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，但没有提供估计80%未接受CR的AMI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）患者转诊至任何类型咨询（包括CR）的数据仍然很少。3.）第三章与不同咨询方法相关的饮食调整和PA的坚持模式尚未描述。这个以病人为导向的研究职业发展奖的目标是双重的。1.）为杰克逊博士提供营养、运动科学、预防和行为医学研究方法方面的高级培训。2.）对两组出院冠心病患者进行营养与PA咨询方法的研究。在观察部分，我们将使用调查和图表审查来检查225例有记录的CHD患者（AMI（n=75），UA（n =75）和在选择性导管插入术中发现CHD的患者（n=75））在住院期间和6个月随访时接受咨询（营养和PA）的情况。主要结局是接受饮食或PA咨询，无论是作为CR（住院和门诊）的一部分还是作为个体咨询干预的一部分。将检查与坚持心脏健康饮食和定期PA相关的因素。我们将构建一个行为模型来描述遵守模式。在可行性部分，我们将评估使用电话咨询提供营养和PA干预。电话咨询干预将根据I. Ockene用于改善CHD风险因素。本可行性研究和观察部分的数据将用作试点数据，以获得资金进行随机对照试验测试电话咨询干预。我们的目标是提供各种咨询干预冠心病患者的数据，并确定创新的方法，以提高接受和坚持咨询的生活方式改变。(End摘要）

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)