There are many advantages to the utilization of empirical research for the development of effective medical and psychological treatments. A recent study by Pischeke and colleagues (2008) examined the impact of a lifestyle intervention program for patients with coronary heart disease (CHD). A number of medical and healthy lifestyle initiatives have targeted this vulnerable population, but CHD remains the leading cause of death in the United States and most other industrialized countries. The development and implementation of programs that demonstrate empirically significant improvements among people with CHD could prevent the premature death associated with this condition.
The study by Pischeke and colleagues included an intervention, called The Lifestyle Change Program, as the independent variable. This intensive program began with a week-long retreat and continued with regular support group meetings and informative lectures. Diet, exercise, stress management, and social support were key elements of the program. Careful assessment monitored the adherence of participants to ensure changes could be associated with response to the intervention. This study used a randomized controlled trial design. Participants were randomly assigned to the experimental or control group. The experimental group participated in the Lifestyle Change Program. The control group did not.
The results of this study confirm the effectiveness of targeting multiple health behaviors to improve the coronary functioning of people with CHD. The researchers used the dependent variables of psychological distress, anger, hostility, perceived social distress. The changes in these variables were examined across three time periods (baseline, 1 year, and 5 years). A number of cardiac variables were also measured during the course of this research. The experimental group experienced significant reductions in hostility for at least five years after the introduction of the Lifestyle Change Program. Psychological distress was also lessened by the program. Long-term changes were only experienced by participants that adhered to the changes for the length of the follow-up (5 years). This intervention also led to improved diet, which was associated with weight loss and improved cardiovascular health. Improved ability to manage stress showed similar gains for participants who received this intervention compared to the control group.
In addition to producing impressive results, this study raises a number of important questions for future investigations. A primary limitation of this study was the small sample size (experimental group, n = 28, control group, n = 20). Could the same results be duplicated using a larger sample of participants? Another question of interest relates to which of the multiple health behaviors targeted by the program holds the greatest potential to improve the cardiovascular and psychological functioning of individuals. Since the program involved multiple variables, it’s impossible to untangle which changes made the most difference. Could a similar intervention program be applied to individuals with different diagnoses? While these questions raise interesting possibilities for future research, the current study is still an impressive contribution to the knowledge base. Supporting patients to change a number of lifestyle behaviors simultaneously is an effective way to improve multiple psychological and health variables.
Pischeke, C. R., Scherwitz, L., Weidner, G., & Ornish, D. (2008). Effects of lifestyle changes on well-being and cardiac variables among coronary heart disease patients. Health Psychology, 27(5), 584-592.