Coronary heart disease (CHD) has been the leading cause of death and disability in the U.S. for over 40 years. Total annual costs associated with CHD, including direct medical care and lost productivity, is estimated to be over $60 million. Evidence now clearly points to elevated blood cholesterol levels as a major cause of CHD, and recent estimates suggest that more than half of the adult population in the U.S. have cholesterol levels that put them at risk for CHD. Given the staggering numbers of afflicted Americans, it is imperative to develop effective treatment methods that can be readily disseminated. The goal of this Phase II project is to continue our efforts to develop an effective, commercially viable self-management program for cholesterol reduction that is based on the use of a hand-held computer. The computerized cholesterol reduction program (CCRP) incorporates the critical features of successful clinic-based programs, such as sound nutrition, exercise, and behavior modification, and packages them in a hand-held computer. The computerized delivery format offers many unique features, e.g., interactive prompts, instantaneous feedback, and simplified self-monitoring, that may result in greater effectiveness than traditional manual-based self-management programs. In particular, it may provide the structure necessary to enhance long-term maintenance where many other approaches have been unsuccessful. This product should have broad-based appeal among consumers who desire an effective self- management approach to modifying diet and exercise habits. The proposed project includes making modifications to an existing Beta-II version of the computer and testing the resulting Beta-III version in a clinical outcome trial lasting 12 months. The CCRP will be compared with a standard manual-based self-management program and a waitlist control group. Following completion of the clinical trial, we will utilize the results, along with input from our consultants, to guide further refinements to the program.
