Evaluation Of A Simple Intervention To Increase Self-efficacy For Independent Exercise In Cardiac Rehabilitation Participants

Abstract

While benefits of exercise after a cardiac event are well documented, participation in and adherence to cardiac rehabilitation (CR) programs is often low. PURPOSE: To test the effectiveness of a self-efficacy coaching intervention (SCI): a simple theory-based behavioral intervention to increase self-efficacy for independent exercise as well as independent exercise behavior in CR patients. It was hypothesized that persons receiving the SCI treatment (T) would have higher levels of self-efficacy for exercise and greater participation in independent exercise than those in an attention control (C) group. METHODS: People referred to a hospital-based CR program by their physician were invited to participate in the study (N = 65). Participants were assigned to either T or C groups which were randomly designated by class time. The SCI was administered every two weeks by CR staff as a supplement to standard CR care. Patients in the T group received coaching about independent exercise, patients in the C group received coaching matched for time and technique but covering information about healthy eating. Self-efficacy for independent exercise was assessed at the beginning and end of the supervised CR program with an Exercise Self-Efficacy (ESE) scale and a Barriers Self-Efficacy (BARSE) scale. Participation in independent exercise was determined by self-report with activity logs. Outcome differences between and within T and C groups were analyzed through one-way ANOVA. RESULTS: Differences between groups were not statistically significant (p >.10) for any outcome variable. Significant within groups changes (p <.05) were seen for BARSE change in the T group, and for independent exercise change in both groups. Analysis of covariance suggested an independent effect of gender on change in ESE and BARSE scores, and an independent effect of previous exercise on exercise change. CONCLUSIONS: This study adds to the limited body of knowledge about theory-based interventions in CR programs and takes an important step in translating self-efficacy theory into a simple, practical application that will promote maintenance of lifestyle changes in this population. Further study is needed to see if the changes translate into maintenance of independent exercise behavior after completion of a formal CR program.