Integrating Motivational Interviewing with Brief Strategic Therapy for Heart Patients

Problem statement: psychological distress, obesity and unhealthy lifestyles may contribute to a worse prognosis of cardiac diseases; an important public health challenge is to motivate people and facilitate health behavior change. Research question: specifically, aim of the current study is to test the mediating effect of motivation in improving lifestyle changes in a long term. Purpose of the study: the MOTIV-HEART (MOTivational strategies for HEART patients) study, a twoarm randomized controlled clinical trial, compares the efficacy of an alternative-integrative brief motivational intervention (MI) with the cardiac rehabilitation programmed treatment - Brief Strategic Therapy (BST) - in order to develop interventions able to improve lifestyle change among heart patients. Research method: inpatients with Coronary Artery Disease (CAD) referred to a single clinical center for cardiac rehabilitation (CR) and weight loss treatment will be randomly allocated into two conditions: a) 3 sessions of BST, b) 3 sessions of BST combined with Motivational Interviewing (MI) techniques. Data are going to be collected at baseline, discharge (1 month after) and after 3, 6, 12 months follow-up. Finding: three kinds of outcomes are going to be relieved: behavioral, psychological and biomedical. Primary outcome is the improvement of patients’ diet and physical activity at 3 months follow-up. Secondary outcomes are (a) the maintenance of healthy lifestyle habits, (b) the reduction of patients' body mass index (BMI) and specific cardiac parameters levels, (c) the improvement of adequate psychological outcomes. Conclusion: obese patients with cardiovascular diseases face numerous difficulties in achieving self-care. Motivational interviewing showed encouraging results in eliciting adoption of high-risk behavioral change, such as initiating an exercise regimen and changing diet. The rationale behind this investigation is that focusing on enhancing motivation would result in better outcomes than those brought about by existing therapy. Study is currently ongoing.