The principal objective of this randomized trial is to compare the effectiveness of two strategies for motivating behavioral change and improving two-year outcomes, survival free from myocardial infarction, stroke, Class II-IV angina or severe ischemia on non-invasive testing, among patients who have undergone angioplasty or coronary artery stent procedures. The will evaluate whether a novel behavioral intervention based on individualized feedback of risk profiles framed as the opportunity to reduce one's biologic age is more effective in reducing mortality and major cardiovascular morbidity than the standard risk reduction approach, which is framed as the opportunity to avoid future risk of morbidity and mortality. This new strategy is based on the economic theory of net-present value. A total of 660 patients who have completed angioplasty or stenting will be enrolled. Both the net-present value and standard treatment groups will receive a baseline risk evaluation. In both groups the potential areas for health risk behavior change are identical: physical activity, smoking, diet, blood pressure and medications. Control group patients will receive the standard post-procedure approach, which will include being shown their profile on 14 selected cardiovascular risk factors, relative to norms on each factor. They will be asked to choose 2-3 behaviors to change to increase their life span. Experimental group patients will receive their current biological age or """"""""real age"""""""" based on their risk profile. They will be asked to choose 2-3 behaviors to change to reduce their biological age and shown the impact each behavior would have on biological age if maintained for 3 months and if maintained for 2 years. During the trial's maintenance phase, patients will be followed every three months, and at each follow-up will have their risk factor profile updated. The net- present value group will receive their updated biological age, and the control group will receive their updated risk factor profile. Final outcomes will be evaluated at two years. This trial is designed to test the effectiveness of the net-present value approach to improving health behavior and long-term outcomes after angioplasty or coronary artery stenting. The long-term objective of this study is to determine whether a net-present value approach for motivating behavior change is effective in improving treatment outcomes, and enhancing quality of life among a group of high-risk patients.
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| Charlson, Mary E; Allegrante, John P; McKinley, Paula S et al. (2002) Improving health behaviors and outcomes after angioplasty: using economic theory to inform intervention. Health Educ Res 17:606-18 |
