title: Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey.
abstract: Preferences for medication treatment versus lifestyle changes are of major importance in the management of chronic diseases. This study aims to investigate determinants of preference for lifestyle changes versus medication for prevention of cardiovascular disease as well as determinants of respondents' beliefs in their ability to maintain lifestyle changes. A representative sample of 40-60-year old Danish inhabitants was in 2012 invited to a survey and were asked to imagine that they had been diagnosed as being at increased risk of heart disease. Subsequently they were presented with a choice between a preventive medical intervention versus lifestyle change. The study population for the present paper comprises 1069 participants. A total of 962 participants preferred lifestyle changes to medication treatment. Significant determinants for preferring lifestyle changes were female gender and high level of physical activity. Significant determinants for not opting for lifestyle changes were being self-employed, poor self-rated health and smoking. Low educational attainment, lifestyle risk factors, self-reported health-related challenges and prior experience with heart disease were associated with a low belief in ability to maintain lifestyle changes. For conclusion we found a pervasive preference for lifestyle changes over medical treatment when individuals were promised the same benefits. Lifestyle risk factors and socioeconomic characteristics were associated with preference for lifestyle changes as well as belief in ability to maintain lifestyle changes. For health professionals risk communication should not only focus on patient preferences but also on patients' beliefs in their own ability to initiate lifestyle changes and possible barriers against maintaining changes.
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Dorte Ejg
authors.initials: DE
authors.lastname: Jarbøl
authors.affiliation: Research Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Pia Veldt
authors.initials: PV
authors.lastname: Larsen
authors.affiliation: COHERE, Department of Public Health & Department of Business and Economics, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Gyrd-Hansen
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Carl
authors.initials: C
authors.lastname: Brandt
authors.affiliation: Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg, Denmark.
authors.forename: Anja
authors.initials: A
authors.lastname: Leppin
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Benedicte Lind
authors.initials: BL
authors.lastname: Barfoed
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000 Odense C, Denmark.
authors.forename: Jesper Bo
authors.initials: JB
authors.lastname: Nielsen
keywords: Cardiovascular disease; Determinants; Lifestyle; Population survey; Preventive treatment; Risk communication