Background: First degree relatives of patients with coronary heart disease (CHD) have a 1.5 to two-fold increase in the risk for developing CHD for genetic, biochemical and/or behavioural reasons. Behavioural based interventions aimed at family members of those with CHD have been shown to have a positive effect on modifying risk factors. Lifestyle counseling, using motivational interviewing is emerging as an effective counseling technique for modifying behaviours. The theory of planned behaviour (TPB) and ecological model are well established theories for behaviour change. The purpose of this abstract is to describe the counseling methodology, used in an ongoing Family Heart Health (FHH) randomized control trial, and its impact on participant retention rate.
Methods: Participants in the FHH program receive a 12-week risk reduction intervention via telephone, managed by a heart health educator and guided by a scripted counseling manual. The health educator and participant negotiate a personal plan for achieving goals through lifestyle change (i.e. increased physical activity, improved nutrition, smoking cessation). The weekly counseling scripts are structured using principles from the TPB and ecological model and are designed to accomplish five goals: (1) to strengthen intentions to engage in the desired behaviour(s); 2) to maintain and develop positive attitudes towards lifestyle change; 3) to provide social support and reinforcement; 4) to increase perceived control over selected behaviours and 5) to help participants identify resources to support long-term change. After the 12-week intensive intervention, there are five "booster" sessions to assist with maintenance over the remainder of the 52 weeks. The Dillman Total Design Method was used to guide the telephone contact schedule.
Results: One hundred and twenty eight participants (43% male, 57% female; mean age = 51.7; 1 risk factor = 24.6%, 2 risk factors = 31.1%, 3+ risk factors = 27.9%), with a family history of heart disease have received behavioral counseling in the FHH program. Based on the Dillman Total Design Method, a contact success rate of 90.14% (Intervention Phase= 94.88%, Maintenance Phase = 86.59%) has been achieved. Satisfaction surveys assessing the content and delivery of the counseling session indicate an 86% satisfaction rate among participants.
Conclusions: Preliminary results have indicated that the current counseling strategy has been effective in motivating and retaining contact with participants in a risk factor modification program who are at high risk for heart disease over a 52 week period.