Abstract 18101: Examining Self-Efficacy and Patient Activation Mechanisms in a Weight Management Intervention for Overweight and Obese Cardiac Rehabilitation Patients
Introduction: Approximately 80% of cardiac patients in cardiac rehabilitation (CR) are overweight. Although weight loss interventions are effective in reducing weight in the short-term, they fail to provide sustained weight reduction and maintain normal weight over time.
Hypothesis: Understanding intervention mechanisms to improve weight management for secondary cardiac risk reduction is critical. The purpose of this secondary analysis was to describe and examine the relationships between self-efficacy for exercise (SEE), patient activation (PA), physical activity intensity (PAI) and weight loss in overweight and obese cardiac revascularization patients who participated in cardiac rehabilitation.
Methods: A correlational design was used for this secondary analysis of the parent study examining. A total of 39 overweight (18.6%) or obese (81.4%) cardiac patients, with complete data from the parent study examining the impact of a telehealth delivered weight management intervention on weight outcomes over time.
Results: The proposed model (Figure 1) had adequate fit based on the fit indices (Chi-square (2) = 2.678, p = 0.261; RMSEA = 0.094; CFI = 0.979). At four months after cardiac revascularization, SEE had a significant direct impact on the level of PA (β = 0.641, p ≤ 0.001). Patient activation was a significant predictor of the IPA; the higher the PA, the greater the IPA (β = 0.389, p = 0.006). Intensity of physical activity was significantly associated with amount of weight loss at 4 months (β = 0.399, p = 0.007). In the model patient activation, the proposed mediator, was a significant predictor of the intensity of physical activity and amount of weight loss. Self-efficacy for exercise no longer directly predicted the amount of weight loss when the patient activation variable was tested simultaneously. These findings support the mediating effect of patient activation.
Conclusions: The mechanism for change in weight loss was a result of self-efficacy’s effect on patient activation, which increases physical activity and leads to a decrease in weight.
Author Disclosures: S.A. Barnason: Research Grant; Significant; NR011404 P20 grant from National Institute of Nursing Research, NIH. L. Young: None. K. Kupzyk: None. L. Zimmerman: None. C. Pullen: Research Grant; Significant; NR011404 P20 grant from National Institute of Nursing Research, NIH.
- © 2016 by American Heart Association, Inc.