The development and validation of scales to measure the presence of a teachable moment following a cardiovascular disease event

Health and self-regulatio

The COVID-19 crisis as a teachable moment for lifestyle change in Dutch cardiovascular disease patients

Objective: When lifestyle changes are needed, life events or crises such as COVID-19 may function as “teachable moments”. This study aimed to explore whether the pandemic can provoke a teachable moment regarding lifestyle change in cardiovascular disease patients.Method: In this cross-sectional survey study, 830 cardiovascular disease patients reported their intentions to change lifestyle, instigated by the corona crisis, together with risk perception, affective impact, and changed self-concept, based on a “teachable moments” framework.Results: Between 8 and 28% of the sample reported increased intentions to optimize lifestyle behaviors, particularly related to general lifestyle (28%), physical activity (25%), and diet (21%). Multivariate regression analyses revealed that changed self-concept was associated with higher intentions to improve general lifestyle (B = 0.26; CI = 0.19–0.33), physical activity (B = 0.23; CI = 0.16–0.30), and smoking (B = 0.29; CI = 0.01–0.57). In addition, changed self-concept and affective impact were both significantly associated with higher intentions to improve diet (resp. B = 0.29; CI = 0.21–0.36 and B = 0.12; CI = 0.04–0.21) and to limit alcohol consumption (resp. B = 0.22; CI = 0.13–0.30 and B = 0.11; CI = 0.01–0.20). We did not find evidence for an important role of risk perception on behavior change intentions.Conclusion: The COVID-19 crisis evoked a potential teachable moment for lifestyle change in cardiovascular disease patients, driven by a change in a patient’s self-concept and to a lesser extent by an affective impact of the COVID-19 crisis. These results suggest an important window of opportunity for healthcare professionals to utilize the pandemic to promote a healthy lifestyle to their patients.Public Health and primary car

The COVID-19 crisis as a teachable moment for lifestyle change in Dutch cardiovascular disease patients

Health and self-regulatio

The development and validation of scales to measure the presence of a teachable moment following a cardiovascular disease event

Better conceptually-driven research is necessary to learn more about 1) the characteristics of life events as teachable moments (TMs) and 2) the potential of life events to evoke lifestyle change intention (LCI). This study aimed to develop and validate two scales for the purposes of TM research in the context of cardiovascular disease (CVD): the CardiacTM and CardiacLCI-scales. After the initial development of items based on a theoretical framework and literature search, six experts rated the content validity of both scales as sufficient. The item list was further adjusted after think-aloud sessions with two CVD patients. The resulting scales were presented online in a cross-sectional survey, which yielded 625 responses of Dutch CVD patients (June 2020). To test construct validity, we conducted Exploratory Factor Analysis (EFA) with Varimax rotation on a random split-half of the sample (n = 300) and evaluated the factor structure with Confirmatory Factor Analysis (CFA) on the holdout sample (n = 325). EFA and CFA on the CardiacTM-scale (α = 0.88) revealed a 28-item six-factor structure explaining 61.0% of the variance, with adequate goodness-of-fit statistics (CFI = 0.87; TLI = 0.85; SRMR = 0.07) and internally reliable factors (Affective impact, Risk CVD, Changed self-concept, CVD group identity, Risk non-communicable disease, Anticipated regret). The CardiacLCI-scale (α = 0.81) revealed an 11-item two-factor structure explaining 51.5% of the variance, with adequate model fit (CFI = 0.92; TLI = 0.90; SRMR = 0.08) and internally reliable factors (Event-related lifestyle change and General healthy lifestyle). The scales may be used to expand knowledge around life events as TMs and to support conversation regarding lifestyle after cardiac and other life events