Integration of information about cardiovascular risk factors: how do highly motivated women in a lifestyle intervention programme act and react?

Objective: To understand the experience of being at risk and of participating in health interventions. How is information about risk factors handled on an individual level with respect to feeling, thinking and doing?

Design: Tape-recorded, open interviews, written out and analysed using a descriptive/analytical method.

Setting: Selected women who had participated in a lifestyle intervention programme aimed at reducing risk factors for cardiovascular disease in Strømstad, a community of 10 000 inhabitants on the west coast of Sweden.

Subjects: Eight women in the most active group who had had some contact with the project during the whole period 1985-94.

Main Outcome Measures: The creation of core concepts as a result of close text reading through codes and categories.

Results: Three core concepts in relation to the handling of risk factors were identified: there is no one but yourself to rely on, resisting invasion, and living with incompatibility, based respectively on the subjects' self-efficacy and self-awareness, their ways of maintaining a good life and their trying to understand the risk-factor concept.

Conclusion: Risk-factor-oriented health interventions focus on disease and create uncertainty as to the relationship between the concepts of risk and disease. The powerful health resources demonstrated by the women in this study to counterbalance the risk pre-occupation suggest changing to health-oriented interventions that focus on individual health resources.