Individual influences on lifestyle change to reduce vascular risk: a qualitative literature review.
BACKGROUND
Management of cardiovascular risk includes adoption of healthy lifestyles. Uptake and completion rates for lifestyle programmes are low and many barriers and facilitators to lifestyle behaviour change have been reported in the literature. Clarity on which barriers  and facilitators to target during consultations in primary care may support a more systematic approach to lifestyle behaviour change in those at high risk of cardiovascular events.


OBJECTIVE
To identify the main barriers and facilitators to lifestyle behaviour change in individuals  at high risk of cardiovascular events.


METHODS
A content synthesis of the qualitative literature reporting patient-level influences on lifestyle change.


METHODS
Qualitative studies involving patients at high risk of cardiovascular events were identified  through electronic searching and screening against predefined selection criteria. Factors (reported influences) were extracted and, using a clustering technique, organised into categories that were then linked to key themes through relationship mapping.


RESULTS
A total  of 348 factors were extracted from 33 studies. Factors were organised into 20 categories and from these categories five key themes were identified: emotions, beliefs, information and communication, friends and family support, and cost/transport.


CONCLUSIONS
It is possible  to organise the large number of self-reported individual influences on lifestyle behaviours into a small number of themes. Further research is needed to clarify which of these patient-level barriers and facilitators are the best predictors of uptake and participation in programmes aimed at  helping people to change lifestyle.
Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, UK. j.y.murray@leeds.ac.uk
Jenni
J
Murray
Stephanie
S
Honey
Kate
K
Hill
Cheryl
C
Craigs
Allan
A
House
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012944:Social Support; D055815:Young Adult