Targeted Health Coaching to Improve Physical Activity Post-Structured Cardiac Rehabilitation

Not Applicable

Completed

Conditions: Cardiac Rehabilitation
Health Coaching
Physical Activity

Registration Number: NCT05773287

Lead Sponsor: Duke University

Brief Summary: To identify factors and triggers influencing physical activity (PA) participation after structured cardiac rehabilitation (CR) among older adults who have enrolled in a center-based CR program, and compare the effects of a targeted health coaching intervention versus standard care immediately following structured CR on PA maintenance and functional fitness.

Detailed Description: Approximately 800,000 individuals in the United States have a heart attack every year, with almost 1 in 4 of those individuals already having suffered a previous heart attack. Attending cardiac rehabilitation (CR) following a cardiovascular event improves cardiorespiratory fitness and health-related quality of life, as well as decreases the risk of future illness and death from heart disease. Unfortunately, once an individual finishes a CR program, continued participation in physical activity (PA) too often reverts to previous sedentary patterns, limiting beneficial health effects. Continued participation in PA post-CR is especially challenging among older adults - likely due to a lack of self-efficacy and confidence in their ability to perform PA due to either their age or other health conditions that make PA more challenging. However, the need to address other health conditions, in conjunction with the benefits of improved strength and mobility, makes continued PA participation following a structured CR program even more useful for older adults. Although individuals typically understand habitual participation in PA is good for their health, we poorly understand why some individuals successfully adhere to and maintain PA habits, while others succumb to barriers preventing them from maintaining the health benefits beyond CR. In addition to understanding factors and triggers influencing PA maintenance beyond CR, little research has developed or investigated interventions targeting this important transition period following structured CR programming to promote continued PA participation "at home". Therefore, this proposal aims to 1) identify factors and triggers influencing PA participation after a traditional 36-session CR program (Stage 0); and 2) test a targeted health coaching intervention using these identified triggers to optimize PA maintenance and mobility among older adults who completed a center-based CR program.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 13

Inclusion Criteria

Willingness to provide informed consent to participate in the Target-CR Study
Must be able to read and speak English well enough to provide informed consent and understand instructions
Age ≥60 years
Diagnosed with coronary heart disease
Of adequate clinical stability to allow study participation
Own a smartphone device for application download

Exclusion Criteria

Planned relocation during the 3-month study period
Medical procedure scheduled within the 3-month study period that may limit physical activity (i.e., joint replacement)
Decompensated heart failure
Heart failure - New York Heart Association class IV
Severe pulmonary hypertension
End-stage renal disease
Cardiac transplantation
Impairment from stroke, injury, or other medical condition that would prevent participation in the intervention
Dementia that would prevent participation in the intervention and following study protocols
Any other illnesses that, in the opinion of the local clinician, would negatively impact or mitigate participation in and completion of the protocol
Psychiatric illness (self-report and screening)
- Hospitalization for any psychiatric condition within one year (self-report)
- Integrative Health Coaching Mental Health Screening Questionnaire score >4 (screening)
Participation in an inpatient substance abuse rehabilitation program within one year

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Change in Physical Activity as Measured by Steps Per Day	Baseline, 3 months
Average Adherence to Physical Activity Prescription	Baseline to 3 months	A metric of adherence to the steps/day prescription, calculated as (steps/day completed) divided by (steps/day prescribed) times 100 and averaged across the study period. Reported as the average adherence (percent) to the steps per day prescription across the three-month study period.

Secondary Outcome Measures

Name	Time	Method
Change in Senior Fitness Test Score (SFT) - Chair Stands	Baseline, 3 months	The chair stand test is similar to a squat test to measure leg strength, in which participants stand up repeatedly from a chair for 30 seconds. Reported as the number of completed chair stands in 30 seconds.
Change in Senior Fitness Test Score (SFT) - Arm Curls	Baseline, 3 months	The Arm Curl test is a test of upper body strength and involves performing as many arm curls as possible in 30 seconds, while sitting in a chair. Reported as change in the number of arm curls completed in 30 seconds.
Change in Senior Fitness Test Score (SFT) - 2-Minute Step Test	Baseline, 3 months	The 2-Minute Step Test is a measure of endurance or physical stamina, reported as change in the number of steps, marching in place, achieved in 2 minutes.
Change in Senior Fitness Test Score (SFT) - Sit & Reach	Baseline, 3 months	The Sit \& Reach test measures lower body flexibility, specifically hamstring flexibility. Reported as the change in distance reached in inches.
Change in Senior Fitness Test Score (SFT) - Back Scratch Test	Baseline, 3 months	The Back Scratch Test is a measure of upper body flexibility. This is reported as the change in distance between fingertip of the middle fingers on each hand in inches.
Change in Senior Fitness Test Score (SFT) - Timed Up and Go Test	Baseline, 3 months	The Timed Up and Go test measures speed, agility, and balance. This is reported as the average change in time to the nearest second among two trials.
Change in Senior Fitness Test Score (SFT) - 6-minute Walk Test (6MWT)	Baseline, 3 months	The 6MWT is reported as the distance walked in 6 minutes to the nearest meter.