Optimizing a Positive Psychology Intervention to Promote Health Behaviors After an Acute Coronary Syndrome: The Positive Emotions After Acute Coronary Events III (PEACE-III) Randomized Factorial Trial
Optimizing a Positive Psychology Intervention to Promote Health Behaviors After an Acute Coronary Syndrome: The Positive Emotions After Acute Coronary Events III (PEACE-III) Randomized Factorial Trial
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DOI：
10.1097/psy.0000000000000584
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发表时间：
2018-07-01
影响因子：
3.3
通讯作者：
Huffman, Jeff C.
中科院分区：
文献类型：
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作者：
Celano, Christopher M.;Albanese, Ariana M.;Huffman, Jeff C.
目的尽管体力活动和相关行为对预后有明显的益处，但大多数急性冠状动脉综合征（ACS）患者仍然不遵守这些行为。积极心理结构的缺陷（例如，乐观）与减少参与健康行为有关，支持基于积极心理学（PP）的干预在ACS后患者中的潜在效用。因此，我们的目的是确定一个PP为基础的干预，以促进后ACS physical activity.Methods的一部分，多阶段优化策略的最佳组件，我们完成了一项随机析因试验，在128后ACS患者的8个条件，有效地确定最佳性能的干预组件。所有参与者都接受了基于PP的干预，条件不同，持续时间（存在/不存在助推器会话），强度（每周/每日PP练习）和内容（单独PP或与动机访谈相结合），允许在试验中进行三次并行比较。该研究的目的包括评估的整体可行性，可接受性，和干预的影响，沿着的主要目的是确定哪些组件与客观测量的身体活动和自我报告的健康行为的坚持在16周，评估使用纵向models.Results的干预是很好地接受，并与行为和心理结果的大幅改善。强化治疗与更大的活动相关，几乎达到显著程度（= 8.58，95%置信区间= -0.49-17.65，效应量差异= 0.43，p = 0.064），动机性访谈与总体依从性相关（= 0.95，95%置信区间= 0.02-1.87，效应量差异= .39，p = .044），结论这些发现将使PP为基础的干预措施的优化，准备一个良好的，临床试验注册Clinicaltrials.gov，NCT 02754895。
Objective Despite the clear benefits of physical activity and related behaviors on prognosis, most patients experiencing an acute coronary syndrome (ACS) remain nonadherent to these behaviors. Deficits in positive psychological constructs (e.g., optimism) are linked to reduced participation in health behaviors, supporting the potential utility of a positive psychology (PP)-based intervention in post-ACS patients. Accordingly, we aimed to identify optimal components of a PP-based intervention to promote post-ACS physical activity.Methods As part of a multiphase optimization strategy, we completed a randomized factorial trial with eight conditions in 128 post-ACS patients to efficiently identify best-performing intervention components. All participants received a PP-based intervention, with conditions varying in duration (presence/absence of booster sessions), intensity (weekly/daily PP exercises), and content (PP alone or combined with motivational interviewing), allowing three concurrent comparisons within the trial. The study aims included assessments of the overall feasibility, acceptability, and impact of the intervention, along with the primary aim of determining which components were associated with objectively measured physical activity and self-reported health behavior adherence at 16 weeks, assessed using longitudinal models.Results The intervention was well accepted and associated with substantial improvements in behavioral and psychological outcomes. Booster sessions were associated with greater activity to a nearly significant degree ( = 8.58, 95% confidence interval = -0.49-17.65, effect size difference = .43, p = .064), motivational interviewing was associated with overall adherence ( = 0.95, 95% confidence interval = 0.02-1.87, effect size difference = .39, p = .044), and weekly exercise completion was generally superior to daily.Conclusions These findings will enable optimization of the PP-based intervention in preparation for a well-powered controlled trial.Clinical Trial Registration Clinicaltrials.gov, NCT02754895.