Christopher M Celano1,2, Julia Golden3, Brian C Healy4,5, Regina M Longley2, Jeff C Huffman1,2. 1. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 2. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 3. University of Connecticut School of Medicine, Farmington, CT, USA. 4. Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA. 5. Departments of Neurology and Biostatistics, Harvard Medical School, Boston, MA, USA.
Abstract
OBJECTIVE: Most individuals with heart failure (HF) struggle to adhere to one or more health behaviors, and interventions to promote adherence are time-intensive and costly. In this analysis, we examined the predictors of engagement and response related to a telephone-delivered health behavior intervention for individuals with HF. METHOD: Using data from two pilot trials (N = 25) of a behavioral intervention for individuals with New York Heart Association (NYHA) class I-II HF, we examined predictors of intervention engagement and response using linear and mixed effects regression analyses. Predictors included medical (NYHA class, physical health-related quality of life [HRQoL], and HF symptoms) and intervention (ease and usefulness/utility ratings of the first intervention exercise) characteristics. Outcomes included percentage of sessions completed, accelerometer-measured physical activity, and sodium intake. RESULTS: Lower physical HRQoL and more frequent HF symptoms were associated with completion of more sessions. In contrast, more frequent HF symptoms and higher NYHA class were associated with less physical activity improvement. Finally, participants' ratings of the first session's utility were associated with greater improvements in physical activity at follow-up. CONCLUSIONS: These findings suggest that while individuals with greater functional impairment are more engaged in a behavioral intervention, they may be less able to increase physical activity in response to the program. Furthermore, the perceived utility of an initial session may predict longer-term behavior change. Larger studies are needed to clarify the presence of additional predictors and determine how they can be used to better tailor health behavior interventions.
OBJECTIVE: Most individuals with heart failure (HF) struggle to adhere to one or more health behaviors, and interventions to promote adherence are time-intensive and costly. In this analysis, we examined the predictors of engagement and response related to a telephone-delivered health behavior intervention for individuals with HF. METHOD: Using data from two pilot trials (N = 25) of a behavioral intervention for individuals with New York Heart Association (NYHA) class I-II HF, we examined predictors of intervention engagement and response using linear and mixed effects regression analyses. Predictors included medical (NYHA class, physical health-related quality of life [HRQoL], and HF symptoms) and intervention (ease and usefulness/utility ratings of the first intervention exercise) characteristics. Outcomes included percentage of sessions completed, accelerometer-measured physical activity, and sodium intake. RESULTS: Lower physical HRQoL and more frequent HF symptoms were associated with completion of more sessions. In contrast, more frequent HF symptoms and higher NYHA class were associated with less physical activity improvement. Finally, participants' ratings of the first session's utility were associated with greater improvements in physical activity at follow-up. CONCLUSIONS: These findings suggest that while individuals with greater functional impairment are more engaged in a behavioral intervention, they may be less able to increase physical activity in response to the program. Furthermore, the perceived utility of an initial session may predict longer-term behavior change. Larger studies are needed to clarify the presence of additional predictors and determine how they can be used to better tailor health behavior interventions.
Authors: Alanna M Chamberlain; Sheila M McNallan; Shannon M Dunlay; John A Spertus; Margaret M Redfield; Debra K Moser; Robert L Kane; Susan A Weston; Véronique L Roger Journal: Circ Heart Fail Date: 2013-04-26 Impact factor: 8.790
Authors: Christopher M Celano; Melanie E Freedman; Eleanor E Beale; Federico Gomez-Bernal; Jeff C Huffman Journal: J Nerv Ment Dis Date: 2018-10 Impact factor: 2.254