title: Does knowledge of coronary artery calcium affect cardiovascular risk perception, likelihood of taking action, and health-promoting behavior change?
abstract: BACKGROUND
  Evidence indicates that a healthy lifestyle can reduce cardiovascular disease risk, yet many people engage in unhealthy behaviors. New technologies such as coronary artery calcium (CAC) screening detect atherosclerosis before clinical disease is manifested. Knowledge of an abnormal finding could provide the "teachable moment" to enhance motivation for change.
  
  
  OBJECTIVE
  The aim of this study was to examine how knowledge of CAC score affects risk perception, likelihood of taking action, and health-promoting behavior change in persons at high risk for cardiovascular disease.
  
  
  METHODS
  This study used a descriptive prospective design with 174 high-risk adults (≥3 major risk factors) recruited at a radiology center offering CAC scans. Baseline self-report surveys using the Perception of Risk of Heart Disease Scale, the Benefits and Barriers Scale, the Quality of Life Index, and the Health-Promoting Lifestyle Profile II were completed immediately after a screening CAC scan but before results were known. Follow-up occurred 3 months later using mailed packets.
  
  
  RESULTS
  Participants' mean age was 58 years; 62% were men, 89% were white, and most were well educated. There was no significant change in risk perception scores over time or between groups, except for a positive interaction in the moderate-risk group (CAC scores of 101-400) (P = .004). Quality of life remained unchanged. Health-promoting behavior changes increased in all groups over time (P < .001). McNemar χ² analysis indicated that risk reduction medication use increased in all groups, with a significant increase in statin (P < .001) and aspirin (P < .001) intake. Predictors of behavior change were perceived barriers (β = -.41; P < .001) and quality of life (β = .44; P < .001).
  
  
  CONCLUSIONS
  Knowledge of CAC score does impact risk perception for some at-risk groups. This knowledge does enhance motivation for behavior change. Knowledge of CAC score does not impact quality of life. It is hoped that through improved understanding of the effect of CAC scoring on behavior change, nurses can better assist patients to modify behaviors during teachable moments.
authors.affiliation: Jennie E. Johnson PhD, RN-BC Lifestyle Counselor, Owner, Living For A Healthy Heart, LLC, Post Falls, Idaho. Meg Gulanick, PhD, APRN, FAAN Professor Emeritus, Niehoff School of Nursing, Loyola University, Chicago, Illinois. Sue Penckofer, PhD, RN, FAAN Professor and Loyola Faculty Scholar, Niehoff School of Nursing, Loyola University, Chicago, Illinois. Joanne Kouba, PhD, RD, LDN Director, Dietetics Programs, Niehoff School of Nursing, Loyola University, Chicago, Illinois.
authors.forename: Jennie E
authors.initials: JE
authors.lastname: Johnson
authors.forename: Meg
authors.initials: M
authors.lastname: Gulanick
authors.forename: Sue
authors.initials: S
authors.lastname: Penckofer
authors.forename: Joanne
authors.initials: J
authors.lastname: Kouba
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000517:prevention & control*; D003331:Coronary Vessels; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D040242:Risk Reduction Behavior; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors