Maintaining Exercise after Cardiac Rehabilitation

描述(由申请人提供)：在完成心脏康复的患者中保持运动参与是二级预防冠状动脉事件和再次住院心脏不可或缺的一部分。在第二阶段心脏康复计划中的患者，大多数是老年人，在计划期间参加定期的监督锻炼；然而，长期坚持锻炼的情况很差，只有30%的人报告在12个月的随访中定期锻炼。为了在完成12周的第二阶段康复计划后促进运动维持，我们建议提供一种基于理论的干预措施，我们已经成功地使用该干预措施在老年初级保健患者中促进运动。该计划(维护咨询)包括心脏康复病例经理在第二阶段计划出院时提供的简短建议，然后是基于跨理论行为改变模型和社会认知理论的电话咨询。健康教育人员将在6个月内提供基于电话的干预。采用随机对照设计，180名患者将被分配到维持性咨询或简短建议加接触控制。结果评估将包括运动耐力测试(基线/康复后和6个月)、自我报告的运动参与度、运动的动机准备情况，以及基线、6个月、12个月和18个月的客观活动监测。这些数据将有助于确定以电话为基础的运动咨询是否是维持心脏康复患者定期运动和健康的有效策略，从而有助于二级预防冠心病。

DESCRIPTION (provided by applicant): Maintaining exercise participation among patients who have completed cardiac rehabilitation is integral to secondary prevention of coronary events and cardiac re-hospitalization. Patients in Phase II cardiac rehabilitation programs, a majority being older adults, participate in regular supervised exercise during the program; however, long-term adherence to exercise is poor, with only 30% reporting regular exercise at 12 month follow-ups. To promote exercise maintenance after completion of a 12 week Phase II rehabilitation program, we propose to offer a theoretically-based intervention that we have used successfully to promote exercise among older, primary-care patients. This program (Maintenance Counseling) includes brief advice from the Cardiac Rehabilitation case manager at Phase II program discharge followed by telephone counseling based on the Transtheoretical Model of Behavior Change and Social Cognitive Theory. Health educators will provide the telephone-based intervention over 6 months. Using a randomized controlled design, 180 patients will be assigned to Maintenance Counseling or Brief Advice plus Contact Control. Outcome assessments will include an exercise tolerance test (baseline/post-rehabilitation and 6 months), self reported exercise participation, motivational readiness for exercise, and objective activity monitoring at baseline, 6, 12 and 18 months. These data will help to identify whether telephone-based exercise counseling is an effective strategy for sustaining regular exercise and fitness among cardiac rehabilitation patients thereby contributing to secondary prevention of coronary heart disease.