Abstract
Heart failure is a major public health problem, and self-management is the primary approach to control the progression of heart failure. The low research participation rate among rural patients hinders the generation of new evidence for improving self-management in rural heart failure patients. The purpose of this study is to identify the barriers and strategies in the recruitment and retention of rural heart failure patients in behavioral intervention programs to promote self-management adherence. This is a descriptive study using data generated from a randomized controlled trial. Eleven common barriers were identified such as the inability to perceive the benefits of the study, the burden of managing multiple comorbidities, and the lack of transportation to appointments. Possible gateways to improve recruitment and retention include using recruiters from the local community and promoting provider engagement with research activities. Multiple challenges inhibited rural heart failure patients from participating in and completing the behavioral intervention study. Anticipation of those barriers, and identifying strategies to remove those barriers, could contribute to an improvement in the rural patients' participation and completion rates, leading to the generation of new evidence and better generalizability of the evidence.
Highlights
Heart failure is a major public health problem, and self-management is the primary approach to control the progression of heart failure
High mortality and readmission rates in rural heart failure patients indicate a need for developing interventions to improve self-management adherence
Heart failure patients admitted to a rural community hospital in Southeastern Nebraska were first screened for eligibility based on the inclusion/exclusion criteria, the eligible patients were approached and asked whether they were interested in participating in the program
Summary
Heart failure is a major public health problem, and self-management is the primary approach to control the progression of heart failure. To fill the gap of knowledge and evidence regarding interventions intended to improve self-management adherence in rural heart failure patients, a two-group, Randomized Control Trial (RCT) was conducted to examine the feasibility and impact of a two-phase, 12-week intervention on patient knowledge and confidence in managing their heart failure a rural community. To evaluate the effectiveness of the intervention on selfmanagement adherence, the on-going assessments were conducted at baseline (before the onset of intervention), 3- and 6-months after the intervention Both objective (assessed by Actigraph monitor) and subjective data (assessed by questionnaires) were collected at each time point
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