Health Education Research Advance Access published online on November 19, 2007
Health Education Research, doi:10.1093/her/cym068
Changing health behaviors to improve health outcomes after angioplasty: a randomized trial of net present value versus future value risk communication
1 Center for Complementary and Integrative Medicine, Weill Cornell Medical College, New York, NY 10065, USA
2 Department of Mathematics, Central Michigan University, Mount Pleasant, 48859
3 Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
4 Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA 94143, USA
5 Department of Medicine, Weill Cornell Medical College New York, New York, NY 10021, USA
6 Department of Health and Behavior Studies, Teachers College and Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10027, USA
Correspondence to: * Correspondence to: M. E. Charlson. E-mail: mecharl{at}med.cornell.edu
Patients who have undergone angioplasty experience difficulty modifying at-risk behaviors for subsequent cardiac events. The purpose of this study was to test whether an innovative approach to framing of risk, based on ‘net present value’ economic theory, would be more effective in behavioral intervention than the standard ‘future value approach’ in reducing cardiovascular morbidity and mortality following angioplasty. At baseline, all patients completed a health assessment, recieved an individualized risk profile and selected risk factors for modification. The intervention randomized patients into two varying methods for illustrating positive effects of behavior change. For the experimental group, each selected risk factor was assigned a numeric biologic age (the net present value) that approximated the relative potential to improve current health status and quality of life when modifying that risk factor. In the control group, risk reduction was framed as the value of preventing future health problems. Ninety-four percent of patients completed 2-year follow-up. There was no difference between the rates of death, stroke, myocardial infarction, Class II–IV angina or severe ischemia (on non-invasive testing) between the net present value group and the future value group. Our results show that a net present risk communication intervention did not result in significant differences in health outcomes.
Received on April 21, 2006; accepted on September 4, 2007