Abstract 13347: Exercise Counseling in Low-income Ethnic Minority Individuals With Heart Failure: A Pilot Study
Background: A primary symptom of heart failure (HF) is exercise intolerance. Unfortunately, many patients are not referred to cardiac rehabilitation, nor counseled about exercise. The positive effects of exercise training on functional status and quality of life (QOL) have been established in patients with HF, with some evidence on improvement in flow-mediated dilation (FMD). However, few ethnic minority individuals of low socio-economic status have been included in these studies. The purpose of this quasi-experimental study was to pilot a brief exercise counseling intervention in a low-income ethnic minority HF clinic, and to assess preliminary efficacy in improving functional status, physical activity, mood, QOL and FMD.
Methods: Adults with HF (n=20) were enrolled from an urban HF clinic and completed a 6-minute walk test (6MWT) and standardized reliable instruments. Each subject participated in brief (15 minutes) exercise counseling based upon the principles of motivational interviewing (MI) to discuss their experience with exercise and future goals. Each received an accelerometer and hand weights with instructions. Subjects were followed via phone for 12 weeks to collect weekly step counts, review symptoms and discuss future exercise goals.
Results: The mean age of the subjects was 52 ± 8.2 years and 60% were men. Half were born outside the United States; 65% were Black; 90% were unemployed; and 70% had a high school degree or less. The mean duration of HF was 4.6 ± 5.4 years; mean ejection fraction was 32.88 ± 18.8%; 65% had hypertension; and 25% had diabetes. At 12 weeks, improvements were found in the 6MWT (p=.0006), walking score of the International Physical Activity Questionnaire (p=.04), weekly step-counts (p=.03), Minnesota Living with Heart Failure Questionnaire (p=.006), depression (p=.02), anxiety (p=.03), self-care maintenance that included physical activity (p=.03), but not FMD (p=.82). A process evaluation indicated the pilot was a feasible and safe intervention.
Conclusion: Brief counseling interventions using MI may lead to improvements in health outcomes in low-income ethnic minority populations with HF. Further testing of the intervention in a randomized trial is warranted.
- © 2013 by American Heart Association, Inc.