This is the first comprehensive guide to the design of behavioral randomized clinical trials (RCT) for chronic diseases. It includes the scientific foundations for behavioral trial methods, problems that have been encountered in past behavioral trials, advances in design that have evolved, and promising trends and opportunities for the future. The value of this book lies in its potential to foster an ability to “speak the language of medicine” through the conduct of high-quality behavioral clinical trials that match the rigor commonly seen in double-blind drug trials. It is relevant for testing any treatment aimed at improving a behavioral, social, psychosocial, environmental, or policy-level risk factor for a chronic disease including, for example, obesity, sedentary behavior, adherence to treatment, psychosocial stress, food deserts, and fragmented care. Outcomes of interest are those that are of clinical significance in the treatment of chronic diseases, including standard risk factors such as cholesterol, blood pressure, and glucose, and clinical outcomes such as hospitalizations, functional limitations, excess morbidity, quality of life, and mortality. This link between behavior and chronic disease requires innovative clinical trial methods not only from the behavioral sciences but also from medicine, epidemiology, and biostatistics. This integration does not exist in any current book, or in any training program, in either the behavioral sciences or medicine.
Despite the stunning progress in medical research that has been achieved over the past few decades, heart disease remains the leading cause of death and disability among adults in many industrialized countries. Behavioral and psychosocial factors play important roles in the development and progression of heart disease, as well as in how patients adapt to the challenges of living with this illness. This volume in the series "Advances in Psychotherapy" provides readers with a succinct introduction to behavioral and psychosocial treatment of the two most prevalent cardiac conditions, coronary heart disease and congestive heart failure. It summarizes the latest research on the intricate relationships between these conditions and psychosocial factors such as stress, depression, and anger, as well as behavioral factors such as physical inactivity and non-adherence to cardiac medication regimens. It draws upon lessons learned from a wide range of studies, including the landmark ENRICHD and SADHART clinical trials. It then goes on to provide practical, evidence-based recommendations and clinical tools for assessing and treating these problems. "Heart Disease" is an indispensable treatment manual for professionals who work with cardiac patients.
Despite the stunning progress in medical research that has been achieved over the past few decades, heart disease remains the leading cause of death and disability among adults in many industrialized countries. Behavioral and psychosocial factors play important roles in the development and progression of heart disease, as well as in how patients adapt to the challenges of living with this illness. This volume in the series "Advances in Psychotherapy" provides readers with a succinct introduction to behavioral and psychosocial treatment of the two most prevalent cardiac conditions, coronary heart disease and congestive heart failure. It summarizes the latest research on the intricate relationships between these conditions and psychosocial factors such as stress, depression, and anger, as well as behavioral factors such as physical inactivity and non-adherence to cardiac medication regimens. It draws upon lessons learned from a wide range of studies, including the landmark ENRICHD and SADHART clinical trials. It then goes on to provide practical, evidence-based recommendations and clinical tools for assessing and treating these problems. "Heart Disease" is an indispensable treatment manual for professionals who work with cardiac patients.
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