Change of Heart

The Change of Heart program is a behavioral intervention to reduce risk factors in patients at increased risk of coronary heart disease. Through the program, nurses are trained in behavioral counseling to encourage lifestyle changes among high risk patients. The three-day training is conducted by a multidisciplinary team of psychologists, primary care providers, and experts in smoking cessation and exercise. The trained nurses in turn counsel patients with modifiable risk factors including regular cigarette smoking, high cholesterol, or high body mass index combined with low physical activity. Over the course of two or three individualized sessions the nurse counsels patients to decrease dietary fat intake, increase fruit and vegetable consumption, increase physical activity, and stop smoking. Smoking counseling is supported by nicotine replacement therapy when necessary. Patients receive personalized advice during sessions, and are contacted by telephone following the sessions to encourage behavior change.

The goal of the Change of Heart behavioral intervention is to reduce risk factors for coronary heart disease.

In a randomized controlled trial, the intervention group had greater positive changes in dietary fat intake, regular exercise, and cigarettes smoked per day at 4- and 12-month follow-ups when compared to the control group. Systolic blood pressure was reduced in the intervention group at the 4-month follow-up, but not at one year following the intervention. The smoking quit rate was 7.4% greater than the control group, but this value was not significant.