Developing a positive psychology intervention to improve cardiac health behaviors

制定积极的心理干预措施以改善心脏健康行为

• 批准号: 8436664
• 负责人: Jeff C Huffman
• 金额: $ 48.27万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-02-01 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8436664
• 关键词: Acute; Adherence; Affect; American; Applied Research; Aspirin; Basic Science; Behavior; Behavior Therapy; Cardiac; Cardiovascular system; Clinical; Clinical Trials Design; Cognition; Communities; Complex; Data; Development; Developmental Process; Diet; Dose; Emotions; Enrollment; Event; Exercise; Fat-Restricted Diet; Feeling; Frequencies; Grant; Happiness; Health; Health behavior; Health behavior change; Heart; Heart Diseases; Human; Individual; Intervention; Intervention Studies; Interview; Link; Measures; Medical; Mental Depression; Methodology; Myocardial Infarction; Names; Outcome; Outcome Measure; Outcome Study; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Physical activity; Play; Population; Prevention; Psychological Factors; Psychology; Public Health; Qualitative Research; Quality of life; Randomized; Recommendation; Recurrence; Regimen; Research; Risk; Role; Secondary Prevention; Structure; Telephone; Testing; Time; Translating; Work; acute coronary syndrome; arm; base; behavioral/social science; cohort; cost; design; diet and exercise; efficacy trial; emotional experience; experience; good diet; gratitude; improved; innovation; medication compliance; meetings; mortality; motivational enhancement therapy; negative emotional state; optimism; pilot trial; positive emotional state; prevent; primary outcome; programs; psychologic; public health relevance; success; therapy development

DESCRIPTION (provided by applicant): Preventing medical events is a critical public health concern, and adherence to recommended health behaviors can play a major role in such prevention. A key example of the importance of health behavior is in the secondary prevention of recurrent cardiovascular events in patients suffering an acute coronary syndrome (ACS). Despite the undeniable importance of health behaviors (e.g., physical activity, following a low-fat diet) in post-ACS patients, many are unable to follow these medical recommendations. Positive psychological states, especially optimism, have been linked to greater participation in healthy behaviors and superior cardiovascular outcomes in persons with and without heart disease. An emerging field of psychological interventions has focused on increasing the frequency and intensity of positive states, and these 'positive psychology' programs have consistently led to improvements in happiness, reductions in depression, and improvements in overall well-being in healthy individuals. However, such interventions have not been well-studied in ACS patients, and their effect on health behaviors has not been examined. Consistent with PA-11-063 (Translating Basic Behavioral and Social Science Discoveries into Interventions to Improve Health-Related Behaviors), we propose a multi-step treatment development project to utilize positive psychological interventions to improve specific health behaviors (physical activity, diet, and medication adherence) in patients initially hospitalized with ACS. We will perform qualitative research via semi-structured interviews to better understand the relationship between positive emotions and health behaviors in this cohort, and will design a positive psychological intervention that is suited to this population. We will then pilot test components of this intervention to assess initial feasibility/acceptability and understand the optimal components and 'dosing' of the intervention. Finally, we will end with a small randomized efficacy trial of our revised treatment in ACS patients. The trials in this grant will enroll a minimum of 208 subjects admitted with ACS, and will utilize a phone-based intervention to improve feasibility and reduce cost. The primary outcome measure for studies in this grant will be physical activity, as measured via an accelerometer. We selected this outcome because of the importance of this health behavior and the substantial difficulty that many ACS patients have in initiating and maintaining a physical activity regimen, and because positive emotions have been linked to greater physical activity. Given that the intervention may have broader effects, however, we will also measure the impact of our intervention on following a heart-healthy diet (evaluated via structured assessment) and adhering to medication (aspirin, as measured by cap openings). By the end of the grant period, we will have (in concordance with the PA) created a viable positive psychology- based intervention that will be ready for testing in a larger, multisite efficacy trial that is adequately powered to detect significant improvements in physical activity and other important health behaviors in ACS patients.

描述（由申请人提供）：预防医疗事件是一个重要的公共卫生问题，坚持推荐的健康行为可以在这种预防中发挥重要作用。健康行为重要性的一个关键例子是急性冠状动脉综合征（ACS）患者心血管事件复发的二级预防。尽管健康行为的重要性是不可否认的(例如，体育活动，遵循低脂饮食