Readiness to change health behaviours among patients at high risk of cardiovascular disease.

OBJECTIVE: To determine readiness to change dietary intake of fat, physical exercise and smoking, using a classification based on the stages of change model, among patients in a primary care population selected to have greater than normal risk of coronary heart disease.
METHODS: We recruited 883 patients from general practices in the south of England who had one or more of the following cardiovascular risk factors: current cigarette smoking, total cholesterol level 6.5-9.0 mmol/l and a body mass index of 25-35 kg/m2 coupled with a lack of regular physical exercise. Measures of cardiovascular risk factors were obtained, together with questionnaire measures of stage of readiness to change smoking behaviour, dietary intake of fat and level of physical exercise.
RESULTS: Patients with high cholesterol levels had a different degree of readiness to reduce dietary fat from that of those with low cholesterol levels. Patients who were overweight and inactive reported a greater readiness to increase their physical activity than did those who were not overweight and not inactive. Readiness to change any of the three behaviours was not affected by the presence of more than one modifiable risk factor. However, patients who were contemplating or preparing to stop smoking were also more ready to increase physical activity than were those who were not considering stopping smoking.
CONCLUSIONS: Risk classification has an impact upon patients' readiness to change modifiable cardiovascular risk behaviours. The relationships between readiness to change various behaviours suggest that there are synergies in counselling strategies and methods of identifying patients who might be especially responsive.