Brief lifestyle advice in cardiac care: an experimental study on message source and framing

• Published in: Netherlands heart journal Vol. 32; no. 1; pp. 38 - 44
• Main Authors: IJzerman, Renée V. H., van der Vaart, Rosalie, Breeman, Linda D., van den Broek, Inge, Keesman, Mike, Kraaijenhagen, Roderik A., Reijnders, Thomas, Weerts, Margo, Evers, Andrea W. M., Scholte op Reimer, Wilma J. M., Janssen, Veronica R.
• Format: Journal Article
• Language: English
• Published: Houten Bohn Stafleu van Loghum 01-01-2024; Springer Nature B.V
• Subjects: Cardiology; Cardiovascular disease; Confidence; Education; Health behavior; Lifestyles; Likert scale; Medical Education; Medicine; Medicine & Public Health; Motivation; Original; Original Article; Patients; Perceptions; Rehabilitation; Self-efficacy; Variables; Cardiac Rehabilitation; Lifestyle; Intention; Secondary Prevention; Very Brief Advice
• ISSN: 1568-5888; 1876-6250
• DOI: 10.1007/s12471-023-01827-7

Objective
Communicating risk information and offering lifestyle advice are important goals in cardiac rehabilitation. However, the most effective way and the most effective source to communicate this information are not yet known. Therefore, we examined the effect of source (cardiologist, physiotherapist) and framing (gain, loss) of brief lifestyle advice on patients’ intention-to-change-lifestyle.
Methods
In an online experimental study, 636 cardiac patients (40% female, 67 (10) yrs.) were randomly assigned to one of four textual vignettes. Effect of source and framing on intention-to-change-lifestyle (assessed using a 5-point Likert scale) was analysed using analysis of covariance (ANCOVA).
Results
Patients expressed positive intention-to-change-lifestyle after receiving advice from the cardiologist (
M
 = 4.1) and physiotherapist (
M
 = 3.9). However, patients showed significantly higher intention-to-change-lifestyle after receiving advice from the cardiologist (0.58 [0.54–0.61]) when compared with the physiotherapist (0.52 [0.48–0.56]), (
F
[1,609] = 7.06,
P
 = 0.01). Gain-framed and loss-framed advice appeared equally effective. However, communicating risks (loss) was remembered by only 9% of patients, whereas 89% remembered benefits (gain).
Conclusions
Our study shows the value of cardiologists and physiotherapists communicating brief lifestyle advice, as cardiac patients expressed positive intention for lifestyle change after receiving advice, irrespective of framing. Lifestyle advice should include benefits due to better recall.