Evaluation of a Web-Based Intervention for Multiple Health Behavior Changes in Patients With Coronary Heart Disease in Home-Based Rehabilitation: Pilot Randomized Controlled Trial

Abstract

BackgroundWeb-based and theory-based interventions for multiple health behaviors appears to be a promising approach with respect to the adoption and maintenance of a healthy lifestyle in cardiac patients who have been discharged from the hospital. Until now, no randomized controlled trials have tested this assumption among Chinese rehabilitation patients with coronary heart disease using a Web-based intervention.ObjectiveThe study aim was to evaluate the effect of an 8-week Web-based intervention in terms of physical activity (PA), fruit and vegetable consumption (FVC), lifestyle changes, social-cognitive outcomes, and health outcomes compared with a waiting control group in Chinese cardiac patients. The intervention content was theory-based on the health action process approach. Self-reported data were evaluated, including PA, FVC, healthy lifestyle (the synthesis of PA and FVC), internal resources (combination of intention, self-efficacy, and planning), and an external resource (social support) of PA and FVC behaviors, as well as perceived health outcomes (body mass index, quality of life, and depression).MethodsIn a randomized controlled trial, 136 outpatients with coronary heart disease from the cardiac rehabilitation center of a hospital in China were recruited. After randomization and exclusion of unsuitable participants, 114 patients were assigned to 1 of the 2 groups: (1) the intervention group: first 4 weeks on PA and subsequent 4 weeks on FVC and (2) the waiting control group. A total of 2 Web-based assessments were conducted, including 1 at the beginning of the intervention (T1, N=114), and 1 at the end of the 8-week intervention (T2, N=83). The enrollment and follow-up took place from December 2015 to May 2016.ResultsThe Web-based intervention outperformed the control condition for PA, FVC, internal resources of PA and FVC, and an external resource of FVC, with an eta-squared effect size ranging from 0.06 to 0.43. Furthermore, the intervention effect was seen in the improvement of quality of life (F1,79=16.36, P<.001, η2=.17). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR 145.60, 95% CI 11.24-1886; P<.001) and the intervention (OR 21.32, 95% CI 2.40-189.20; P=.006) were found to be significant predictors. Internal resources for FVC mediated the effect of the intervention on the adoption of a healthy lifestyle (R2adj=.29; P=.001), indicating that if the intervention increased the internal resource of behavior, the adoption of a healthy lifestyle was more likely.ConclusionsPatients’ psychological resources such as motivation, self-efficacy, planning, and social support as well as lifestyle can be improved by a Web-based intervention that focuses on both PA and FVC. Such an intervention enriches extended rehabilitation approaches for cardiac patients to be active and remain healthy in daily life after hospital discharge.Trial RegistrationClinicalTrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/...

Effects of Two Web‐Based Interventions and Mediating Mechanisms on Stage of Change Regarding Physical Activity in Older Adults

“…However, some studies report coping planning to have adverse effects on self‐efficacy and motivation for health behavior maintenance (Inauen, Stocker, & Scholz, ; Williams & French, ). There is research on significant mediating mechanisms in the web‐based intervention effect on exercise as well as fruit and vegetable intake through change in social‐cognitive predictors, for example, in rehabilitation patients (Duan et al., ) and the general population (Lippke, Corbet, Lange, Parschau, & Schwarzer, ). The current study suggests that previous findings also apply to PA stage in older adults.…”

“…However, they did not investigate the potentially mediating mechanisms in this effect. While there are studies investigating the working mechanisms of web‐based intervention effects on a healthy lifestyle, for example, in rehabilitation patients (Duan et al., ), the question whether there is a mediating effect of social‐cognitive changes on PA stages of change resulting from web‐based interventions has not yet been addressed in community‐dwelling older adults.…”

A web-based lifestyle intervention program for Chinese college students: study protocol and baseline characteristics of a randomized placebo-controlled trial

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Cognitive rehabilitation program to improve cognition of cancer patients treated with chemotherapy: A 3‐arm randomized trial

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