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The Evaluation of a Brief Motivational Intervention to Promote Intention to Participate in Cardiac Rehabilitation: A Randomized Controlled Trial

Title:

The Evaluation of a Brief Motivational Intervention to Promote Intention to Participate in Cardiac Rehabilitation: A Randomized Controlled Trial

Bacon, Simon L. ORCID: https://orcid.org/0000-0001-7075-0358, Rouleau, Codie R., King-Shier, Kathryn M., Tomfohr-Madsen, Lianne M., Aggarwal, Sandeep, Arena, Ross and Campbell, Tavis S. (2018) The Evaluation of a Brief Motivational Intervention to Promote Intention to Participate in Cardiac Rehabilitation: A Randomized Controlled Trial. Patient Education and Counseling . ISSN 07383991 (In Press)

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Official URL: http://dx.doi.org/10.1016/j.pec.2018.06.015

Abstract

Objectives
Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR.

Methods
Individuals recovering from acute coronary syndrome (n = 96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation.

Results
Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR (p = .001), viewed CR as more necessary (p = .036), had fewer concerns about exercise (p = .011), and attended more exercise sessions (p = .008). There was an indirect effect of the intervention on CR enrollment (b = 0.45, 95% CI 0.04–1.18) and CR adherence (b = 2.59, 95% CI 0.95–5.03) via higher levels of intention. Overall, patients reported high intention to attend CR (M = 6.20/7.00, SD = 1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions.

Conclusion
A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence.

Practice Implications
The findings will inform future efforts to optimize behavioral interventions to enhance CR participation.

Divisions:Concordia University > Faculty of Arts and Science > Exercise Science
Item Type:Article
Refereed:Yes
Authors:Bacon, Simon L. and Rouleau, Codie R. and King-Shier, Kathryn M. and Tomfohr-Madsen, Lianne M. and Aggarwal, Sandeep and Arena, Ross and Campbell, Tavis S.
Journal or Publication:Patient Education and Counseling
Date:2018
Digital Object Identifier (DOI):10.1016/j.pec.2018.06.015
Keywords:cardiac rehabilitation; motivational interviewing; enrollment; adherence; intention; randomized controlled trial
ID Code:984016
Deposited By: ALINE SOREL
Deposited On:06 Jul 2018 14:37
Last Modified:26 Jun 2019 00:00

References:

D.M. Kolansky. Acute coronary syndromes: Morbidity, mortality, and pharmacoeconomic. burden Am. J. Manag, Care., 15 (2009), pp. S36-S41

World Health Organization. Cardiovascular diseases (CVDs) fact sheet http://www.who.int/mediacentre/factsheets/fs317/en/ (2016) (accessed December 29, 2016)

D. Mozaffarian, E.J. Benjamin, A.S. Go, D.K. Arnett, M.J. Blaha, M. Cushman, S.R. Das, S. de Ferranti, J.P. Despres, H.J. Fullerton, V.J. Howard, M.D. Huffman, C.R. Isasi, M.C. Jimenez, S.E. Judd, B.M. Kissela, J.H. Lichtman, L.D. Lisabeth, S. Liu, R.H. Mackey, D.J. Magid, D.K. McGuire, E.R. Mohler, C.S. Moy, P. Muntner, M.E. Mussolino, K. Nasir, R.W. Neumar, G. Nichol, L. Palaniappan, D.K. Pandey, M.J. Reeves, C.J. Rodriguez, W. Rosamond, P.D. Sorlie, J. Stein, A. Towfighi, T.N. Turan, S.S. Virani, D. Woo, R.W. Yeh, M.B. Turner, Heart disease and stroke statistics--2016 update: A report from the American Heart Association. Circulation, 133 (2015), pp. e38-e360, 10.1161/CIR.0000000000000350

K. Smolina, F.L. Wright, M. Rayner, M.J. Goldacre. Long-term survival and recurrence after acute myocardial infarction in England, 2004 to 2010. Circ, Cardiovasc. Qual. Outcomes., 5 (2012), pp. 532-540, 10.1161/CIRCOUTCOMES.111.964700

