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*, 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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)789-796
Number of pages8
JournalJournal of Cardiac Failure
Volume17
Issue number10
DOIs
StatePublished - Oct 2011

Keywords

  • Heart failure
  • counseling
  • patient education
  • self-care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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