Facilitating Exercise Habit Formation among Cardiac Rehabilitation Patients: A Randomized Controlled Pilot Trial

Abstract

Background: The importance of promoting exercise adherence among individuals with acute coronary syndrome (ACS) is imperative. However, challenges in maintaining behavior among ACS patients are also well-documented. Emerging findings in the general population have supported the use of habit-formation techniques, which include incorporating routine consistency and cues, to be effective for facilitating exercise behavior. The effectiveness of habit formation approaches, however, has not been tested on participants with ACS. The purpose of this study was to test the effectiveness of facilitating physical activity habits among patients with ACS in a two-arm, parallel design, randomized controlled pilot trial. Methods: Participants (n = 13) were older adult patients (M age = 64.20, SD = 5.35) with ACS who were referred to a cardiac rehabilitation center. The experimental group attended monthly group meetings from months 1–3 and received phone call follow-ups from months 4–6. Conclusions: The experimental group showed an increase in weekly moderate-to-vigorous level physical activity, M = 228.20 mins (SD = 112.45), compared with the control group, M = 151.17 (SD = 112.22), d = 0.61. The experimental condition also showed greater use of routine consistency (experimental: M = 4.60 (SD = 0.548); control: M = 3.76 (SD = 1.62)) and cue usage (experimental: M = 3.60 (SD = 0.471); control: M= 2.60 (SD = 0.398)) over the control condition at the six-month mark. The study supports the effectiveness of habit-building techniques among patients with ACS, with effect sizes ranging from a medium to large magnitude. Findings from this pilot study support a full clinical trial with larger sample size.

Exploring physical activity preferences and motivation in long-term cardiac prevention: An Austrian cross-sectional survey

“…Possible reasons for this are that patients are not provided with the resources, knowledge or time to integrate these behaviours into their daily lives. To combat this, habit-formation techniques (e.g., guidance, cues, reminders, discussed shared experiences and action planning) may be of particularly use in increasing adherence [ 77 ]. Thus, improvements in long-term PA interventions could be focused on increasing patient autonomy and capacity to establish PA habits in conjunction with service models that cater for patients long-term, such as provision of ongoing supervised exercise therapy and digital/telerehabilitation offers.…”

Perceived Facilitators and Barriers for Actual Arm Use during Everyday Activities in Community Dwelling Individuals with Chronic Stroke

“…Within a health behavior framework, creating habits minimizes cognitive effort and decision making, which helps individuals increase a desired action or behavior [ 31 ]. Habit formation facilitates exercise and physical activity in stroke, cardiac rehabilitation, and general adult populations [ 32 , 33 , 34 ]. Interestingly, facilitators within the Person domain encompassed all phases of skill acquisition, suggesting that the participant’s stage of motor reacquisition must be taken into consideration when addressing actual arm use in everyday activities.…”

How and Why Patients Adhere to a Prescribed Cardiac Rehabilitation Program: A Longitudinal Phenomenological Study of Patients with Acute Coronary Syndrome

“…The overall status of health, which included cardiac-related symptoms, were slightly above average. Complete demographic characteristics have been previously reported [10]. The sample size was deemed to be valid based on several recommendations on conducting a phenomenological investigation, in addition to similarities of related studies.…”

“…The trial comprised a quantitative and qualitative investigation. The quantitative components were recently published, which also includes details on the trial design [10]. In summary, participants in the experimental arm attended monthly presentations (workshops) from months 1-3 and received phone call follow-ups from months 4-6.…”

“…Additional details regarding the presentation have been previously reported [10]. Participants were then monitored and contacted via a phone call during the maintenance phase (months 4-6) to assess if there were any safety concerns and to conduct semi-structured interviews.…”