A 2-Year Stage of Change Evaluation of Dietary Fat and Fruit and Vegetable Intake Behaviors of Cardiac Rehabilitation Patients

Purpose. To track the 2-year movement of cardiac rehabilitation patients through the stages of change for dietary fat reduction and increasing fruit and vegetable intake. Design. A cross-sectional, longitudinal evaluation of a convenience sample of cardiac rehabilitation patients. Setting. Department of Pulmonary and Cardiac Rehabilitation, Moses H. Cone Memorial Hospital, Greensboro, North Carolina. Subjects. Subjects (n = 118) were predominately white, overweight, married men with a history of tobacco use. Intervention. Group nutrition education sessions for 12 weeks. Measures. Stage of change assessments for dietary fat reduction and increasing fruit and vegetable intake were performed at the start (baseline), conclusion (3 months), and 2 years after cardiac rehabilitation. Results. Baseline staging demonstrated patients' efforts to reduce dietary fat intake (preparation, 10.2%; action, 35.6%; maintenance, 47.5%). The assessment at 2 years staged 87.3% of the population in the maintenance stage. In contrast, the precontemplation (30.0%), contemplation (7.6%), and preparation (49.2%) stages dominated baseline staging for modifying fruit and vegetable intake. Patients in the precontemplation and contemplation stages increased to 58.5% at 2 years. Conclusions. Cardiac rehabilitation patients are in different stages for two food behaviors linked to the same illness. Results support the appropriateness of nutrition education that emphasizes instrumental information for affecting fat reduction behaviors. Modifying fruit and vegetable intake behaviors is more appropriately addressed with noninstrumental interventions that emphasize health benefits and barriers to change.