title: Changing health behaviors to improve health outcomes after angioplasty: a randomized trial of net present value versus future value risk communication.
abstract: Patients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on 'net present value' economic theory, would be more effective in behavioral intervention than the standard 'future value approach' in reducing cardiovascular morbidity and mortality following angioplasty. At baseline, all patients completed a health assessment, received an individualized risk profile and selected risk factors for modification. The intervention randomized patients into two varying methods for illustrating positive effects of behavior change. For the experimental group, each selected risk factor was assigned a numeric biologic age (the net present value) that approximated the relative potential to improve current health status and quality of life when modifying that risk factor. In the control group, risk reduction was framed as the value of preventing future health problems. Ninety-four percent of patients completed 2-year follow-up. There was no difference between the rates of death, stroke, myocardial infarction, Class II-IV angina or severe ischemia (on non-invasive testing) between the net present value group and the future value group. Our results show that a net present risk communication intervention did not result in significant differences in health outcomes.
authors.affiliation: Center for Complementary and Integrative Medicine, Weill Cornell Medical College, New York, NY 10065, USA. mecharl@med.cornell.edu
authors.forename: M E
authors.initials: ME
authors.lastname: Charlson
authors.forename: J C
authors.initials: JC
authors.lastname: Peterson
authors.forename: C
authors.initials: C
authors.lastname: Boutin-Foster
authors.forename: W M
authors.initials: WM
authors.lastname: Briggs
authors.forename: G G
authors.initials: GG
authors.lastname: Ogedegbe
authors.forename: C E
authors.initials: CE
authors.lastname: McCulloch
authors.forename: J
authors.initials: J
authors.lastname: Hollenberg
authors.forename: C
authors.initials: C
authors.lastname: Wong
authors.forename: J P
authors.initials: JP
authors.lastname: Allegrante
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001521:Behavior Therapy / Q000379:methods*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D018570:Risk Assessment; D040242:Risk Reduction Behavior