Design of a Remote Coaching Program to Bridge the Gap From Hospital Discharge to Cardiac Rehabilitation: Intervention Mapping Study (Preprint)

Abstract

BACKGROUND Remote coaching might potentially be suited for providing information and support to patients with coronary artery disease (CAD) in the vulnerable phase between hospital discharge and the start of cardiac rehabilitation (CR). OBJECTIVE To explore and summarize information- and support needs of patients with CAD, and to develop an early remote coaching program providing tailored information and support. METHODS We used the intervention mapping (IM) approach to develop a remote coaching program. Three consecutive steps were completed in this study: (1) identification of information- and support needs in patients with CAD, using an exploratory literature study and semi-structured interviews; (2) definition of program objectives; (3) selection of theory-based methods and practical intervention strategies. RESULTS Our exploratory literature study (n=42) and semi-structured interviews (n=17) identified that after hospital discharge, patients with CAD report a need for tailored information and support about: CAD itself and the specific treatment procedures, medication and side effects, physical activity, and psychological distress. Based on the preceding steps, we defined the following program objectives: 1. Patients gain knowledge on how CAD and revascularization affects their bodies and health. 2. Patients gain knowledge about medication and side effects and adhere to their treatment plan. 3. Patients know which daily physical activities they can and can’t do safely after hospital discharge and are physically active. 4. Patients know the psychosocial consequences of CAD and know how to discriminate between harmful and harmless body signals. Based on the preceding steps, a remote coaching program was developed with the theory of health behavior change as theoretical framework, and behavioral counseling and video modelling as practical strategies for the program. CONCLUSIONS In this study we present the design of an early remote coaching program based on the needs of patients with CAD. The development of this program constitutes a step in the process of bridging the gap from hospital discharge to start of CR.