S.C. Smith, E.J. Benjamin, R.O. Bonow, L.T. Braun, M.A. Creager, B.A. Franklin, R.J. Gibbons, S.M. Grundy, L.F. Hiratzka, D.W. Jones, D.M. Lloyd-Jones, M. Minissian, L. Mosca, E.D. Peterson, R.L. Sacco, J. Spertus, J.H. Stein, K.A. Taubert, AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation., 124 (2011), pp. 2458-2473, 10.1161/CIR.0b013e318235eb4d

National Institute for Health and Care Excellence. Secondary prevention in primary and secondary care for patients following a myocardial infarction: NICE clinical guideline 172, guidance.nice.org.uk/cg172 (2013)

L. Anderson, N. Oldridge, D.R. Thompson, A.-D. Zwisler, K. Rees, N. Martin, R.S. Taylor. Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis, J. Am. Coll. Cardiol., 67 (2016), pp. 1-12, 10.1016/j.jacc.2015.10.044

N. Oldridge. Exercise-based cardiac rehabilitation in patients with coronary heart disease: Meta-analysis outcomes revisited, Future Cardiol., 8 (2012), pp. 729-751

C.J. Lavie, A.R. Menezes, A. De Schutter, R.V. Milani, J.A. Blumenthal. Impact of cardiac rehabilitation and exercise training on psychological risk factors and subsequent prognosis in patients with cardiovascular disease, Can. J. Cardiol., 32 (2016), pp. S365-S373, 10.1016/j.cjca.2016.07.508

D.A. Alter, B. Yu, R.R. Bajaj, P.I. Oh. Relationship between cardiac rehabilitation participation and health service expenditures within a universal health care system, Mayo Clin. Proc., 92 (2017), pp. 500-511, 10.1016/j.mayocp.2016.12.024

P.A. Ades, S.J. Keteyian, J.S. Wright, L.F. Hamm, K. Lui, K. Newlin, D.S. Shepard, R.J. Thomas. Increasing cardiac rehabilitation participation from 20% to 70%: A road map from the Million Hearts Cardiac Rehabilitation Collaborative, Mayo Clin. Proc., 92 (2017), pp. 234-342, 10.1016/j.mayocp.2016.10.014

R. Humphrey, M. Guazzi, J. Niebauer. Cardiac rehabilitation in Europe, Prog. Cardiovasc. Dis., 56 (2014), pp. 551-556, 10.1016/j.pcad.2013.08.004

Y. Goto. Current state of cardiac rehabilitation in Japan, Prog. Cardiovasc. Dis., 56 (2014), pp. 557-562, 10.1016/j.pcad.2013.12.001

S. Gravely-Witte, Y.W. Leung, R. Nariani, H. Tamim, P. Oh, V.M. Chan, S.L. Grace. Effects of cardiac rehabilitation referral strategies on referral and enrollment rates, Nat. Rev. Cardiol., 7 (2010), pp. 87-96, 10.1038/nrcardio.2009.223

E. Oosenbrug, R. Marinho, J. Zhang, S. Marzolini, T. Colella, M. Pakosh, S. Grace. Sex differences in cardiac rehabilitation adherence: A meta-analysis, Can. J. Cardiol., 32 (2016), pp. 1316-1324, 10.1016/j.cjca.2016.01.036

C.R. Rouleau, K.M. King-Shier, L.M. Tomfohr-Madsen, S.G. Aggarwal, R. Arena, T.S. Campbell. A qualitative study exploring factors that influence enrollment in outpatient cardiac rehabilitation, Disabil. Rehabil., 40 (2018), pp. 469-478, 10.1080/09638288.2016.1261417

S. Shanmugasegaram, L. Gagliese, P. Oh, D.E. Stewart, S.J. Brister, V. Chan, S.L. Grace. Psychometric validation of the Cardiac Rehabilitation Barriers Scale, Clin. Rehabil., 26 (2012), pp. 152-164, 10.1177/0269215511410579

