Patient Educ Couns. 1998 Nov; 35(3): 177-88.

Behavioral and psychosocial effects of intensive lifestyle management for women with coronary heart disease.

Toobert DJ, Glasgow RE, Nettekoven LA, Brown JE.

Oregon Research Institute, Chronic Illness Research Group, Eugene 97403-1983, USA. deborah@ori.org

Females, especially older women, historically have been excluded from coronary heart disease (CHD) studies. The PrimeTime program was a randomized clinical trial designed to study the effects of a comprehensive lifestyle management program (very low-fat vegetarian diet, smoking cessation, stress-management training, moderate exercise, and group support) on changes in behavioral risk factors among postmenopausal women with CHD. The study also explored program effects on four psychosocial clusters: coping with stress, distress, social support, and self-efficacy. The program produced significant behavioral improvements in 4- and 12-months adherence to diet, physical activity, and stress-management in the PrimeTime women compared to the Usual Care (UC) group. In addition, the PrimeTime participants demonstrated improvements relative to UC on psychosocial measures of self-efficacy, perceived social support, and ability to cope with stress. Strengths and weaknesses of the study, and implications for future research are discussed.