The Use of a Cognitive Behavioral Program for Diabetes and Cardiovascular Risk Reduction

  • Jeroen Lakerveld
  • Sandra D. M. Bot
  • Giel Nijpels


The number of people with cardiovascular disease (CVD) and type 2 diabetes (T2DM) is rapidly increasing. To a large extent, this increase is due to lifestyle-dependent risk factors, such as overweight, reduced physical activity, and an unhealthy diet. Changing these risk factors has the potential to postpone or prevent the development of CVD and T2DM. Numerous lifestyle programs are described in the literature, and many interventions are based on a cognitive behavioral approach. Cognitive behavioral programs vary in many aspects: they differ in content, setting, instruments of change, target population, theoretical background, outcome measures, and effectiveness. This qualitative “review of reviews” provides an overview of programs with a cognitive behavioral approach to reduce the risk of CVD and T2DM by modifying dietary behavior, physical activity, or both. It also provides a description of the theories and instruments of change that are used in various programs. The effectiveness of such programs reported in the literature is very mixed. Generating a long-lasting change in lifestyle behavior is shown to be difficult and complicated. Extensive programs that have a multiple risk factor approach and include long-term follow-up booster sessions appear to work best. The effectiveness of cognitive behavioral programs is greater for participants who have a high risk of developing CVD or T2DM than for participants with a lower risk. It is suggested that interventions might be more successful if they target specific theory-based determinants. Additionally, certain requirements seem to be necessary for the participants in order to enable them to achieve a successful behavioral change: they need to be aware, motivated, and able to change. To address these requirements, specific “instruments of change” might be of use, e.g. risk communication, motivational interviewing and/or problem-solving treatment.


Lifestyle Intervention Motivational Interview Risk Communication Lifestyle Behavior Physical Activity Intervention 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Cognitive behavior program


Cardiovascular diseases


Motivational interviewing


Problem-solving treatment


Randomized, controlled trial


Type 2 diabetes mellitus


Theory of planned behavior


Transtheoretical model


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jeroen Lakerveld
    • 1
  • Sandra D. M. Bot
  • Giel Nijpels
  1. 1.Department of General Practice and the EMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamThe Netherlands

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