L. Neubeck, B. Freedman, A.M. Clark, T. Briffa, A. Bauman, J. Redfern. Participating in cardiac rehabilitation: A systematic review and meta-synthesis of qualitative data, Eur. J. Cardiovasc. Prev. Rehabil., 19 (2011), pp. 494-503, 10.1177/1741826711409326

W.R. Miller, S. Rollnick. Motivational interviewing: helping people change. (3rd ed.), The Guilford Press, New York, NY (2013)

W.W.M. Lee, K.C. Choi, R.W.Y. Yum, D.S.F. Yu, S.Y. Chair. Effectiveness of motivational interviewing on lifestyle modification and health outcomes of clients at risk or diagnosed with cardiovascular diseases: A systematic review, Int. J. Nurs. Stud., 53 (2016), pp. 331-341, 10.1016/j.ijnurstu.2015.09.010

G. Pietrabissa, M. Ceccarini, M. Borrello, G.M. Manzoni, A. Titon, F. Nibbio, M. Montano, G. Bertone, L. Gondoni, G. Castelnuovo. Enhancing behavioral change with motivational interviewing: A case study in a cardiac rehabilitation unit, Front. Psychol., 6 (2015), pp. 1-9, 10.3389/fpsyg.2015.00298

B. Everett, P.M. Davidson, N. Sheerin, Y. Salamonson, M. DiGiacomo. Pragmatic insights into a nurse-delivered motivational interviewing intervention in the outpatient cardiac rehabilitation setting, J. Cardiopulm. Rehabil. Prev., 28 (2008), pp. 61-64, 10.1097/01.HCR.0000311511.23849.35

K.N. Karmali, P. Davies, F. Taylor, A. Beswick, N. Martin, S. Ebrahim. Promoting patient uptake and adherence in cardiac rehabilitation, Cochrane Database Syst. Rev., 6 (2014), p. CD007131, 10.1002/14651858.CD007131.pub3

S.M. Czajkowski, L.H. Powell, N. Adler, S. Naar-King, K.D. Reynolds, C.M. Hunter, B. Laraia, D.H. Olster, F.M. Perna, J.C. Peterson, E. Epel, J.E. Boyington, M.E. Charlson. Obesity Related Behavioral Intervention Trials (ORBIT) Consortium, From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases, Heal. Psychol., 34 (2015), pp. 971-982, 10.1037/hea00001612015-03938-001 [pii]

L. Nielsen, M. Riddle, J.W. King, W.M. Aklin, W. Chen, D. Clark, E. Collier, S. Czajkowski, L. Esposito, R. Ferrer, P. Green, C. Hunter, K. Kehl, R. King, L. Onken, J.M. Simmons, L. Stoeckel, C. Stoney, L. Tully, W. Weber. The NIH Science of Behavior Change Program: Transforming the science through a focus on mechanisms of change, Behav. Res. Ther., 101 (2017), pp. 3-11, 10.1016/j.brat.2017.07.002

M. Campbell, R. Fitzpatrick, A. Haines, A.L. Kinmonth, P. Sandercock, D. Spiegelhalter, P. Tyrer. Framework for design and evaluation of complex interventions to improve health, Br. Med. J., 321 (2000), pp. 694-696

R. Schwarzer, F. Sniehotta, S. Lippke, A. Luszczynska, U. Scholz, B. Schüz, M. Wegner, J. Ziegelmann. On the assessment and analysis of variables in the health action process approach: Conducting an investigation, Berlin, http://userpage.fu-berlin.de/~gesund/hapa_web.pdf (2003)

I. Ajzen. The theory of planned behavior, Organ. Behav. Hum. Decis. Mak., 50 (1991), pp. 179-211

C.M. Blanchard, K.S. Courneya, W.M. Rodgers, S.N. Fraser, T.C. Murray, B. Daub, B. Black. Is the theory of planned behavior a useful framework for understanding exercise adherence during phase II cardiac rehabilitation?, J. Cardiopulm. Rehabil., 23 (2003), pp. 29-39

