Cardiovascular disease predominates as the leading health burden among middle-aged and older American adults, but progress in improving cardiovascular health remains slow. Comprehensive, evidenced-based behavioral counseling interventions in primary care are a recommended first-line approach for promoting healthy behaviors and preventing poor cardiovascular disease outcomes in adults with cardiovascular risk factors. Assisting patients to adopt and achieve their health promotion goals and arranging follow-up support are critical tenets of the 5A Model for behavior counseling in primary care. These 2 steps in behavior counseling are considered essential to effectively promote meaningful and lasting behavior change for primary cardiovascular disease prevention. However, adoption and implementation of behavioral counseling interventions in clinical settings can be challenging. The purpose of this scientific statement from the American Heart Association is to guide primary health care professional efforts to offer or refer patients for behavioral counseling, beyond what can be done during brief and infrequent office visits. This scientific statement presents evidence of effective behavioral intervention programs that are feasible for adoption in primary care settings for cardiovascular disease prevention and risk management in middle-aged and older adults. Furthermore, examples are provided of resources available to facilitate the widespread adoption and implementation of behavioral intervention programs in primary care or community-based settings and practical approaches to appropriately engage and refer patients to these programs. In addition, current national models that influence translation of evidence-based behavioral counseling in primary care and community settings are described. Finally, this scientific statement highlights opportunities to enhance the delivery of equitable and preventive care that prioritizes effective behavioral counseling of patients with varying levels of cardiovascular disease risk.

中文翻译：

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中老年人心血管疾病预防和风险因素管理的初级保健和社区实践中的健康行为改变计划：美国心脏协会的科学声明

心血管疾病是美国中老年人的主要健康负担，但改善心血管健康的进展仍然缓慢。初级保健中全面、循证的行为咨询干预是推荐的一线方法，用于促进有心血管危险因素的成年人的健康行为和预防不良心血管疾病结局。协助患者采用并实现其健康促进目标并安排后续支持是初级保健行为咨询 5A 模式的关键原则。行为咨询中的这两个步骤被认为对于有效促进对原发性心血管疾病预防的有意义和持久的行为改变至关重要。然而，在临床环境中采用和实施行为咨询干预可能具有挑战性。美国心脏协会发表这份科学声明的目的是指导初级卫生保健专业人员努力为患者提供或转诊行为咨询，而不仅仅是在短暂和不频繁的办公室访问中所能做的。该科学声明提供了有效的行为干预计划的证据，这些计划可在初级保健机构中采用，用于中老年人的心血管疾病预防和风险管理。此外，举例说明了可用于促进在初级保健或社区环境中广泛采用和实施行为干预方案的资源，以及适当地让患者参与和转介这些方案的实用方法。此外，还描述了影响初级保健和社区环境中基于证据的行为咨询翻译的当前国家模式。最后，这一科学声明强调了加强提供公平和预防性护理的机会，该护理优先考虑对心血管疾病风险不同程度的患者进行有效的行为咨询。