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Celano CM, Healy BC, Jacobson LH, Bell M, Carrillo A, Massey CN, Chung WJ, Legler SR, Huffman JC. An adaptive text message intervention to promote psychological well-being and reduce cardiac risk: The Text4Health controlled clinical pilot trial. J Psychosom Res 2024; 177:111583. [PMID: 38171212 DOI: 10.1016/j.jpsychores.2023.111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE In a two-arm pilot trial, we examined the feasibility, acceptability, and preliminary efficacy of a 12-week, adaptive text message intervention (TMI) to promote health behaviors and psychological well-being in 60 individuals with multiple cardiac risk conditions (i.e., hypertension, hyperlipidemia, and/or type 2 diabetes) and suboptimal adherence to exercise or dietary guidance. METHODS Participants were allocated to receive the TMI or enhanced usual care (eUC). The TMI included daily adaptive text messages promoting health behaviors, twice-weekly messages to set goals and monitor progress, and monthly phone check-ins. Feasibility (primary outcome) and acceptability were measured by rates of successful text message delivery and daily participant ratings of message utility (0-10 Likert scale). We also assessed impact on health behavior adherence, psychological health, and functional outcomes. RESULTS The TMI was feasible (99.3% of messages successfully sent) and well-accepted (mean utility = 7.4/10 [SD 2.6]). At 12 weeks, the TMI led to small-sized greater improvements in moderate to vigorous physical activity (d = 0.37), overall physical activity (d = 0.23), optimism (d = 0.20), anxiety (d = -0.36), self-efficacy (d = 0.22), and physical function (d = 0.20), compared to eUC. It did not impact other outcomes substantially at this time point. CONCLUSION This 12-week, adaptive TMI was feasible, well-accepted, and associated with small-sized greater improvements in health behavior and psychological outcomes. Though larger studies are needed, it has the potential to be a scalable, low-intensity program that could be used in clinical practice. CLINICALTRIALS govregistration:NCT04382521.
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Affiliation(s)
- Christopher M Celano
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Brian C Healy
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Lily H Jacobson
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Margaret Bell
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Alba Carrillo
- Faculty of Psychology, University of Valencia, Spain
| | - Christina N Massey
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Wei-Jean Chung
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sean R Legler
- Division of Hospital Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jeff C Huffman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
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Ahrari S, Karimi Moonaghi H, Mahdizadeh SM, Heidari Bakavoli A. Experiences of what influences physical activity adherence in Iranian patients with heart failure: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:276. [PMID: 37849884 PMCID: PMC10578557 DOI: 10.4103/jehp.jehp_1029_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/06/2022] [Indexed: 10/19/2023]
Abstract
BACKGROUND Heart failure (HF) is becoming one of the important health care problems around the world. Physical activity as the foundation of the cardiac rehabilitation program is poorly adhered by patients with HF. This study aimed to understand the experiences of patients with HF in terms of adherence to physical activity. MATERIALS AND METHODS This study was conducted using conventional qualitative content analysis. Data were collected by semistructured telephone interviews with 25 patients with HF through open-ended questions. Data were collected from patients with HF in Birjand and Mashhad hospitals and heart departments from December 2021 to March 2022. Data were analyzed using Max-QDA10 and data analysis was continuous, comparative, and simultaneous with data collection. RESULTS After data analysis, three main categories were identified: (1) patient-related barriers and facilitators, (2) support system-related barriers and facilitators, and (3) environmental barriers and facilitators. These categories were subdivided into two main themes: (1) threatening disease and (2) challenging disease. CONCLUSION The results showed that beyond patient-related, support system-related, and environmental categories, perceiving the disease as a challenge or a threat is crucial in the activity of patients with HF. Nurses and other health care providers can train problem-solving behaviors to patients with HF to improve their physical and mental well-being. It is suggested that theoretical-behavioral approaches can be used in future clinical trials to improve adherence to physical activity.
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Affiliation(s)
- Shahnaz Ahrari
- School of Nursing and Midwifery, Department of Para Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Karimi Moonaghi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, and Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mousa Mahdizadeh
- Department of Medical-Surgical, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari Bakavoli
- Department of Cardiology, School of Medicine, Ghaem Hospital Mashhad University of Medical Sciences, Mashhad, Iran
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The Situation-Specific Theory of Heart Failure Self-care: An Update on the Problem, Person, and Environmental Factors Influencing Heart Failure Self-care. J Cardiovasc Nurs 2022; 37:515-529. [PMID: 35482335 PMCID: PMC9561231 DOI: 10.1097/jcn.0000000000000919] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care.
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