Behavioural Modification for CV and Respiratory Health

Question 1

Components of health promotion

Answer 1

Information, beliefs, motivation, skills, plans, opportunities, health, feedback and support, environmental context

Question 2

Facilitating Healthier choices

Answer 2

Smacks: eliminate choice (smoking bans)
Shoves: restrict choice (sugar tax)
Nudges: guide and enable healthier choices (make healthy choices more visible)

Question 3

Individual Cognitive Factors

Answer 3

Contemplation and planning: develop skills for initiation, work out perceived and actual barriers, attitudes
Action and maintenance: cues to action (reasons), monitoring progress, managing relapse
Interventions: one to one, group, pharmacotherapy

Question 4

Psychosocial impact and secondary prevention in CVD

Answer 4

Depression, anxiety and PTSD more likely in those diagnosed with CVD
Psychosocial distress more likely among those who perceive more serious consequences of CVD, don’t understand their condition, have a stronger initial emotional response
These people have to find to limits and goals in a different lifestyle

Question 5

Psychosocial interventions can alleviate distress

Answer 5

Lead to better outcomes
Resilience and adaptive responses to stressful situations - secondary prevention to CVD
Group intervention focused on knowledge, skills, stress management, counteracting anxiety/depression, relaxation techniques and improving social relations/support
Reduced likelihood of premature death by 1/3

Question 6

Lifestyle and behavioural impact of CVD

Answer 6

Cardiac rehab is cost effective, but half drop out of rehab programmes - rehab involves health promotion, behaviour change, stress management, psychotherapy, support groups
Lifestyle changes are often not sustained long term
65% change to healthier diet
1/2 of these maintain changes after a year
60% smokers quit, 1/2 maintain for more than a year
Relapse is common - manage triggers/temptations and plan alternative response

Question 7

SMART goals

Answer 7

To be ready to change a person must believe that their current behaviour is bad and they will be better off if they try to change, and they have a good chance of succeeding
Specific
Measurable
Achievable
Relevant/Realistic
Time-limited

Question 8

Facilitating self-monitoring and behaviour change in asthma

Answer 8

Patient centred interventions - monitor lung function and triggers, develop action plans, modify unhelpful illness beliefs -> less hospitalisation and less absenteeism
Interventions delivered in various ways - eg testing useful for those who don’t engage face to face, effective and cost effective, can address illness perceptions and treatment perceptions to boost medication adherence