Crouch M, Sallis J F, Farquhar J W, Haskell W L, Ellsworth N M, King A B, Rogers T
Prev Med. 1986 May;15(3):282-91. doi: 10.1016/0091-7435(86)90047-2.
Methods of effective cardiovascular risk reduction that are suitable for use in clinical settings are needed. Several behavioral interventions were designed to be compatible with office-based medical practice, to be delivered by paraprofessional counselors, and to be of low intensity and low cost. Eighty-three hypercholesterolemic volunteers were assigned to one of three experimental conditions (face-to-face counseling, mail and telephone counseling, initial session only). Twenty-six nonrandomized subjects served as a no-contact group and were followed for 1 year. Participants in the first three groups received risk factor education, behavioral recommendations, and a packet of materials, while those in the face-to-face and mail/telephone counseling groups were contacted for five brief follow-up sessions over a 4-month period. At the 1-year follow-up evaluation, subjects in the face-to-face and mail/telephone counseling conditions showed decreases in plasma cholesterol of 6.2 and 4.6%, respectively (P less than 0.01), while the other two groups evidenced small increases. There were no differences by condition for plasma triglycerides, systolic or diastolic blood pressure, or weight. Low-intensity, low-cost behavioral interventions delivered by paraprofessionals can produce long-term decreases in a major cardiovascular risk factor. Physicians are encouraged to incorporate similar interventions into their practices.
需要有适用于临床环境的有效降低心血管疾病风险的方法。设计了几种行为干预措施，使其与门诊医疗实践相兼容，由辅助专业顾问提供，且强度低、成本低。83名高胆固醇血症志愿者被分配到三种实验条件之一（面对面咨询、邮件和电话咨询、仅初始阶段）。26名非随机受试者作为无接触组，随访1年。前三组的参与者接受了风险因素教育、行为建议和一包资料，而面对面咨询组和邮件/电话咨询组的参与者在4个月内接受了五次简短的随访。在1年的随访评估中，面对面咨询组和邮件/电话咨询组的受试者血浆胆固醇分别下降了6.2%和4.6%（P<0.01），而其他两组则略有上升。血浆甘油三酯、收缩压或舒张压以及体重在不同条件下没有差异。由辅助专业人员提供的低强度、低成本行为干预可使主要心血管风险因素长期降低。鼓励医生将类似干预措施纳入他们的实践中。
