Dorien Brouwer

110 Chapter 2.2 PART 2 ABSTRACT Background Modification of health behavior is an important part of stroke risk management. However, the majority of people with cardiovascular disease fail to sustain lifestyle modification in the long-term. We aimed to evaluate the effectiveness of motivational interviewing to encourage lifestyle behavior changes after TIA or minor ischemic stroke. Methods We performed a randomized controlled open label phase II trial with blinded endpoint assessment. The intervention consisted of three 15-minute visits in three months by a motivational interviewing trained nurse practitioner. Patients in the control group received standard consultation after one and three months by a nurse practitioner. Primary outcome was lifestyle behavior change, defined as smoking cessation and/or increased physical activity (30 minutes/day) and/or healthy diet improvement (5 points at the Food Frequency Questionnaire) at 6 months. We adjusted for age and sex with multivariable logistic regression. Results Between January 2014 and February 2016, we included 136 patients (of whom 68 were assigned to the intervention group.) Twenty-five of 55 patients in the intervention group (45%) and 27 of 61 patients in the control group (44%) had changed their lifestyle at six months. We found no effect of motivational interviewing on lifestyle behavior change after six months (aOR 0.99; 95% CI 0.44-2.26). Conclusion Our results do not support the effectiveness of motivational interviewing in supporting lifestyle behavior change after TIA or minor ischemic stroke. However, the overall lifestyle behavior change was high and might be explained by the key role of specialized nurses in both groups. Submitted