Predictors of completion of a psychological-behavioral intervention in acute coronary syndrome patients

Abstract

ObjectiveDropout from health behavior interventions in patients with heart disease is a major clinical issue that can impact recovery and prognosis. Positive psychology (PP)-based treatments have the potential to promote health behaviors, but predictors of PP intervention completion have not been examined in persons with heart disease. MethodsAmong 128 patients receiving a phone-based PP intervention to promote physical activity among acute coronary syndrome (ACS) patients, numerous baseline sociodemographic, medical, and psychological variables, along with self-reported pre/post improvements in happiness and optimism (on 0–10 Likert scales) associated with an initial PP exercise, were examined as potential predictors of intervention completion. Logistic and linear regression analyses were used to assess relationships between these predictors and (a) intervention completion (at least 4 of 8 sessions completed) and (b) number of total sessions completed. ResultsNo patient characteristic was associated with greater likelihood of completing the PP intervention. However, immediate pre-post change in optimism following the initial exercise was associated with intervention completion (odds ratio = 1.98; 95% confidence interval: 1.28–3.05; p = .002; mean post-exercise increase in optimism 0.79 [SD 1.52] in completers vs. mean optimism decrease of 0.59 [SD 1.42] in non-completers). ConclusionsPre-post change in optimism with a single PP activity predicted completion of an 8-week PP-based health behavior intervention in post-ACS patients. This information could be used clinically by having potential enrollees complete a single PP activity to assess intervention fit.