PPO 09-310 – HSR&D Study
Career Development Projects
Developing Strategies for Maintaining Behavior Change
Corrine I. Voils PhD
Durham VA Medical Center, Durham, NC
April 2010 -
Health behavior change involves initiation of new behaviors (e.g., making dietary changes, starting medication) and maintenance of those newly adopted behaviors. Several interventions have proven effective for initiating health behavior change. However, new behaviors typically falter after some time, resulting in relapse. Therefore, effective behavioral maintenance strategies are needed.
The goal of this pilot study was to develop the intervention material and obtain preliminary evidence of the effectiveness of a telephone-delivered behavioral intervention incorporating the psychological processes and behavioral strategies involved in behavior maintenance.
Patients enrolled in the study as they completed a trial of telephone-delivered lifestyle change intervention to reduce low-density lipoprotein cholesterol. The final outcome visit from the trial served as baseline for this pilot study. During months 1-3, participants received monthly telephone calls focusing on behavior maintenance strategies. Follow-up data were obtained at month 4.
The average age of the 20 enrolled patients was 60.89 (SD= 12.56). 75% were White, 90% were male, 45% completed high school or less education, and 40% were employed full-time. Four participants were lost to follow-up, resulting in a final sample size of 16. One participant did not have blood drawn for LDL-C at follow-up. Two participants did not complete the psychosocial measures at follow-up. One participant did not complete the Food Frequency Questionnaire at baseline, and 9 did not at follow-up.
Cohen's d was calculated as the effect size representing change from baseline to follow-up. LDL-C level and physical activity levels were maintained, with effect sizes ranging from .08 to .17. Dietary intake continued to improve, with decreases in saturated fat (d=.59) and poly-unsaturated fat (d=.71). Self-efficacy for diet (d=.01) and exercise remained unchanged (d=.04).
If this telephone-delivered behavioral maintenance intervention proves effective and cost-effective in a randomized trial, it could be incorporated into primary care to improve veterans' health at relatively low cost.
None at this time.
Mental, Cognitive and Behavioral Disorders
Treatment - Comparative Effectiveness