Design and Evaluation of a Brief Motivational Intervention to Promote Enrolment in Outpatient Cardiac Rehabilitation: A Mixed-Methods Feasibility Study

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atmire.migration.oldid5593
dc.contributor.advisorCampbell, Tavis S.
dc.contributor.authorRouleau, Codie R
dc.contributor.committeememberKing-Shier, Kathryn M
dc.contributor.committeememberTomfohr-Madsen, Lianne
dc.contributor.committeemembervon Ranson, Kristin M
dc.contributor.committeememberRussell-Mayhew, Michelle K
dc.contributor.committeememberOh, Paul I
dc.date.accessioned2017-05-17T14:54:16Z
dc.date.available2017-05-17T14:54:16Z
dc.date.issued2017
dc.date.submitted2017en
dc.description.abstractObjective: Patients who are referred to exercise-based cardiac rehabilitation (CR) following an acute coronary syndrome (ACS) event stand to benefit from a range of positive CR-related outcomes, including reduced morbidity and mortality. Yet, only 19-34% of eligible patients participate in CR in the United States and Canada. Motivational interviewing could be useful for encouraging CR enrolment, but empirical support does not exist. Research that examines patients’ decision-making about CR enrolment is needed to inform effective motivational intervention in this context. Methods: A two-part study was conducted to design and evaluate a brief motivational intervention to enhance intention to attend a 12-week CR program. Part 1 involved a qualitative examination of decision-making about CR enrolment using semi-structured interviews with ACS patients following CR referral but prior to enrolment (n = 14). A brief motivational intervention was subsequently designed to target obstacles to CR identified by patients in Part 1. Part 2 involved a two-group randomized controlled trial to examine preliminary efficacy and mechanisms of the intervention, using a usual care control group (n = 96). The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, CR barriers, self-efficacy, illness perception, social support, CR enrolment/adherence, and intervention acceptability. Results: Thematic analysis of qualitative data in Part 1 suggested the intervention should aim to bolster anticipated benefits of CR; assist patients in overcoming concerns about exercise, transportation, finances, and scheduling; and address contextual variables such as emotional distress and knowledge gaps. Randomization to the motivational intervention was associated with greater intention to attend CR (p = .001), greater perceived necessity of CR (p = .036), lower exercise concerns (p = .011), and higher CR adherence (p = .008), compared to usual care. Conclusions: Results provide preliminary evidence for the efficacy of a brief motivational intervention to enhance intention to attend CR. Implementing strategies that enhance the perceived necessity of CR and reduce exercise concerns may help improve adherence to CR following an ACS event. This body of work will help optimize efforts to promote participation in an under-utilized, cost-effective program that significantly improves ACS outcomes.en_US
dc.identifier.citationRouleau, C. R. (2017). Design and Evaluation of a Brief Motivational Intervention to Promote Enrolment in Outpatient Cardiac Rehabilitation: A Mixed-Methods Feasibility Study (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/25567en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/25567
dc.identifier.urihttp://hdl.handle.net/11023/3829
dc.language.isoeng
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgaryen
dc.publisher.placeCalgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectHealth Care Management
dc.subjectRehabilitation and Therapy
dc.subjectPsychology
dc.subjectPsychology--Clinical
dc.subject.othercardiac rehabilitation
dc.subject.othermotivational interviewing
dc.subject.otherintention
dc.subject.otheradherence
dc.subject.otherenrolment
dc.titleDesign and Evaluation of a Brief Motivational Intervention to Promote Enrolment in Outpatient Cardiac Rehabilitation: A Mixed-Methods Feasibility Study
dc.typedoctoral thesis
thesis.degree.disciplinePsychology
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.item.requestcopytrue
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