Experimenting with environment changes can boost heart health

As you think about your special Valentine today—and the way he or she makes your heart flutter—it’s a good time to remember that a few changes in diet and exercise can improve heart health for people of all ages, says a researcher at the Frances Payne Bolton School of Nursing.

“It’s American Heart Month,” says Shirley Moore, professor and associate dean of the nursing school. “It’s a time to take stock of what you can do to prevent heart disease.”

In a National Institutes of Health-funded study, Moore is studying ways to get cardiac patients to exercise more.

Recently, the American Heart Association honored Moore and her work helping cardiac patients finds ways to make changes in their environment that promote heart health. She was awarded the “Best Abstract Award” during the American Heart Association Scientific Sessions Council of Cardiovascular Nursing.

“It could be a walk at lunch or after dinner,” Moore says. “It could be adhering to a shopping list at the grocery store or putting fruit on the kitchen counter for snacking. The list goes on and on.”

The research comes out of the NIH’s National Institute of Nursing Research-funded SMART Center (Center for Excellence for Self-Management Advancement through Research & Translation) at the nursing school, which is studying how people self-manage chronic illnesses, such as heart disease.

“The issue is that many people with cardiac conditions didn’t exercise before their event and have trouble exercising afterward,” Moore explains.

So Moore and a research team are working with patients to approach exercise and diet from three different angles: simply prescribing new behaviors to the patient, motivating the person to change poor behaviors, or encouraging patients to self-design ways to change the environment to incorporate better habits.

“Selling the car and then walking everywhere is one drastic environment change,” Moore says, adding that she recognized most people won’t go to such an extreme.

She studied 379 people who had cardiac experiences (heart attack, bypass surgery or placement of stent). The patients had different education, income and other demographic qualities, but they all shared similar health problems—ones that Moore suspects, for many, stem from a lack exercise and poor diets.

Over 12 months, she randomly divided the individuals into three groups. One used a program called CHANGE+ that focused on motivation to improve eating and exercise habits; the second was SystemChange that worked changes into individuals’ everyday life, such as walking to work; the third group (the control group) was just told to exercise more and eat better.

What she found was that having individuals experiment with ways to change their habits until they found what worked within their particular home or work environment was more effective than dictating to or even attempting to motivate people.

Moore calls these changes “experiments” because, if they don’t work, then the cardiac patient tries something new until something does work.

Changes people made included: shopping with a grocery list, a grandfather walking his grandchildren a mile to and from school instead of driving, and pet owners taking the dog for a walk.

Individuals tracked what they did each day, and families monitored it, too. In some situations, the family began to make changes to support the cardiac patient.  After two weeks using the experiment, they would propose a new change if the old one didn’t work.

“It’s not easy to make these changes,” Moore says, adding that eventually people find a way. “The important thing is that people exercise and are able to fit it into their daily lives.”