Diet and Exercise Counseling Among Patients with CHD

描述(由申请人提供)： 目前关于心脏病患者饮食和体力活动(PA)咨询干预的信息有限，原因有几个。1)大多数研究检查了早期门诊心脏康复(CR)计划，并没有提供关于估计80%没有接受CR的急性心肌梗死患者的咨询信息。2.)关于不稳定型心绞痛(UA)或其他形式的冠心病(CHD)患者转诊至包括CR在内的任何类型咨询的比率的数据仍然很少。3.)与不同咨询方法相关的饮食调整和PA的坚持模式尚未被描述。这个以患者为导向的研究职业发展奖有两个目标。1)为杰克逊博士提供营养、运动科学以及预防和行为医学研究方法方面的高级培训。2.)[目的]对冠心病患者出院时的营养和PA咨询方法进行两部分的研究。在观察部分，我们将使用调查和图表回顾来检查225名有记录的冠心病患者在住院期间和6个月随访时接受咨询(营养和PA)的情况(急性心肌梗死(AMI)75例，不稳定型心绞痛(UA)75例，以及选择性导尿术中发现冠心病(CHD)患者75例)。主要结果是接受饮食或PA咨询，无论是作为CR(住院和门诊患者)的一部分，还是作为个别咨询干预的一部分。与坚持心脏健康饮食和有规律的PA相关的因素将被检查。我们将构建一个行为模型来描述遵守模式。在可行性部分，我们将评估电话咨询在提供营养和PA干预方面的使用。电话咨询干预将借鉴I.Ockene博士用于改善CHD危险因素的成功模式。这项可行性研究的数据和观察部分将作为试点数据，以获得资金，进行一项随机对照试验，测试电话咨询干预。我们的目标是为冠心病患者提供关于各种咨询干预措施的数据，并确定改善接受和遵守咨询以改变生活方式的创新方法。(摘要结束)

DESCRIPTION (provided by applicant): 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)