Fig. 1

Steps based on the concepts in self-regulation theory and applied to IPAF in the context of CVD risk reduction. Starting at step 1 (top left), a person acquires new data. At step 2, compares new data to a pre-determined and desired reference point. Then decides (3) whether or not data are congruent with the reference point. If yes, record and stop (4a). If discrepant with the reference point (4b), take action (5) for improvement so future data would be congruent with the reference point. These steps apply for clinic staff comparing their performance to desired performance goals or patients targeting health goals