Christopher M Celano1, Melanie E Freedman2, Lauren E Harnedy3, Elyse R Park4, James L Januzzi5, Brian C Healy6, Jeff C Huffman4. 1. Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. Electronic address: ccelano@mgh.harvard.edu. 2. Department of Psychology, Northwestern University, Chicago, IL, USA. 3. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 4. Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 5. Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Baim Institute for Clinical Research, Boston, MA, USA. 6. Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Departments of Neurology and Biostatistics, Harvard Medical School, Boston, MA, USA.
Abstract
OBJECTIVE: Most patients with heart failure (HF) struggle to adhere to health behaviors, and existing health behavior interventions have significant limitations. We developed a 12-week, phone-delivered, combined positive psychology (PP) and motivational interviewing (MI) intervention to promote well-being and adherence to physical activity, diet, and medications. In this three-arm, randomized trial, we assessed the feasibility, acceptability, and preliminary efficacy of the intervention compared to treatment as usual and MI-alone conditions in 45 patients with HF and suboptimal health behavior adherence. METHODS: Participants in the PP-MI or MI-alone conditions completed weekly phone sessions for 12 weeks. Those in PP-MI completed weekly PP exercises and set health behavior goals, while those in the MI-alone condition learned about HF-specific health behaviors and identified potential behavior changes. Primary study outcomes were feasibility (sessions completed) and acceptability (0-10 ratings of PP exercise ease and utility). The intervention's impact on psychological and behavioral outcomes was assessed using mixed effects regression analyses. RESULTS: Participants in the PP-MI condition completed 73% of sessions and rated PP exercises as easy to complete (mean = 7.5 [SD 1.7] out of 10) and subjectively useful (mean = 7.5 [SD 1.6] out of 10). Compared to the control conditions, PP-MI led to medium effect-size improvements in positive affect (Cohen's d = 0.32-0.77), moderate to vigorous physical activity (d = 0.41-0.74), and medication adherence (d = 0.48-0.78). CONCLUSION: This PP-MI intervention was feasible, well-accepted, and associated with promising improvements in well-being and health behavior outcomes. Larger trials are needed to examine this intervention's impact on health behavior adherence and other important outcomes (NCT03220204).
RCT Entities:
OBJECTIVE: Most patients with heart failure (HF) struggle to adhere to health behaviors, and existing health behavior interventions have significant limitations. We developed a 12-week, phone-delivered, combined positive psychology (PP) and motivational interviewing (MI) intervention to promote well-being and adherence to physical activity, diet, and medications. In this three-arm, randomized trial, we assessed the feasibility, acceptability, and preliminary efficacy of the intervention compared to treatment as usual and MI-alone conditions in 45 patients with HF and suboptimal health behavior adherence. METHODS:Participants in the PP-MI or MI-alone conditions completed weekly phone sessions for 12 weeks. Those in PP-MI completed weekly PP exercises and set health behavior goals, while those in the MI-alone condition learned about HF-specific health behaviors and identified potential behavior changes. Primary study outcomes were feasibility (sessions completed) and acceptability (0-10 ratings of PP exercise ease and utility). The intervention's impact on psychological and behavioral outcomes was assessed using mixed effects regression analyses. RESULTS:Participants in the PP-MI condition completed 73% of sessions and rated PP exercises as easy to complete (mean = 7.5 [SD 1.7] out of 10) and subjectively useful (mean = 7.5 [SD 1.6] out of 10). Compared to the control conditions, PP-MI led to medium effect-size improvements in positive affect (Cohen's d = 0.32-0.77), moderate to vigorous physical activity (d = 0.41-0.74), and medication adherence (d = 0.48-0.78). CONCLUSION: This PP-MI intervention was feasible, well-accepted, and associated with promising improvements in well-being and health behavior outcomes. Larger trials are needed to examine this intervention's impact on health behavior adherence and other important outcomes (NCT03220204).
Authors: Christopher M Celano; Ariana M Albanese; Rachel A Millstein; Carol A Mastromauro; Wei-Jean Chung; Kirsti A Campbell; Sean R Legler; Elyse R Park; Brian C Healy; Linda M Collins; James L Januzzi; Jeff C Huffman Journal: Psychosom Med Date: 2018 Jul/Aug Impact factor: 4.312
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Authors: Gbenga O Ogedegbe; Carla Boutin-Foster; Martin T Wells; John P Allegrante; Alice M Isen; Jared B Jobe; Mary E Charlson Journal: Arch Intern Med Date: 2012-01-23
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Authors: Christopher M Celano; Eleanor E Beale; Melanie E Freedman; Carol A Mastromauro; Emily H Feig; Elyse R Park; Jeff C Huffman Journal: Nurs Health Sci Date: 2020-03-22 Impact factor: 1.857
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