? ? Current information on counseling interventions for diet and physical activity (PA) in cardiac patients is limited for several reasons. 1.) The majority of studies examine early outpatient cardiac rehabilitation (CR) programs and don't provide information on counseling for the estimated 80% of AMI patients who do not receive CR. 2.) Data on rates of referral to any type of counseling including CR for patients with unstable angina (UA) or other forms of coronary heart disease (CHD) remain scarce. 3.) Patterns of adherence to dietary modification and PA associated with different counseling methodologies have not been described. The objectives of this Patient-Oriented Research Career Development Award are two-fold. 1.) To provide Dr. Jackson with advanced training in nutrition, exercise science, and preventive and behavioral medicine research methods. 2.) To conduct a research study on nutritional and PA counseling methods for patients discharged from the hospital with CHD in two components. In the observational component, we will use surveys and chart review to examine receipt of counseling (nutritional, and PA) in 225 patients with documented CHD (AMI (n=75), UA (n=75) and patients found to have CHD at elective catheterization (n=75)) during hospitalization and at 6-month follow-up. The primary outcome is receipt of dietary or PA counseling, whether as part of CR (inpatient and outpatient) or in individual counseling interventions. Factors associated with adherence to a cardiac healthy diet and regular PA will be examined. We will construct a behavioral model to describe adherence patterns. In the feasibility component, we will assess the use of telephone counseling for the delivery of nutrition and PA interventions. The telephone counseling intervention will be adapted from a successful model used by Dr. I. Ockene for improvement in CHD risk factors. The data from this feasibility study and the observational component will be used as pilot data to obtain funding to conduct a randomized controlled trial testing the telephone counseling intervention. Our objective is to provide data on a variety of counseling interventions available to CHD patients and to identify innovative methods to improve receipt of and adherence to counseling for lifestyle modification. (End of Abstract) ? ?
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