促进积极选择以推动行为改变从而降低心血管风险：一项基于网络的随机对照试验。

Fostering active choice to empower behavioral change to reduce cardiovascular risk: A web-based randomized controlled trial.

作者信息

Landais Lorraine L, Jelsma Judith G M, Damman Olga C, Verhagen Evert A L M, Timmermans Danielle R M

机构信息

Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

出版信息

PLoS One. 2024 Aug 1;19(8):e0304897. doi: 10.1371/journal.pone.0304897. eCollection 2024.

DOI:10.1371/journal.pone.0304897

PMID:39088470

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11293644/

Abstract

OBJECTIVE

To investigate the effect of an active choice (AC) intervention based on creating risk and choice awareness-versus a passive choice (PC) control group-on intentions and commitment to cardiovascular disease (CVD) risk-reducing behavior.

METHODS

Adults aged 50-70 (n = 743) without CVD history participated in this web-based randomized controlled trial. The AC intervention included presentation of a hypothetical CVD risk in a heart age format, information about CVD risk and choice options, and a values clarification exercise. The PC group received a hypothetical absolute numerical CVD risk and brief information and advice about lifestyle and medication. Key outcomes were reported degree of active choice, intention strength, and commitment to adopt risk-reducing behavior.

RESULTS

More AC compared to PC participants opted for lifestyle change (OR = 2.86, 95%CI:1.51;5.44), or lifestyle change and medication use (OR = 2.78, 95%CI:1.42;5.46), than 'no change'. No differences were found for intention strength. AC participants made a more active choice than PC participants (β = 0.09, 95%CI:0.01;0.16), which was sequentially mediated by cognitive risk perception and negative affect. AC participants also reported higher commitment to CVD risk-reducing behavior (β = 0.32, 95%CI:0.04;0.60), mediated by reported degree of active choice.

CONCLUSIONS

Fostering active choices increased intentions and commitment towards CVD risk-reducing behavior. Increased cognitive risk perception and negative affect were shown to mediate the effect of the intervention on degree of active choice, which in turn mediated the effect on commitment. Future research should determine whether fostering active choice also improves risk-reducing behaviors in individuals at increased CVD risk in real-life settings.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05142280. Prospectively registered.

摘要

目的

研究基于创建风险和选择意识的主动选择（AC）干预措施——与被动选择（PC）对照组相比——对心血管疾病（CVD）风险降低行为的意图和承诺的影响。

方法

年龄在50 - 70岁（n = 743）且无CVD病史的成年人参与了这项基于网络的随机对照试验。AC干预包括以心脏年龄格式呈现假设的CVD风险、关于CVD风险和选择选项的信息，以及一次价值观澄清练习。PC组接受假设的绝对数值CVD风险以及关于生活方式和药物治疗的简短信息与建议。主要结果是报告的主动选择程度、意图强度以及采取风险降低行为的承诺。

结果

与PC参与者相比，更多的AC参与者选择了生活方式改变（OR = 2.86，95%CI：1.51；5.44），或者生活方式改变和药物使用（OR = 2.78，95%CI：1.42；5.46），而非“不改变”。在意图强度方面未发现差异。AC参与者比PC参与者做出了更积极的选择（β = 0.09，95%CI：0.01；0.16），这依次由认知风险感知和负面影响介导。AC参与者还报告了对CVD风险降低行为的更高承诺（β = 0.32，95%CI：0.04；0.60），由报告的主动选择程度介导。