Abstract 13341: Improving Lifestyle Exercise in Cardiac Patients: Results of the SystemCHANGE Trial
Assisting individuals to adopt and maintain lifestyle exercise after a cardiac event remains challenging. The purpose of this 3- group, randomized controlled trial was to test two theoretically-distinct behavior change interventions against a usual care (UC) group to increase lifestyle exercise after a cardiac event. In a new intervention, SystemCHANGE (SC), based on process improvement and ecological theories, participants were taught to use a series of small self-designed experiments to change their daily routines associated with exercise. The emphasis was on changing systems in their lives rather than relying on motivation or memory. The second intervention, CHANGE+ (C+), based on cognitive behavioral theory, included contemporary approaches to increase self efficacy, motivation, and problem solving skills. Subjects (n =379; mean age = 67.1; 27% female; 86% Caucasian) were recruited from five Phase II cardiac rehab programs (CRP) and randomly assigned to one of three study arms. Enrolled near the end of their CRP, subjects were followed for 12 months using objective measures of exercise obtained from heart rate monitors worn during exercise. The number of hours exercised during exercise adoption (mos. 1-3) and maintenance (mos. 4-12) was calculated. Multiple linear regression was used to determine if study group membership predicted exercise adoption and maintenance.
During both the adoption and maintenance phases of exercise, the SC group had greater exercise amount (in hours) than either the C+ or UC group (adoption: SC = 41.2, C+ = 35.5, UC = 31.2; maintenance: SC = 96.3, C+ = 82.5, UC = 71.6). After controlling for important covariates, the SC group was a significant predictor of both exercise adoption (F = 5.87, p =.02) and exercise maintenance (F = 6.21, p = .01) as compared to the UC group. There were no significant differences between the C+ and UC groups. Although the SC group had more exercise in all months than the C+ intervention group, these differences were not statistically significant. In summary, the positive effects of the SystemCHANGE intervention on the adoption and maintenance of lifestyle exercise is encouraging and supports the need to continue to design and test behavior change interventions that are based on new theoretical approaches.
- © 2011 by American Heart Association, Inc.