Evaluation of a Simple Intervention to Increase Self- Efficacy for Independent Exercise in Cardiac Rehabilitation Participants

Purpose: While benefits of exercise after a cardiac event are well documented, participation in and adherence to cardiac rehabilitation (CR) programs is often low. The purpose of this study was to test the effectiveness of a self- efficacy coaching intervention (SCI): a simple theory-based behavioral intervention to increase self-efficacy for independent exercise as well as independent exercise behavior in CR patients. It was hypothesized that persons receiving the SCI treatment (T) would have higher levels of self-efficacy for exercise and greater participation in independent exercise than participants in an attention control (C) group. Methods: People referred to a hospitalbased CR program by their physician were invited to participate in the study (N = 65). Participants were assigned to either T or C groups which had been randomly designated by class time. The SCI was administered approximately every two weeks by CR staff as a supplement to standard CR care. Patients in the T group received coaching about independent exercise, patients in the C group received coaching matched for time and technique but covering information about healthy eating. Self-efficacy for independent exercise was assessed at the beginning and end of the supervised CR program with an Exercise Self-Efficacy (ESE) scale and a Barriers Self-Efficacy (BARSE) scale. Participation in independent exercise was determined by self- report with activity logs. Outcome differences between T and C groups were analyzed through one-way ANOVA. Results: Mean change scores for the T group were larger than those seen in the C group, but differences between groups were not statistically significant (p \u3e .10). Significant difference between change scores for ESE, BARSE and independent exercise were noted when interaction effects between SCI treatment and previous exercise were considered. Conclusions: This study adds to the limited body of knowledge about theory-based interventions in cardiac rehabilitation programs and takes an important step in translating self-efficacy theory into a simple, practical application that will promote maintenance of lifestyle changes in this population