully integrate D&PA counseling into patient care. The healthcare environment very seldom replicates the settings and the intensive resources available for clinical trials, and thus the results of this research and clinical guidelines become an elusive goal for the practicing physician. Bridging the gap between clinical research and clinical practice requires additional research that will design and evaluate D&PA counseling interventions sustainable in the """"""""real-world"""""""" settings of the current clinical practice. The counseling intervention we propose uses a novel approach to the assessment and delivery of patient care in this area. The proposed approach states that the role of the physician is not to deliver the D&PA counseling process per se, but to promote and validate the integration of D&PA into the long term management of cardiovascular patients. The delivery of the counseling process will be done using e-technology (Internet in this case). The e-healthcare is a consumer focused healthcare delivery paradigm physicians and the healthcare system can no longer ignore (Iverson 2008).
The aims of this study are: 1) - to develop a patient self-administered, computerized system for D&PA data collection (based on existing validated questionnaires), processing, and analysis that will enable busy primary care physicians to generate, in the course of few minutes, a patient tailored D&PA counseling plan: """"""""the prescription for lifestyle changes""""""""; 2) ?create a secure, HIPAA compliant, interactive web-based counseling application that will allow patients to receive personalized counseling on a weekly basis, using an automatic, interactive Internet technology, and; 3) - test the feasibility of this intervention in the clinical settings of primary care, and evaluate its effect on CV risk factors.
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