The Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) tool predicts reduction in sedentary time following pulmonary rehabilitation in people with chronic obstructive pulmonary disease (COPD)

Abstract

ObjectivesTo examine the predictive validity, minimal important difference (MID) and responsiveness of the PRAISE tool. DesignRetrospective data analysis from HomeBase trial of home vs centre-based pulmonary rehabilitation. SettingTertiary health service. ParticipantsOne hundred and sixty-six participants with COPD (100 men) with mean age 69 (SD 9) years, FEV1% predicted 50% (19). InterventionsEight-week pulmonary rehabilitation program, conducted at the hospital or at home. Main outcome measuresThe 15-item PRAISE tool comprising 10 general and five pulmonary rehabilitation-specific self-efficacy questions. Predictive validity was examined by exploring the relationship between baseline PRAISE score and objective change in physical activity following pulmonary rehabilitation using the SenseWear Armband. The MID was evaluated using anchor-based and distribution-based methods. Responsiveness was assessed with effect sizes. ResultsA higher baseline PRAISE score (indicating better self-efficacy) was an independent predictor of reduced sedentary time following pulmonary rehabilitation (P=0.03). A one point increase in PRAISE was associated with a decrease in sedentary time of 4minutes/day (95% confidence interval −7.8 to −0.4minutes/day). Anchor-based estimates of the MID were 0.5 to 1.5 points; however sensitivity and specificity were modest (area under the curve <0.70). Change in PRAISE score following pulmonary rehabilitation had an effect size of 0.21. ConclusionsThe PRAISE tool has predictive validity and may be useful to identify those with high self-efficacy who are more likely to achieve important health behaviour changes with pulmonary rehabilitation. The small effect size suggests that the PRAISE tool was not responsive to changes following pulmonary rehabilitation. Trial registration numberNCT01423227, clinicaltrials.gov.