Starting to eat healthier, work out, and begin other lifestyle changes can be challenging according to a recent study of behavioral health interventions published by Oregon State University assistant professor Veronica Irvin, but the study shows a connection between behavioral changes and increased cardiovascular health.

Irvin, an assistant professor in the College of Public Health and Human Sciences worked with co-author Robert Kaplan of the Agency for Healthcare Research and Quality on the study to analyze 38 published cases where participants saw changes in their health, known as interventions.

In the context of Irvin’s study, an intervention is comprised of a health program in some capacity to make a behavioral change that will result in a clinical change in weight or blood pressure.

“For each of these trials I accessed; Did they change behavior, yes or no?  Did they change a physiological outcome, blood pressure or weight?  Did they make a clinical change, number hospitalizations, number of heart attacks?  That’s how I coded trial.  Then I accessed how big the changes were, how big were these behavior and physiological changes,” Irvin said.

Operating under the assumption behavior changes would not work, patients are often prescribed drugs to help combat heart disease.  Irvin worked to determine the validity of this statement.

The majority of participants reported being able to make a behavioral change.  People were able to eat healthier, make a change to their physical activity, adhere to medication and or stop smoking, according to Irvin.

According to the study, 26 trials reported a behavioral outcome with 81 percent reporting significant improvements for the target behavior.  Thirty-two trials reported a physiological outcome.  All were objectively measured, and 81 percent reported significant benefit.

Irvin pointed to benefits in blood pressure, weight and cholesterol as examples of positive outcomes experienced by those in the original studies.  Unlike other behavioral studies, the objective nature of these data points led to concrete numbers that could be easily analyzed.

While Irvin did not conduct any interventions herself, she combed carefully through existing studies to analyze information she could compile.

“I didn’t actually get their original data sets, I just compiled the results from their published papers.  I looked at how many found a significant benefit.  I looked at trials that were larger in terms of money or participants because those results were more likely to be published.  They were all federally funded,” Irvin said.

Performing a systematic review of large dollar grants that conducted various behavioral programs, and compiling all the analyses, Irvin was able to make a comprehensive review.

According to Irvin, the study identified large-budget grants of over $500,000 and among 106 grants that potentially met inclusion criteria 20 studies were not published and 48 were excluded, leaving 38 publications for analysis.

Irvin said that the results and concepts taken away from her study can be applied in a more general context as well, especially students who are struggling to set behavioral change goals and stick to them.

“You can make behavior changes, you can sustain them,” Irvin said.  “Even small changes can have a large impact over time, and if you can do more than one behavior change simultaneously, you’ll see better results physiologically.”

According to Irvin, the relation between changing two or more behaviors at the same time and the long term effect of that action is important.

“They found a better benefit to the physiological changes if they improved two or more behaviors at once, and not just once.  For example, focusing on diet and exercise, had a better impact,” Irvin said.

Dr. Erica Woekel, a clinical assistant professor at OSU in biological and population health sciences and as public health and human sciences, and the director of the Lifetime Fitness for Health program pushes for the use of SMART goals to achieve desired changes in physiological nature.  

“SMART goals are useful for put the dream of change or what you are wanting to change into a practical plan.  They help to focus your goal into a specific, trackable and personal manner while also allowing you to set a time frame to accomplish that goal,” Woekel said.

Irvin and Woekel both outlined the importance for setting goals that are both attainable, as well as reasonable and measurable.

“They are useful because it make you focus on the task at hand, it transforms ‘I want to be healthier’ or ‘I want to exercise more’ into what does that really mean at a practical level,” Woekel said.

The study can be viewed here.