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Effects of a CHANGE intervention to increase exercise maintenance following cardiac events

Abstract

Background: Despite participation in a cardiac rehabilitation program, there is a downward trajectory of exercise participation during the year following a cardiac event.Purpose: The purpose of this study was to test the effectiveness of CHANGE (Change Habits by Applying New Goals and Experiences), a lifestyle modification program designedto increase exercise maintenance in the year following a cardiac rehabilitation program. The CHANGE intervention consists of 5 small-group cognitive-behavioral change counseling sessions in which participants are taught self-efficacy enhancement, problem-solving skills, and relapse prevention strategies to address exercise maintenance problems.Method: Participants (N = 250) were randomly assigned to the CHANGE intervention (supplemental to usual care) or a usual-care-only group. Exercise was measured using portable wristwatch heart rate monitors worn during exercise for 1 year. Cox proportional hazards regression was used to determine differences in exercise over the study year between the study groups.Results: Participants in the usual-care group were 76% more likely than those in the CHANGE group to stop exercising during the year following a cardiac rehabilitation program (hazard ratio = 1.76, 95% confidence interval = 1.08–2.86, p = .02) when adjusting for the significant covariates race, gender, comorbidity, muscle and joint pain, and baseline motivation. Most participants, however, had less than recommended levels of exercise amount and intensity.Conclusions: Counseling interventions that use contemporary behavior change strategies, such as theCHANGEintervention, can reduce the number of individuals who do not exercise following cardiac events.

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Correspondence to Shirley M. Moore R.N., Ph.D., F.A.A.N..

Additional information

This study was funded by a grant from the National Institute of Nursing Research at the National Institutes of Health R01-NR04704.

We acknowledge the contributions of the cardiac rehabilitation staff at Parma Community Hospital, University Hospitals of Cleveland, and the Cleveland Clinic Foundation.

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Moore, S.M., Charvat, J.M., Gordon, N.H. et al. Effects of a CHANGE intervention to increase exercise maintenance following cardiac events. ann. behav. med. 31, 53–62 (2006). https://doi.org/10.1207/s15324796abm3101_9

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Keywords

  • Cardiac Rehabilitation
  • Behavioral Medicine
  • Cardiorespiratory Fitness
  • Cardiac Rehabilitation Program
  • Exercise Frequency