Supporting cardiac patient physical activity: a brief health psychological intervention

Abstract

SummaryBackgroundOne of the most important risk factors for coronary artery disease is physical inactivity. Health psychological research demonstrates the importance of planning for behaviour change success. Consequently, a health action process approach (HAPA) model-based design to support the uptake of physical activity was initiated for the first time in an acute cardiac ward.MethodsFor impact evaluation, a control group (CG) and an intervention group (IG) of coronary artery disease patients were compared in a controlled longitudinal study. Baseline assessment included socio-demographic variables, intentions regarding physical activity, and actual physical activity prior to the coronary artery disease event. Follow-up data were collected 2 and 6 months after discharge.ResultsIn total, 193 patients participated in this controlled longitudinal study (63 ± 9 years; CG: N = 78; IG: N = 115). The IG reported a higher increase in physical activity (p < 0.05), intentions, and coping planning (p < 0.05), and also in action planning and control (p < 0.01) 2 months after discharge. Both CG and IG increased their physical activity 6 months after discharge to the point of no significant difference (p = 0.664).ConclusionsA HAPA model-based health psychological intervention on an acute cardiac ward is able to increase patients’ physical activity over the short term. However, integration of follow-up interventions (preferable in cardiac rehabilitation settings) would be necessary to support sustained physical activity.

Telephone-delivered lifestyle support with action planning and motivational interviewing techniques to improve rehabilitation outcomes.

“…TC patients reported more action plans regarding exercise, which helped to maintain their exercise behavior after rehabilitation. This connection has also been found with cardiac and orthopedic patients (Fleig et al, 2013;Platter et al, 2016;Reuter, Ziegelmann, Lippke, & Schwarzer, 2009). We did not find any differences in coping planning, which may be especially important for behavior maintenance in already active patients (Scholz, Schüz, Ziegelmann, Lippke, & Schwarzer, 2008).…”

Contemplation‐action‐maintenance model of behaviour change for persons with coronary heart disease: A qualitative study

“…Health Action Process Approach (HAPA) (Schwarzer 2008) HAPA has been widely used in guiding the design of behaviour change interventions for patients with chronic disease, including cardiac disease (Aliabad et al, 2014;Dohnke et al, 2010). However, HAPA theoretically informed interventions do not always improve the long-term adherence to health behaviours of patients with CHD (Ghisi et al, 2015;Platter et al, 2016). The reason for such difficulties is partially because HAPA focuses on how to move patients from the pre-contemplation stage to the contemplation and action stages.…”

“…However, HAPA theoretically informed interventions do not always improve the long-term adherence to health behaviours of patients with CHD (Ghisi et al, 2015;Platter et al, 2016). The reason for such difficulties is partially because HAPA focuses on how to move patients from the pre-contemplation stage to the contemplation and action stages.…”

“…However, patients, who have been diagnosed with CHD or even experienced acute cardiac ischaemic events and/or revascularisation procedures, do not have difficulties in initiating behavioural change, but have difficulties in maintaining healthy behaviours. Patients experience difficulties in improving their long‐term adherence to health behaviours (Ghisi et al, 2015; Platter et al, 2016) and often relapse to their unhealthy behaviours over time (Sarrafzadegan et al, 2007).…”

Development of interventions for an intelligent and individualized mobile health care system to promote healthy diet and physical activity: using an intervention mapping framework

“…Thirdly, evidence from a meta-analysis [24] shows that traditional interventions have generally been guided by continuum behavioral change theories, such as Social Cognitive Theory [25] and Theory of Planned Behavior [26]. However, those theories [25, 26] may be inappropriate in guiding the development of interventions which are targeted at the maintenance of healthy diet and physical activity for CHD patients, because those theories typically do not account for the post-intentional phase [20, 27, 28]. Finally, it has been argued that most traditional interventions do not provide patients with individualized interventions and real-time feedback [15].…”