Tailoring Cardiovascular Risk Management Educational Interventions: A Synergy of SCORE Risk Assessment and Behaviour Change Model

Quality and timely patient education can reduce cardiovascular risk. The PULSE (Personalization Using Linkages of SCORE and behaviour change readiness to webbased Education) project objectives are to generate and evaluate a web-based personalized educational intervention for the management of cardiovascular risk. The program is based on a patient profile generated by combining: (a) an electronic data capture template (DCT); (b) the Systematic COronary Risk Evaluation (SCORE) algorithm for ten-year risk assessment for fatal cardiovascular disease; and (c) a Stage determination model for behavioural change readiness. The DCT inherently contains a set of evidence-based parameters for patient description and disease evaluation. The SCORE estimation directs the selection of clinical guideline target values for risk factors. The patient’s Stage of behaviour Change determines messages consistent with the individual’s change processes, decisional balance, and selfefficacy. The interventions are designed to address both medical and psychosocial aspects of risk management and, as such, we combine staged lifestyle modification materials and non-staged messages based on Canadian clinical guidelines to motivate personal risk management. The personalization decision logic is represented in Medical Logic Modules implemented in Java. The PULSE educational process is initiated by a healthcare professional in a primary care setting. An intelligent interactive system generates the personally relevant educational materials and delivers them to the patient via the Web. An evaluation study will be conducted to determine whether web-based personalized educational strategies that incorporate behavioural change readiness can exert favourable influence on patient's interest, knowledge, and perceived compliance to the suggested lifestyle modifications.