K. Parker, J.A. Stone, R. Arena, D. Lundberg, S. Aggarwal, D. Goodhart, M. Traboulsi. An early cardiac access clinic significantly improves cardiac rehabilitation participation and completion rates in low-risk ST-elevation myocardial infarction patients, Can. J. Cardiol., 27 (2011), pp. 619-627, 10.1016/j.cjca.2010.12.076

J.A. Stone (Ed.), Canadian guidelines for cardiac rehabilitation and cardiovascular disease prevention: Translating knowledge into action (3rd ed.), Canadian Association of Cardiac Rehabilitation, Winnipeg, MB (2009)

K.E. Freedland, D.C. Mohr, K.W. Davidson, J.E. Schwartz. Usual and unusual care: Existing practice control groups in randomized controlled trials of behavioral interventions, Psychosom. Med., 73 (2011), pp. 323-335, 10.1016/j.pestbp.2011.02.012.Investigations

C.R. Rouleau. Design and Evaluation of a Brief Motivational Intervention to Promote Enrolment in Outpatient Cardiac Rehabilitation: A Mixed-Methods Feasibility Study, (Unpublished Doctoral Dissertation), University of Calgary (2017)

T.R. Apodaca, R. Longabaugh. Mechanisms of change in motivational interviewing: A review and preliminary evaluation of the evidence, Addiction, 104 (2009), pp. 705-715, 10.1111/j.1360-0443.2009.02527.x.Mechanisms

M.B. Madson, R.S. Mohn, A. Zuckoff, J.A. Schumacher, J. Kogan, S. Hutchison, E. Magee, B. Stein. Measuring client perceptions of motivational interviewing: Factor analysis of the Client Evaluation of Motivational Interviewing scale, J. Subst. Abuse Treat., 44 (2013), pp. 330-335, 10.1016/j.jsat.2012.08.015

P.A. Ades, M.L. Waldmann, D.M. Polk, J.T. Coflesky. Referral patterns and exercise response in the rehabilitation of female coronary patients aged 62 years, Am. J. Cardiol., 69 (1992), pp. 1422-1425

M. Irwin, K.H. Artin, M.N. Oxman. Screening for depression in the older adult: Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D), Arch. Intern. Med., 159 (1999), pp. 1701-1704

C.M. Blanchard, K.S. Courneya, W.M. Rodgers, B. Daub, G. Knapik. Determinants of exercise intention and behavior during and after phase 2 cardiac rehabilitation: An application of the theory of planned behavior, Rehabil. Psychol., 47 (2002), pp. 308-323, 10.1037//0090-5550.47.3.308

S.M. Mosleh, C.M. Bond, A.J. Lee, A. Kiger, N.C. Campbell. Effectiveness of theory-based invitations to improve attendance at cardiac rehabilitation: A randomized controlled trial, Eur. J. Cardiovasc. Nurs., 13 (2014), pp. 201-210, 10.1177/1474515113491348

A.F. Cooper, J. Weinman, M. Hankins, G. Jackson, R. Horne. Assessing patients’ beliefs about cardiac rehabilitation as a basis for predicting attendance after acute myocardial infarction, Heart., 93 (2007), pp. 53-58, 10.1136/hrt.2005.081299

W.M. Rodgers, P.M. Wilson, C.R. Hall, S.N. Fraser, T.C. Murray. Evidence for a multidimensional self-efficacy for exercise scale, Res. Q. Exerc. Sport., 79 (2008), pp. 222-234

S.N. Fraser, W.M. Rodgers. An examination of psychosocial correlates of exercise tolerance in cardiac rehabilitation participants, J. Behav. Med., 33 (2010), pp. 159-167, 10.1007/s10865-009-9240-5

W.M. Rodgers, T.C. Murray, A.-M. Selzler, P. Norman. Development and impact of exercise self-efficacy types during and after cardiac rehabilitation, Rehabil. Psychol., 58 (2013), pp. 178-184, 10.1037/a0032018

E. Broadbent, K.J. Petrie, J. Main, J. Weinman. The brief illness perception questionnaire, J. Psychosom. Res., 60 (2006), pp. 631-637, 10.1016/j.jpsychores.2005.10.020

