Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Oct;17(10):789-96.
doi: 10.1016/j.cardfail.2011.06.374. Epub 2011 Jul 23.

The effect of progressive, reinforcing telephone education and counseling versus brief educational intervention on knowledge, self-care behaviors and heart failure symptoms

David W Baker  1 , Darren A Dewalt, Dean Schillinger, Victoria Hawk, Bernice Ruo, Kirsten Bibbins-Domingo, Morris Weinberger, Aurelia Macabasco-O'Connell, Kathy L Grady, George M Holmes, Brian Erman, Kimberly A Broucksou, Michael Pignone
Affiliations
Randomized Controlled Trial

The effect of progressive, reinforcing telephone education and counseling versus brief educational intervention on knowledge, self-care behaviors and heart failure symptoms

David W Baker et al. J Card Fail. 2011 Oct.

Abstract

Background: The optimal strategy for promoting self-care for heart failure (HF) is unclear.

Methods and results: We conducted a randomized trial to determine whether a "teach to goal" (TTG) educational and behavioral support program provided incremental benefits to a brief (1 hour) educational intervention (BEI) for knowledge, self-care behaviors, and HF-related quality of life (HFQOL). The TTG program taught use of adjusted-dose diuretics and then reinforced learning goals and behaviors with 5 to 8 telephone counseling sessions over 1 month. Participants' (n = 605) mean age was 61 years; 37% had marginal or inadequate literacy; 69% had ejection fraction <0.45; and 31% had Class III or IV symptoms. The TTG group had greater improvements in general and salt knowledge (P < .001) and greater increases in self-care behaviors (from mean 4.8 to 7.6 for TTG vs. 5.2 to 6.7 for BEI; P < .001). HFQOL improved from 58.5 to 64.6 for the TTG group but did not change for the BEI group (64.7 to 63.9; P < .001 for the difference in change scores). Improvements were similar regardless of participants' literacy level.

Conclusions: Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.

Trial registration: ClinicalTrials.gov NCT00378950.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT Diagram Showing Participant Study Flow *Some sites were able to identify potentially eligible patients using administrative and electronic health records. Not all patients were approached.
Figure 2
Figure 2
Mean Self-Care Scores (95% CI) at Baseline (●) and One-Month Follow-Up (■) for the Brief Educational Intervention (BEI) and the Teach to Goal (TTG) Groups, Stratified by Health Literacy Level (Adequate and Marginal/Inadequate). CI indicates confidence intervals
Figure 3
Figure 3
Mean Heart Failure Symptom Score (95% CI) at Baseline (●) and One-Month Follow-Up (■) for the Brief Educational Intervention (BEI) and the Teach to Goal (TTG) Groups, Stratified by Health Literacy Level (Adequate and Marginal/Inadequate). CI indicates confidence intervals
See this image and copyright information in PMC

References

    1. Lloyd-Jones D, A R, Brown TM, Carnethon M, Dai S, De Simone G, Ferguson TB, Ford E, Furie K, Gillespie C, Go A, Greenlund K, Haase N, Hailpern S, Ho PM, Howard V, Kissela B, Kittner S, Lackland D, Lisabeth L, Marelli A, McDermott MM, Meigs J, Mozaffarian D, Mussolino M, Nichol G, Roger V, Rosamond W, Sacco R, Sorlie P, Stafford R, Thom T, Wasserthiel-Smoller S, Wong ND, Wylie-Rosett J. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2010 Update: a report from the American Heart Association. Circulation. 2010;121:e46–e215. - PubMed
    1. Riegel B, M D, Anker SD, Appel LJ, Dunbar SB, Grady KL, Gurvitz MZ, Havranek EP, Lee CS, Lindenfeld J, Peterson PN, Pressler SJ, Schocken DD, Whellan DJ. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120:1141–1163. - PubMed
    1. McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004;44:810–9. - PubMed
    1. Jovicic A, Holroyd-Leduc JM, Straus SE. Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC Cardiovasc Disord. 2006;6:43. - PMC - PubMed
    1. Yehle KS, Plake KS. Self-efficacy and educational interventions in heart failure: a review of the literature. J Cardiovasc Nurs. 2010 May-Jun;25(3):175–88. - PubMed

Publication types

Associated data