Behavior determinants among cardiac rehabilitation patients receiving educational interventions: An application of the health action process approach

Highlights • HAPA is a useful framework for understanding of the social-cognitive processes in CR. • Education interventions in CR are effective in improving patients’ knowledge. • Knowledge is a significant construct leading to behavioral intention formation.

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Published in	Patient education and counseling Vol. 98; no. 5; pp. 612 - 621
Main Authors	Ghisi, Gabriela Lima de Melo, Grace, Sherry L, Thomas, Scott, Oh, Paul
Format	Journal Article
Language	English
Published	Ireland Elsevier Ireland Ltd 01.05.2015
Subjects	Cardiac Rehabilitation Cardiovascular Diseases - psychology Curriculum Exercise Therapy - methods Female Health Behavior Health behavior theory Health Promotion Humans Intention Internal Medicine Knowledge Male Middle Aged Nursing Patient Compliance Patient education Patient Education as Topic - methods Physical exercise Self Efficacy Surveys and Questionnaires Canada Physical exercise Patient education Knowledge Health behavior theory Cardiac rehabilitation
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Abstract	Highlights • HAPA is a useful framework for understanding of the social-cognitive processes in CR. • Education interventions in CR are effective in improving patients’ knowledge. • Knowledge is a significant construct leading to behavioral intention formation.
AbstractList	Objectives: To (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to traditional education on patient knowledge and HAPA constructs; and, (2) investigate the theoretical correlates of exercise behavior among CR patients receiving theory-based education. Methods: CR patients were exposed to an existing or HAPA-based 6 month education curriculum in this quasi-experimental study. Participants completed a survey assessing exercise behavior, HAPA constructs, and knowledge pre and post-program. Results: 306 patients consented to participate, of which 146 (47.7%) were exposed to the theory-based educational curriculum. There was a significant improvement in patients' overall knowledge pre- to post-CR, as well as in some HAPA constructs and exercise behavior, regardless of curriculum (p < 0.05). Path analysis revealed that knowledge was significantly related to intention formation, and intentions to engage in exercise were not directly related to behavior, which required action planning. Conclusions: The theoretically-informed education curriculum was not associated with greater knowledge or exercise behavior as expected. Education in CR improves knowledge, and theoretical constructs related to exercise behavior. Practice implications: Educational curricula should be designed to not only increase patients knowledge, but also enhance intentions, self-efficacy, and action planning. To (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to traditional education on patient knowledge and HAPA constructs; and, (2) investigate the theoretical correlates of exercise behavior among CR patients receiving theory-based education. CR patients were exposed to an existing or HAPA-based 6 month education curriculum in this quasi-experimental study. Participants completed a survey assessing exercise behavior, HAPA constructs, and knowledge pre and post-program. 306 patients consented to participate, of which 146 (47.7%) were exposed to the theory-based educational curriculum. There was a significant improvement in patients' overall knowledge pre- to post-CR, as well as in some HAPA constructs and exercise behavior, regardless of curriculum (p < 0.05). Path analysis revealed that knowledge was significantly related to intention formation, and intentions to engage in exercise were not directly related to behavior, which required action planning. The theoretically-informed education curriculum was not associated with greater knowledge or exercise behavior as expected. Education in CR improves knowledge, and theoretical constructs related to exercise behavior. Educational curricula should be designed to not only increase patients' knowledge, but also enhance intentions, self-efficacy, and action planning. OBJECTIVESTo (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to traditional education on patient knowledge and HAPA constructs; and, (2) investigate the theoretical correlates of exercise behavior among CR patients receiving theory-based education.METHODSCR patients were exposed to an existing or HAPA-based 6 month education curriculum in this quasi-experimental study. Participants completed a survey assessing exercise behavior, HAPA constructs, and knowledge pre and post-program.RESULTS306 patients consented to participate, of which 146 (47.7%) were exposed to the theory-based educational curriculum. There was a significant improvement in patients' overall knowledge pre- to post-CR, as well as in some HAPA constructs and exercise behavior, regardless of curriculum (p < 0.05). Path analysis revealed that knowledge was significantly related to intention formation, and intentions to engage in exercise were not directly related to behavior, which required action planning.CONCLUSIONSThe theoretically-informed education curriculum was not associated with greater knowledge or exercise behavior as expected. Education in CR improves knowledge, and theoretical constructs related to exercise behavior.PRACTICE IMPLICATIONSEducational curricula should be designed to not only increase patients' knowledge, but also enhance intentions, self-efficacy, and action planning. Highlights • HAPA is a useful framework for understanding of the social-cognitive processes in CR. • Education interventions in CR are effective in improving patients’ knowledge. • Knowledge is a significant construct leading to behavioral intention formation. •HAPA is a useful framework for understanding of the social-cognitive processes in CR.•Education interventions in CR are effective in improving patients’ knowledge.•Knowledge is a significant construct leading to behavioral intention formation. To (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to traditional education on patient knowledge and HAPA constructs; and, (2) investigate the theoretical correlates of exercise behavior among CR patients receiving theory-based education. CR patients were exposed to an existing or HAPA-based 6 month education curriculum in this quasi-experimental study. Participants completed a survey assessing exercise behavior, HAPA constructs, and knowledge pre and post-program. 306 patients consented to participate, of which 146 (47.7%) were exposed to the theory-based educational curriculum. There was a significant improvement in patients’ overall knowledge pre- to post-CR, as well as in some HAPA constructs and exercise behavior, regardless of curriculum (p<0.05). Path analysis revealed that knowledge was significantly related to intention formation, and intentions to engage in exercise were not directly related to behavior, which required action planning. The theoretically-informed education curriculum was not associated with greater knowledge or exercise behavior as expected. Education in CR improves knowledge, and theoretical constructs related to exercise behavior. Educational curricula should be designed to not only increase patients’ knowledge, but also enhance intentions, self-efficacy, and action planning.
Author	Ghisi, Gabriela Lima de Melo Grace, Sherry L Thomas, Scott Oh, Paul
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Snippet	Highlights • HAPA is a useful framework for understanding of the social-cognitive processes in CR. • Education interventions in CR are effective in improving... •HAPA is a useful framework for understanding of the social-cognitive processes in CR.•Education interventions in CR are effective in improving patients’... To (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to traditional... OBJECTIVESTo (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to... Objectives: To (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to...
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SubjectTerms	Cardiac Rehabilitation Cardiovascular Diseases - psychology Curriculum Exercise Therapy - methods Female Health Behavior Health behavior theory Health Promotion Humans Intention Internal Medicine Knowledge Male Middle Aged Nursing Patient Compliance Patient education Patient Education as Topic - methods Physical exercise Self Efficacy Surveys and Questionnaires
Title	Behavior determinants among cardiac rehabilitation patients receiving educational interventions: An application of the health action process approach
URI	https://www.clinicalkey.es/playcontent/1-s2.0-S0738399115000129 https://dx.doi.org/10.1016/j.pec.2015.01.006 https://www.ncbi.nlm.nih.gov/pubmed/25638305 https://search.proquest.com/docview/1669839937 https://search.proquest.com/docview/1710665329
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