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Compliance with cardiovascular disease prevention strategies: A review of the research

Burke, LE and Dunbar-Jacob, JM and Hill, MN (1997) Compliance with cardiovascular disease prevention strategies: A review of the research. Annals of Behavioral Medicine, 19 (3). 239 - 263. ISSN 0883-6612

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The efficacy of cardiovascular risk-reduction programs has been established. However, the extent to which risk-reduction interventions are effective may depend on adherence. Non-compliance, or non-adherence, may occur with any of the recommended or prescribed regimens and may vary across the treatment course. Compliance problems, whether occurring early or late in the treatment course, are clinically significant, as adherence is one mediator of the clinical outcome. This article, which is based on a review of the empirical literature of the past 20 years, addresses compliance across four regimens of cardiovascular risk reduction: pharmacological therapy, exercise, nutrition, and smoking cessation. The criteria for inclusion of a study in this review were: (a) focus on cardiovascular disease risk reduction; (b) report of a quantitative measure of compliance behavior; and (c) use of a randomized controlled design. Forty-six studies meeting these criteria were identified. A variety of self-report, objective, and electronic measurement methods were used across these studies. The interventions employed diverse combinations of cognitive, educational, and behavioral strategies to improve compliance in an array of settings. The strategies demonstrated to be successful in improving compliance included behavioral skill training, self-monitoring, telephone/mail contact, self-efficacy enhancement, and external cognitive aids. A series of tables summarize the intervention strategies, compliance measures, and findings, as well as the interventions demonstrated to be successful. This review reflects the progress made over the two decades in compliance measurement and research and, further, advances made in the application of behavioral strategies to the promotion of cardiovascular risk reduction.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Burke, LElbu100@pitt.eduLBU1000000-0003-2434-9867
Dunbar-Jacob, JMdunbar@pitt.eduDUNBAR
Hill, MN
Date: 1 January 1997
Date Type: Publication
Journal or Publication Title: Annals of Behavioral Medicine
Volume: 19
Number: 3
Page Range: 239 - 263
DOI or Unique Handle: 10.1007/bf02892289
Schools and Programs: School of Nursing > Nursing
Refereed: Yes
ISSN: 0883-6612
Article Type: Review
MeSH Headings: Behavior Therapy; Cardiovascular Agents--administration & dosage; Cardiovascular Diseases--prevention & control; Cardiovascular Diseases--psychology; Diet, Fat-Restricted--psychology; Exercise--psychology; Humans; Patient Compliance--psychology; Risk Factors; Smoking Cessation--psychology; Treatment Outcome
PubMed ID: 9603699
Date Deposited: 18 Sep 2012 14:31
Last Modified: 25 Jan 2022 11:55


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