P.H. Mitchell, L. Powell, J. Blumenthal, J. Norten, G. Ironson, C.R. Pitula, E.S. Froelicher, S. Czajkowski, M. Youngblood, M. Huber, L.F. Berkman. A short social support measure for patients recovering from myocardial infarction: The ENRICHD Social Support Inventory, J. Cardiopulm. Rehabil. Prev., 23 (2003), pp. 398-403, 10.1097/00008483-200311000-00001

M.S. Adamian, C.E. Golin, L.S. Shain, B. DeVellis. Brief motivational interviewing to improve adherence to antiretroviral therapy: development and qualitative pilot assessment of an intervention, AIDS Patient Care STDS., 18 (2004), pp. 229-238, 10.1089/108729104323038900

M.J. Mazzini, G.R. Stevens, D. Whalen, A. Ozonoff, G.J. Balady. Effect of an American Heart Association Get With the Guidelines program-based clinical pathway on referral and enrollment into cardiac rehabilitation after acute myocardial infarction, Am. J. Cardiol., 101 (2016), pp. 1084-1087, 10.1016/j.amjcard.2007.11.063

J. Daly, A.P. Sindone, D.R. Thompson, K. Hancock, E. Chang, P. Davidson. Barriers to participation in and adherence to cardiac rehabilitation programs: A critical literature review, Prog. Cardiovasc. Nurs., 17 (2002), pp. 8-17

K.I. Turk-Adawi, N.B. Oldridge, S.S. Tarima, W.B. Stason, D.S. Shepard. Cardiac rehabilitation enrollment among referred patients: Patient and organizational factors, J. Cardiopulm. Rehabil. Prev., 34 (2014), pp. 114-122, 10.1097/HCR.00000000000000179p

J. Cohen. Statistical power analysis for the behavioral sciences, (2nd ed.), Lawrence Erlbaum Associates, Hillsdale, NJ (1988)

S. Pryjmachuk, D.A. Richards. Look before you leap and don’t put all your eggs in one basket: The need for caution and prudence in quantitative data analysis, J. Res. Nurs., 12 (2007), pp. 43-54, 10.1177/1744987106070260

A.F. Hayes. Introduction to mediation, moderation, and conditional process analysis: A regression based approach, The Guilford Press, New York, NY (2013)

E.J. D’Amico, J.N.V Miles, S.A. Stern, L.S. Meredith. Brief motivational interviewing for teens at risk of substance use consequences: A randomized pilot study in a primary care clinic, J. Subst. Abuse Treat., 35 (2008), pp. 53-61, 10.1016/j.jsat.2007.08.008

B.-J. Martin, T. Hauer, R. Arena, L.D. Austford, P.D. Galbraith, A.M. Lewin, M.L. Knudtson, W.A. Ghali, J.A. Stone, S.G. Aggarwal. Cardiac rehabilitation attendance and outcomes in coronary artery disease patients, Circulation., 126 (2012), pp. 677-687

J.M. Fiszdon, M.M. Kurtz, J. Choi, M.D. Bell, S. Martino. Motivational interviewing to increase cognitive rehabilitation adherence in schizophrenia, Schizophr. Bull., 42 (2016), pp. 327-334, 10.1093/schbul/sbv143

G.J. Connors, K.S. Walitzer, K.H. Dermen. Preparing clients for alcoholism treatment: effects on treatment participation and outcomes, J. Consult. Clin. Psychol., 70 (2002), pp. 1161-11619, 10.1037/0022-006X.70.5.1161

M.S. Mcdermott, M. Oliver, D. Iverson, R. Sharma. Effective techniques for changing physical activity and healthy eating intentions and behaviour: A systematic review and meta-analysis, Br. J. Health Psychol., 21 (2016), pp. 827-841, 10.1111/bjhp.12199

S.L. Williams, D.P. French. What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour--and are they the same?, Health Educ. Res., 26 (2011), pp. 308-322, 10.1093/her/cyr005

G.J. Balady, P.A. Ades, V.A. Bittner, B.A. Franklin, N.F. Gordon, R.J. Thomas, G.F. Tomaselli, C.W. Yancy. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: A presidential advisory from the American Heart Association
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