Dr Rob Nolan Explains Behavioral Principles Behind eCounseling Hypertension Program

The REACH trial of an eCounseling program to reduce hypertension was effective because it encouraged patients to see themselves as an active member of the team, according to lead study author Rob Nolan, PhD, CPsych, director of Cardiac eHealth at the Peter Munk Cardiac Centre and clinical psychologist and scientist at the Toronto General Research Institute. The research, which was presented at the American College of Cardiology 66^th Scientific Session, also incorporated evidence-based strategies like motivational interviewing and cognitive-behavioral therapy into the online intervention.

Transcript (slightly modified)

How did the eCounseling program work to encourage self-management?

I think the way it worked was by letting patients know that they were an active member of the team. We had a video at the very outset of this for the eCounseling group in which we actually said that, that we looked at them as an active member of the team and we wanted them to know what the program was like for the whole 12 months, so they could see the kinds of modules that they would be receiving.

Also, we really made an effort to adapt to the internet the kind of counseling that we have seen being effective over the past 50 years to modify health risk behaviors. We drew from evidence-based models of behavioral counseling, principally motivational interviewing and cognitive-behavioral therapy. This allowed us to help people feel more ready to make changes, to resolve their ambivalence about initiating or sustaining lifestyle change, to see it as being connected to salient priorities or personal goals.

We had feedback sheets that helped to reinforce their confidence in sustaining change, and performance-based feedback and perceived peer support are very important for that.