Abstract 17017: Lifestyle Readiness to Change is a Predictor of Cardiac Rehabilitation Participation

Abstract

Background: The utility of the transtheoretical model (Stages of Change, SOC) in assessing behavioral changes is well demonstrated, but remains largely untested in Cardiac Rehabilitation (CR) populations. We hypothesized that baseline SOC would be predictive of attending CR.

Methods At hospital discharge, 148 patients (age 60 ± 12 yr., 56% male, 49% Black; with diagnoses of 17% STEMI, 47 % NSTEMI, 30% PCI, 6% stable angina) were given a 10-question self-administered survey as part of a comprehensive referral to CR. Using the survey, patients reported their SOC in domains such as exercise, diet, smoking and medication compliance. Individual answers were scored from 1 to 5 corresponding to the 5 stages (maintenance, action, preparation, contemplation, and pre-contemplation). A summary score (10 to 50) was then tabulated, with lower scores representing healthier behaviors.

Results: The average baseline summary score was 18 ± 5, corresponding to an action stage. Although, summary scores (table1) were not predictive of first CR session (orientation visit, p=0.15), they were predictive of attending the first CR session and subsequently exercising ≥ 1 sessions (OR= 0.989, 95% CI 0.980 to 0.997, p = 0.009 for exercising per each 1-point score increase). In individual questions, non-smoking status (p=0.014) and avoiding high-fat foods (p=0.019) predicted attendance at first CR session.

Conclusions: Following non-surgical cardiac events, patients exhibit a high readiness to change (i.e., action stage) at the time of hospital discharge. This model could be utilized to evaluate and appropriately individualize patient counseling. Emphasis should also be directed toward those patients with poor SOC scores as a means to increase their CR and exercise participation.