Effectiveness of a motivated, action-based intervention on improving physical activity level, exercise self-efficacy and cardiovascular risk factors of patients with coronary heart disease in Sri Lanka: A randomized controlled trial protocol

Abstract

Background Coronary heart disease (CHD), is the major contributor to cardiac-associated mortality worldwide. Lifestyle modification, including physical activity, is highly recommended for secondary prevention for patients with CHD. However, many people in Sri Lanka with CHD do not engage in adequate physical activity. Objective To develop a culture-specific, motivated, and action-based intervention and examine its effects on physical activity level, exercise self-efficacy, and cardiovascular risk factors among patients with CHD. Methods and materials This is an assessor-blinded randomized controlled trial that will recruit 150 patients with CHD from the inpatients cardiac unit of a hospital in Batticaloa, Sri Lanka, and will randomly assign them either to the intervention group or the control group. The participants in the intervention group will receive a culture-specific and motivated, action-based intervention in addition to the usual care, while participants in the control will only receive the usual care. The intervention consists of a face-to-face preparatory session and 12-week motivated, action-based sessions which were developed based on the health action process approach (HAPA) framework. The face-to-face preparatory session will identify the health needs of the participants, develop a goal-oriented patient-centered action plan, and provide knowledge and an overview of the program. The 12-week motivated, action-based sessions consist of three monthly group education and center-based group exercises, followed by three 20-min individualized telephone follow-ups. Outcomes will be assessed immediately after the intervention and at one-month post-intervention. Discussion This protocol proposes a supervised centered-based group exercise with group education, and individualized telephone follow-ups guided by the HAPA framework to improve the physical activity level, exercise self-efficacy, and cardiovascular risk factors of patients with CHD. Results from this study will inform the effectiveness of a motivated, action-based intervention in a low-resource setting and provide information on the feasibility, barriers, and facilitators for lifestyle modification in Sri Lanka. Trial registration ClinicalTrial.gov.org PRS: NCT05051774; Date of registration: September 21, 2021.

Effectiveness of Theory-Based Intervention on Knowledge Level, Psychological Constructs, Metabolic Index and Physical Activity Status in Patients with Type 2 Diabetes: Application of the Health Action Process Approach (HAPA) Model

“…Finally, the results of the present study emphasized the improvement of the physical activity status in the T2D patients participating in a theory-based online educational intervention, which was in line with the results of previous studies [33,36,37]. A systematic review of 52 studies focusing on web-based behavior change interventions by Lin et al (2022) indicated that providing strategies such as self-monitoring of behavior, problem solving, while significantly increasing the mean of the HAPA model constructs and Self-regulation, led to an improvement in the level of physical activity in patients with chronic diseases [36].…”

“…In accordance with the findings of previous researches, the results of the present study also showed a significant increase in the mean of the action and maintenance self-efficacy constructs in the T2D patients after participating in the mobile-based educational program based on the HAPA model [36][37][38]. People who have strong beliefs about their abilities show more effort and persistence in doing tasks than people who doubt their abilities, and as a result, their performance in doing tasks is better.…”

The Need for Indigenous Games to Combat Noncommunicable Diseases in South Africa: A Narrative Review

“…Although a sedentary lifestyle places an individual at greater risk for development of various disorders and diseases, regular exercise is often associated with a wider variety of psychological and physical health benefits [9,19,20]. According to the American Association of cardiovascular and pulmonary rehabilitation (AACVPR) in 1999, physical inactivity has been declared the most prevalent NCD risk factor [37].…”

The Role of K-12 Teachers as Agents for Change (RTP)

“…These findings are linked to the purpose of using Action-Based Research to promote changes by teachers. Using action-based research as a methodology is conducted by researchers to encourage buy-in groups and mitigate stress and anxiety [34,35].…”