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International Journal of Hypertension
Volume 2012, Article ID 191789, 5 pages
Clinical Study

Psychosocial Determinants of Health Behaviour Change in an E-Counseling Intervention for Hypertension

1Department of Psychology, York University, 4700 Keele Street, Toronto, ON, Canada M3J 1P3
2Behavioural Cardiology Research Unit, University Health Network, 585 University Avenue, Toronto, ON, Canada M5G 2N2
3Department of Psychiatry, University of Toronto, 1 Kings College Circle, Toronto, ON, Canada M5S 1A8

Received 1 August 2011; Revised 14 October 2011; Accepted 14 November 2011

Academic Editor: Simon L. Bacon

Copyright © 2012 Samir Durrani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We evaluated the influence of psychological stress and depression on motivation to adhere to recommended guidelines for exercise and diet. This study was conducted within a larger e-counseling trial. Subjects diagnosed with hypertension ( , age = 44–74 years, 59% female) completed assessments at baseline and within 2 weeks after a 4-month intervention period. Outcomes included mean level of readiness to change diet and exercise and symptoms of depression and stress. Per protocol analysis defined e-counseling support as follows: ≥8 e-mails = therapeutic dose, 1–7 e-mails = subtherapeutic dose, and 0 e-mails = Controls. Baseline adjusted symptoms of depression and stress were inversely correlated with improvement in exercise (partial , , and partial , , resp.) but not diet or e-counseling. Subjects who received a therapeutic dose of e-counseling demonstrated greater readiness for diet adherence versus Controls ( ). Similarly, subjects receiving a therapeutic level of e-counseling demonstrated significantly greater readiness for exercise adherence versus Controls ( ). In sum, e-counseling is associated with improved motivation to adhere to exercise and diet among patients with hypertension, independent of symptoms of psychological stress and depression.