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From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification
Umeå University, Faculty of Social Sciences, Department of Psychology. (VIPVIZA)ORCID iD: 0000-0002-9847-4196
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0003-4942-611x
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-1617-6102
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-9643-5257
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2023 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 12, no 1, article id 47Article in journal (Refereed) Published
Abstract [en]

Background: Non-adherence in the general population to preventive guidelines on cardiovascular disease calls for an interdisciplinary approach acknowledging psychological factors of relevance for risk communication and lifestyle modification. Evidence is building up regarding the advantage of sharing arterial imaging evidence of subclinical atherosclerosis with asymptomatic individuals, but there is limited understanding of how this relates to mechanisms of importance for behavioural change. Longitudinal studies on associations between patients’ reactions and lifestyle modification are missing. The population-based randomized controlled trial VIPVIZA investigates the impact of pictorial information about subclinical atherosclerosis, added to traditional risk factor-based communication. The intervention includes a personalized, colour-coded and age-related risk communication strategy and a motivational conversation, and has been shown to reduce cardiovascular disease risk. 

Methods: In the present study we assessed cognitive and emotional reactions to the intervention, and how these reactions are associated to lifestyle modification. The participants’ evaluation of the risk communication was assessed in the intervention group (n=1749). Lifestyle modification was assessed with a lifestyle index based on physical activity, diet, smoking and alcohol consumption at baseline and after 3 years. Associations between cognitive and emotional response and lifestyle modification were tested with analyses of covariance in a subset of participants (n=714-857).

Results: The intervention increased understanding of personal CVD risk, the possibility to influence the risk, and how to influence the risk. Severity of atherosclerosis was associated with emotional reactions, but emotions of strong negative valence were uncommon. Cognitive response and emotional arousal evoked by the intervention were positively associated with lifestyle modification, whereas negative emotions in isolation were not. High level of cognitive response in combination with high level of emotional arousal was found to be most beneficial for lifestyle modification.

Conclusions: The results demonstrate the potential of communicating asymptomatic atherosclerosis with a pictorial, colour-coded and age-related strategy, also including a motivational conversation. Furthermore, the results show the importance of CVD risk communication evoking engagement, and that an interaction between cognitive and emotional reactions might be central for sustained lifestyle modification. Our results also indicate that, in an asymptomatic population, atherosclerosis screening may strengthen disease prevention and health promotion.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 12, no 1, article id 47
Keywords [en]
Atherosclerosis, Lifestyle, Health behaviour, Prevention, Health promotion, Decision making, Cognition, Emotion 
National Category
Psychology Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-218585DOI: 10.1186/s40359-023-01467-xISI: 001148313000002PubMedID: 38268015Scopus ID: 2-s2.0-85182977469OAI: oai:DiVA.org:umu-218585DiVA, id: diva2:1822224
Funder
Region Västerbotten, Central ALFRegion Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL- 643391Swedish Research Council, 521–2013-2708Swedish Research Council, 2016- 01891Swedish Research Council, 2017–02246Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481The Swedish Stroke AssociationSwedish Insurance SocietyVisare NorrAvailable from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-02-07Bibliographically approved

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Andersson, Elin M.Lindvall, KristinaWennberg, PatrikJohansson, HeleneNordin, Steven

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Andersson, Elin M.Lindvall, KristinaWennberg, PatrikJohansson, HeleneNordin, Steven
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PsychologyCardiac and Cardiovascular Systems

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