POST CARDIAC REHABILITATION ADHERENCE INTERVENTION

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DESCRIPTION: (Adapted from investigator's abstract) The risk for future cardiac events can be reduced through healthy life style changes. The basic tenets of the multifaceted, cardiac rehabilitation (CR) program are that risk factors for coronary heart disease can be reduced through adherence to an exercise prescription, dietary modifications, smoking cessation, and reduction of stress and anxiety. In order to benefit from these health lifestyle changes which are either initiated or further emphasized in the CR Phase II program, it is crucial that individuals maintain these changes following discharge from CR. Research attention has focused on adherence to the cardiac rehabilitation program, and few studies have focused specifically on interventions designed to maximize adherence following discharge from CR Phase II. The specific aims of this study are: (1) to evaluate adherence to the cardiac risk factor reduction program following CR Phase II discharge, and (2) to evaluate the cost effectiveness of a nursing intervention following CR Phase II, in terms of adherence and cost per favorable outcome effectiveness. Outcome measures will correspond to the basic risk reduction tenants of a CR program and will include measures of exercise capacity, diet adherence, smoking cessation adherence, and stress reduction and coping skills. The study will be conducted in two parts. Part one will be an observational study that evaluates cardiac risk factor reduction adherence among CR participants (N =60) following discharge from Phase II to establish baseline data. Part two of the study will be a randomized clinical trial evaluating intervention group (N=72) and a control group (N=72). The post-CR intervention is comprised of a series of 4 brochures that will be developed from a successful community based Transtheoretical Model exercise brochure series, results of the PI's preliminary research, and other Transtheoretical Model research studies. The purpose of the intervention will be to increase adherence to exercise, diet, smoking cessation, and stress management skills. This study will evaluate a nursing intervention in terms of beneficial effect in increased adherence of cardiac risk reduction behavior following discharge from CR Phase II. This study will further develop scientific knowledge in health behavior adherence.