The Coronary Health Improvement Projects Impact on Lowering Eating, Sleep, Stress, and Depressive Disorders

Oct 15, 2026

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The Coronary Health Improvement Project (CHIP) is a health education intervention designed to reduce cardiovascular risk factors among generally healthy participants. The study evaluates whether CHIP improves eating, sleep, stress, and depressive disorders using a randomized health-education experimental design with 348 adults (ages 24–81) from metropolitan Rockford, Illinois. Baseline Beck Depression Inventory scores correlated with multiple lifestyle and psychosocial factors, while intervention participants showed significantly greater improvements and lower BDI scores through six-week and six-month follow-up.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Background

Purpose

Methods

Subject Recruitment and Design

Research Article The Coronary Health Improvement Projects Impact on Lowering Eating, Sleep, Stress, and Depressive Disorders Ray M. Merrill, Stephen G. Aldana, Roger L. Greenlaw, and HansA. Diehl ABSTRACT Background: The Coronary Health Improvement Project (CHIP) is designed to lower cardiovascular risk factors among a group of generally healthy individuals through health education. Purpose: This study will evaluate the efficacy of the CHIP intervention at improving eating, sleep, stress, and depressive disorders. Methods: A health education randomized experimental study was used, with 348 participants, ages 24 to 81 years, from metropolitan Rockford, Illinois. Results: Higher Beck Depression Inventory (BDI) scores at baseline were significantly associated with being overweight, being physically inactive, eating little or no breakfast, eating fast, sleeping less than six hours per night, restless sleep, insomnia, very few vacations, feeling under pressure, being easily emotionally upset, feeling muscular tension, and feeling fearful or depressed. Each of these items showed a significantly greater improvement through six weeks and six months among those in the intervention group compared with the control group. BDI scores through six weeks and six months of follow-up were also significantly lower among those in the intervention group compared with the control group. Discussion: Selected eating and sleep practices were associated with depression. Eating little or no breakfast has been associated with health-compromising behaviors that may increase stress and depression. The health education intervention designed to reduce cardiovascular risk improved eating and sleep practices and reduced stress and depression. Translation to Health Education Practice: Lifestyle change programs such as CHIP aimed at improving physical health behaviors can likewise have a profound influence on mental health. BACKGROUND Health education intervention programs are currently available to improve cognitive understanding of the importance of adopting certain dietary and physical activity behaviors and lifestyle choices. The aims of such programs are to improve health. The Coronary Health Improvement Project (CHIP) is a health education intervention that teaches people the importance of making better choices in nutrition, physical activity, and tobacco in order to prevent, arrest, and even reverse coronary heart disease.1-2 Since 1988, over 40,000 individuals in faith-based communities, worksites, hospitals, and municipalities have participated in the CHIP.3 Today there are over 150 CHIP alumni groups representing diverse settings.3 This intervention is designed to improve people’s knowledge of risk factors associated with chronic conditions such as diabetes, hypertension, cardiovascular disease, and cancer, with the goal of improving health behaviors. A randomized experimental study, along with other studies, have identified the efficacy of the CHIP intervention at improving health knowledge, diet and physical activity, and reducing several cardiovascular risks, including obesity and physical inactivity.4-8 Weight loss has been shown to improve mood state, psychosocial functioning, men- tal well-being, as well as decrease anxiety and depression.9-13 Physical activity has also been associated with improved mood and lower levels of anxiety and depression.14-18 Ray M. Merrill is a professor in the Department of Health Science, Brigham Young University, 229-A Richards Building, Provo, UT 84602; E-mail: [ray_merrill@byu.edu. Steven](ray_merrill@byu.edu. Steven) G. Aldana, [Ph.D. is](Ph.D. is) the CEO of WellSteps, 935 East 900 North, Mapleton, Utah 84664. Roger L. Greenlaw is founder of the Rockford Gastroenterology Associates, Ltd., Rockford, IL, 61107. HansA. Diehl is Director of the Lifestyle Medicine Institute, 11538 Anderson St., Loma Linda, CA 92354. American Journal of Health Education—November/December 2008, Volume 39, No. 6

FAQs

What is the purpose of the CHIP intervention in this study?

CHIP aims to improve health behaviors related to nutrition, physical activity, and tobacco to lower cardiovascular risk. In this study, it is also evaluated for effects on eating, sleep, stress, and depressive disorders.

How were participants recruited and assigned in the study?

A randomized experimental design was used with 348 participants after eligibility screening and exclusions. Participants were randomly assigned to a health intervention class or a control group, with control scheduled to receive the intervention six months later.

Which baseline factors were linked with higher depressive symptoms?

Higher Beck Depression Inventory scores at baseline were associated with factors including being overweight, physical inactivity, skipping or eating no breakfast, fast eating, short or restless sleep, insomnia, low vacation frequency, feeling under pressure, emotional upset, muscular tension, and feeling fearful or depressed.

Oct 15, 2026

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