Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients With Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study

Tilakavati Karupaiah, Kimberly Wong, Karuthan Chinna, Kanimolli Arasu, Winnie Siew Swee Chee

Research output: Contribution to journalArticle

Abstract

The CORFIS (Community-Based Cardiovascular Risk Factors Intervention Strategies) program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen’s d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p <.001) and TA (d = 0.45, p <.001) compared to N-A (d = 0.13, p >.05). Marginally increasing fruit and vegetable consumption (Δ = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p <.001) > TA (d = 0.54, p <.001) > N-A (d = 0.21, p >.05) and in WC for NA (d = 0.68, p <.00) > TA (d = 0.53, p <.001) > N-A (d = 0.52, p >.05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC.

Original languageEnglish
Pages (from-to)339-351
Number of pages13
JournalHealth Education and Behavior
Volume42
Issue number3
DOIs
Publication statusPublished - 4 Jun 2015

Fingerprint

Blood Pressure
Hypertension
Waist Circumference
Exercise
Weights and Measures
Vegetables
Fruit
Sodium
Risk Factors
Adherence
Diet Records
Malaysia
Disease Management
Health Education
Weight Loss
Chronic Disease
Research Design
Maintenance
deoxythymidylyl-3'-5'-deoxyadenylate

Keywords

  • adherence
  • diet
  • exercise
  • healthful behaviors
  • hypertension
  • stages of change

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health

Cite this

Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients With Hypertension : Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study. / Karupaiah, Tilakavati; Wong, Kimberly; Chinna, Karuthan; Arasu, Kanimolli; Chee, Winnie Siew Swee.

In: Health Education and Behavior, Vol. 42, No. 3, 04.06.2015, p. 339-351.

Research output: Contribution to journalArticle

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