Table 2.

Intervention Module and Associated Theoretical Constructs

MODULE CONTENT	THEORETICAL CONSTRUCTS	EXAMPLE QUESTIONS	DATA SOURCE
1. Medication reconciliation • Medication indication(s) • Medication(s) safety for improved tolerance • Proper drug administration • Barriers to adherence • Strategies to increase adherence • Medication side effects	Perceived barriers, susceptibility, and benefits (HBM)	“What is the main reason you changed/stopped taking this medication(s) for your high blood pressure?” Responses include: • Because of side effects • My medication schedule is too complicated • Cannot remember to take it • Pill(s) too hard to swallow • Afraid to take medications due to side effects • Did not think it was working • Do not think I need it	Pharmacist intervention
2. Knowledge/risk perception of cardiovascular disease • Patient-perceived risk of heart attack and stroke • Education of modifiable and nonmodifiable risk factors for CVD • Risks of uncontrolled hypertension, cholesterol • Benefits of therapy • Appropriate goal setting to reduce CVD risk factors	Perceived severity and threat (HBM)	“How serious do you think it is to have high blood pressure?” Responses include: • Very serious • Serious • A little serious • Not at all serious • Do not know “If over the next 6 months, you don't change any of your health behaviors related to CVD, what do you think is your chance of having a stroke in the next year?” Responses include: • Very likely • Likely • Not likely • Do not know	Patient interview
3. Health behaviors • Education about weight management, diet, exercise, smoking habits, and stress reduction as appropriate given patients' characteristics • Importance of incorporating these as a lifestyle change	Self-efficacy (HBM)	“On a scale of 1 to 10, with 1 being not at all hard and 10 being extremely hard, please rate how hard it is for you to follow recommendations to improve your cardiovascular health regarding diet?” “On a scale of 1 to 10, with 1 being not at all hard and 10 being extremely hard, please rate how hard it is for you to follow recommendations to improve your cardiovascular health regarding exercise?”	Patient interview
a. Weight management • Importance of maintaining a healthy weight • Setting reasonable weight management goals	Readiness to change (TTM)	“Based on your most recent weight at your doctor's office, you are above what guidelines say is ideal. Lowering your weight can help control your heart risk factors. At this time how ready are you to lose weight?” Responses include: • Not ready to do anything at present • Thinking about losing weight • Preparing to lose weight • Taking action to lose weight	Pharmacist intervention
b. Diet • Assessment of dietary habits (i.e., fruit and vegetable consumption) • Explanation of the DASH diet • Sodium reduction; increase fiber and protein consumption • Understanding nutrition labels and portion control • Opportunity to talk about portion control, healthy carbohydrates, and heart-healthy diet in subsequent encounters	Goal setting (HDM)	“Now that we have talked about the benefits of weight loss, is there a weight loss goal you could set for yourself to achieve in 6 months?” Responses include: • Open ended	Pharmacist intervention
c. Exercise • Benefits of increased physical activity and positive exercise behaviors • Problem-solving regarding functional impairments and other physical activity-limiting barriers • Using motivational interviewing techniques goal setting for exercising goals	Readiness to change (TTM)	“Physical activity lowers your cardiac risk factors, relieves stress, and strengthens your heart, muscles, and bones. If you are trying to lose weight, a combination of physical activity and careful food choices can help you reach your target weight and maintain it. You can start getting these benefits even if you haven't been very active in the past. At this time how interested are you in changing your level of physical activity?” Responses include: • Not ready to do anything at present • Taking action to lose weight • Not ready to change at present • Thinking about changing my activity level • Preparing for changed activity level • Already physically active	Pharmacist intervention
d. Smoking • Benefits of smoking cessation and risks of continued smoking tailored to patient's healthcare status and concerns • Initiating and maintaining smoking cessation goals • Strategies to quit (i.e., local resources smoking cessation clinics) • Prescription for nicotine replacement therapy when clinically indicated	Readiness to change (TTM) Goal setting (HDM)	“How interested are you in quitting smoking or using tobacco products?” Responses include: • Not ready to quit yet • Thinking about quitting • Planning to quit soon • In process of quitting “Now that we have talked about the benefits in stopping smoking or using tobacco products, what goal, would you like to set for yourself to achieve in 6 months?” Responses include: • Open ended	Pharmacist intervention
e. Mental health, sleep, and stress reduction • Screening for depression and posttraumatic stress disorder • Educating about the relationship between elevated levels of stress and CVD symptoms • Stress coping mechanisms (i.e., relaxation, meditation) • Benefits of quality sleep • When clinically indicated referral to appropriate resources	Perceived severity (HBM)	“To what extent do you consider your sleep problem to interfere with your daily functioning (e.g., daytime functioning, ability to function at work/daily chores, concentration, memory, mood, etc.)?” Responses include: • Not at all • A little • Somewhat • Much • Very much • Do not know	Patient interview

The items listed are not exhaustive, but are intended to provide examples of questions that are used to tailor intervention content.

CVD, cardiovascular disease; DASH, Dietary Approaches to Stop Hypertension; HBM, health belief model; HDM, health decision model; TTM, transtheoretical model.