title: Effectiveness of Goal-Setting Telephone Follow-Up on Health Behaviors of Patients with Ischemic Stroke: A Randomized Controlled Trial.
abstract: BACKGROUND
  Adopting healthy behaviors is critical for secondary stroke prevention, but many patients fail to follow national guidelines regarding diet, exercise, and abstinence from risk factors. Compliance often decreases with time after hospital discharge, yet few studies have examined programs promoting long-term adherence to health behaviors. Goal setting and telephone follow-up have been proven to be effective in other areas of medicine, so this study evaluated the effectiveness of a guideline-based, goal-setting telephone follow-up program for patients with ischemic stroke.
  
  
  METHODS
  This was a multicenter, assessor-blinded, parallel-group, randomized controlled trial. Ninety-one stroke patients were randomized to either a control group or an intervention group. Intervention consisted of predischarge education and 3 goal-setting follow-up sessions conducted by phone. Data were collected at baseline and during the third and sixth months after hospital discharge.
  
  
  RESULTS
  Six months after discharge, patients in the intervention group exhibited significantly higher medication adherence than patients in the control group. There were no statistically significant differences in physical activity, nutrition, low-salt diet adherence, blood pressure monitoring, smoking abstinence, unhealthy use of alcohol, and modified Rankin Scale (mRS) scores between the 2 groups.
  
  
  CONCLUSIONS
  Goal-setting telephone follow-up intervention for ischemic stroke patients is feasible and leads to improved medication adherence. However, the lack of group differences in other health behavior subcategories and in themRS score indicates a need for more effective intervention strategies to help patients reach guideline-recommended targets.
authors.affiliation: School of Nursing, Sun Yat-sen University, Guangzhou, China.
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Wan
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Xiao-Pei
authors.initials: XP
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
authors.forename: Miao-Miao
authors.initials: MM
authors.lastname: Mo
authors.affiliation: Department of Neurology and Stroke Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Xiao-Ni
authors.initials: XN
authors.lastname: Xiong
authors.affiliation: Department of Neurology and Stroke Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Cui-Ling
authors.initials: CL
authors.lastname: Ou
authors.affiliation: School of Nursing, Sun Yat-sen University, Guangzhou, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: You
authors.affiliation: School of Public Health, Sun Yat-sen University, Guangzhou, China. Electronic address: chenshaoxian5@163.com.
authors.forename: Shao-Xian
authors.initials: SX
authors.lastname: Chen
authors.affiliation: Department of Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D012307:Risk Factors; D020521:Stroke / Q000523:psychology* / Q000628:therapy*; D013689:Telephone
keywords: RCT; Stroke; goal setting; health behaviors; nursing; secondary prevention; telephone follow-up