title: Changes in Dietary Behavior among Coronary and Hypertensive Patients: A Longitudinal Investigation Using the Health Action Process Approach.
abstract: BACKGROUND
  Cardiovascular diseases (CVDs) are a major cause of worldwide morbidity and mortality. Nutrition plays an important role in the primary, secondary, and tertiary prevention of CVDs. The present longitudinal study used the Health Action Process Approach (HAPA) to investigate changes in dietary behavior in coronary patients (CPs) affected by acute coronary syndrome and hypertensive patients (HPs) affected by essential arterial hypertension.
  
  
  METHODS
  CPs (N = 250) and HPs (N = 246) completed a questionnaire during three measurement points (baseline, 6-month follow-up, and 12-month follow-up). Statistical analyses included a repeated measures ANOVA and a multi-sample structural equation model.
  
  
  RESULTS
  HPs showed no changes in dietary behavior, whereas CPs improved their nutrition at 6 months and then maintained the healthier diet. The multi-sample analysis indicated equivalence of the HAPA model for both patient populations.
  
  
  CONCLUSIONS
  These findings provide further evidence for the generalisability of the HAPA model, shedding light on dietary behavior among CVD patients and particularly on hypertensive patients which has received little attention. Moreover, the equivalence of the model suggests that the process of change is almost identical for individuals who are at high risk for a coronary event (i.e. HPs) and individuals who have already had the event (i.e. CPs).
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Steca
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Pancani
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Greco
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: D'Addario
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Magrin
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Miglioretti
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Sarini
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Scrignaro
authors.affiliation: University of Milan "Bicocca", Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Vecchio
authors.affiliation: Niguarda Ca' Granda Hospital, Milan and University of Milan "Bicocca", Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cesana
authors.affiliation: Niguarda Ca' Granda Hospital, Milan and University of Milan "Bicocca", Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Giannattasio
authors.affiliation: University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattirolli
authors.affiliation: Istituti Clinici di Perfezionamento Hospital, Milan, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Zanettini
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology*; D000704:Analysis of Variance; D004032:Diet / Q000523:psychology*; D000075222:Essential Hypertension; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D020377:Self Efficacy; D013997:Time Factors
keywords: Health Action Process Approach; acute coronary syndrome; dietary change; essential arterial hypertension