Abstract 1173: Nutrition Factors, Readiness to Change and Goal Setting Confidence Are Interrelated and Have a Beneficial Impact on Health Outcomes for Patients in the Community Cardiovascular Hearts in Motion Program
Purpose: Nutrition intervention outcome measures are often limited to body weight changes instead of nutritional status changes. In the Community Cardiovascular Hearts in Motion (CCHIM) program, nutrition, motivational enhancement and behavior change strategies are combined to investigate impact on vascular health outcomes.
Methods: CCHIM is a 3 month multi-vascular program combining nutrition intervention, weekly exercise, and risk factor management. The dietitian assesses each patient along with a multidisciplinary team and evaluates nutrition progress during the program and at 6 and 12 month follow-up. “The Eating Score” was developed to incorporate readiness to change in 5 key nutrition categories including % fat calories, portion control and fruit & vegetable intake. Patients identified personal nutrition goals and rated confidence to achieve their goals. Anthropometric measures, clinical data and behavior interventions are measured at baseline, program completion, 6 and 12 months.
Results: 452 patients completed the CCHIM program with follow up data. Average weight lost at 3m was 3.5% which was sustained at 12m (p=0.0001). Readiness to change and confidence in nutrition factors improved at 3 months and was sustained at 12m. Action readiness for ‘Low Fat’ (p= 0.02) and ‘Portion Control’ (p= 0.001) was statistically correlated with weight loss. Twenty-six percent of patients lowered fat intake from high to moderate, 19% went from high to low fat, and 17% decreased from moderate to a low fat intake, while 11% started and maintained a low fat intake. The results for dietary fat reduction were sustained at 6 and 12 months with 39% in the moderate fat category and 49% in the low fat category respectively. Patients improved nutrition with an average fruit increase of 45% (from 1 to 3 fruit/day) (p=0.0001) and a 33% increase in vegetable servings bringing the daily total to 2 3/4 servings (p=0.0001) with sustained change at 6m (p=0.0001) and 12 m (p=0.0001).
Conclusions: Enhancing nutrition intervention by addressing motivation, readiness and confidence to change, improves adoption and maintenance of key eating behaviors. The sustained change in improved nutrition beneficially impacts on vascular risk factor management and overall improved health.