The Stages of Change for Dietary Fat and Fruit and Vegetable Intake of Patients at the Outset of a Cardiac Rehabilitation Program

PURPOSE: To determine the stages of change for dietary fat and fruit and vegetable intake of cardiac patients entering a rehabilitation program. DESIGN: A cross-sectional study using a convenience sample of newly admitted cardiac rehabilitation patients. SETTING: Department of Pulmonary and Cardiac Rehabilitation, Moses H. Cone Memorial Hospital, Greensboro, North Carolina. SUBJECTS: Subjects (n = 226) were predominantly men, Caucasian, married, smokers with 9 to 12 years of education, and with primary diagnoses of coronary artery bypass graft. MEASURES: Stages of change and food frequency questionnaires were completed by subjects upon admission to cardiac rehabilitation. RESULTS: Subjects in action and maintenance stages for dietary fat reduction comprised 78.7% of the population. Subjects' percentage of energy from fat decreased linearly from the precontemplation stage (38.8%) to the maintenance stage (30.9%). Eighty-one percent of subjects were in precontemplation/contemplation for increasing fruit and vegetable intake. Daily servings of fruits and vegetables ranged from 2.6 for precontemplation to 5.1 for maintenance subjects. Age, body mass index (BMI), education, and family history for coronary disease were unrelated to stage of change for the dependent variables. CONCLUSIONS: Patients were in different stages of change for two nutritional behaviors linked to the same disease. Results support the need to assess patients for food behaviors and apply different educational interventions for each food behavior.