The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease

Objectives. This study assessed stages of change in fat intake, physical ac tivity, and cigarette smoking during a randomized controlled trial of behav ioral counseling. Methods. Twenty general practices (primary health care centers) were random ized to lifestyle counseling by behavioral methods or to usual health promo tion. A total of 883 patients were selected for the presence of 1 or more o f the following risk factors: cigarette smoking, high cholesterol, or a com bination of a high body mass index and low physical activity. Stage of chan ge (precontemplation, contemplation, preparation, and action/maintenance) w as assessed at baseline and after 4 and 12 months. Results. The odds of moving to action/maintenance for behavioral interventi on vs control patients at 4 months were 2.15 (95% confidence interval [CI] = 1.30, 3.56) for fat reduction, 1.89 (95% CI=1.07, 3.36) for increased phy sical activity, and 1.77 (95% CI=0.76, 4.14) for smoking cessation. The lik elihood of achieving action/maintenance was related to baseline stage for a ll 3 behaviors. Conclusions. Brief behavioral counseling based on advice matched to stage o f readiness for change may be valuable in encouraging healthy lifestyles am ong patient sin primary care at raised risk of cardiovascular disease.