None listed
Conditions
Brief summary
Only 15% of cardiac rehabilitation attendees are achieving the physical activity guidelines. In people with heart disease, insufficient physical activity is an independent risk factor for all-causes of death. Within cardiac rehabilitation, people with heart disease are encouraged to meet the physical activity guidelines. Yet clearly, an innovative and effective physical activity intervention is needed in these programs. Our preliminary work has found that regular physical activity measurement by health professionals alone can drive physical activity adherence in insufficiently active adults. However, the optimum frequency of measurement in cardiac rehabilitation is unknown. ‘Measure It!’ is a very brief intervention, taking clinicians less than 5 minutes to complete. It includes a self-report and objective measure of physical activity (wearable activity tracker steps) plus physical activity advice. We will test two frequencies of physical activity measurement (2 and 5 measurements in total) by cardiac rehabilitation clinicians over 24-weeks. This hybrid effectiveness-implementation trial will recruit 190 insufficiently active cardiac rehabilitation attendees from 5 cardiac rehabilitation programs in the Australian Capital Territory and New South Wales. Daily minutes of accelerometer moderate-to-vigorous physical activity is the primary effectiveness outcome. Implementation outcomes will include acceptability, appropriateness, adoption, costs and sustainability. We hypothesize that 5 physical activity measurements over 24-weeks will result in increased accelerometer daily minutes of moderate-to-vigorous physical activity in insufficiently active cardiac rehabilitation attendees with heart disease compared with 2 physical activity measurements. If ‘Measure It!’ is successful, we will be able to recommend ways to incorporate this very brief intervention into cardiac rehabilitation service delivery. It will be a time and cost-effective approach to targeting physical activity within and beyond cardiac rehabilitation programs. Results will potentially drive changes in current practice, directly informing the development and implementation of cardiac rehabilitation services, leading to improved health for a large number of Australians with heart disease.
Interventions
Physical activity measurement (PAM) intervention: ‘Measure It!’ includes a self-report and objective measure of physical activity plus physical activity advice provided by their cardiac rehabilitation clinician. Patients will be asked about their current level of physical activity using the Physical Activity Vital Sign (On average how many days per week do you engage in moderate or greater physical activity?; On average how many minutes per day do you engage in activity at this level?), taking l
Physical activity measurement (PAM) intervention: ‘Measure It!’ includes a self-report and objective measure of physical activity plus physical activity advice provided by their cardiac rehabilitation clinician. Patients will be asked about their current level of physical activity using the Physical Activity Vital Sign (On average how many days per week do you engage in moderate or greater physical activity?; On average how many minutes per day do you engage in activity at this level?), taking less than 30 seconds to complete. Patients will also be asked to provide the average number of steps/day they completed in the last week according to their wearable activity tracker or smartphone app. The physical activity guidelines will be very briefly discussed (2 minutes) at each measurement. An example of the very brief physical activity advice provided is ‘moderate intensity physical activity means you should be able to talk in full sentences but not sing’, or ‘any activity is better than none’. Patients will be encouraged to safely increase their physical activity levels during the 24-week intervention period aiming to progress towards the Australian Physical Activity and Sedentary Behaviour Guidelines for Adults, that is, accumulate 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity or a combination of both each week. The ‘Measure It!’ intervention will be delivered face-to-face at baseline (5-PAM), 6 (5-PAM, end-cardiac rehabilitation program) and 24-weeks (5-PAM) but may be delivered via telehealth at 12 (5-PAM) and 18-weeks (5-PAM) depending on the site-specific cardiac rehabilitation model. The number of times the intervention is delivered to each patient will be recorded. From our pilot study (ACTRN12616000566437) in a healthy adult population, the total time required for measuring physical activity and provision of brief advice was less than 5 minutes, classifying this as a very brief intervention.
Sponsors
A/Prof Nicole Freene
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Eligible patients must: • be 18+ years old • be enrolled in a hospital-based phase II cardiac rehabilitation program • have stable coronary heart disease and be receiving optimal medical treatment ± revascularisation (eg, coronary artery bypass graft surgery, percutaneous coronary intervention), or have had a myocardial infarction • have a wearable activity tracker OR smartphone (step tracker app) OR computer/tablet • be insufficiently active (<150 mins of self-reported moderate-to-vigorous physical activity/wk), • have no serious medical conditions or functional impairments that could limit participation in moderate intensity physical activity, • have adequate English language and cognitive skills to participate in the study.
Exclusion criteria
Participants will be excluded if they have New York Heart Association class II-IV symptoms of heart failure (or documented signs and symptoms of chronic heart failure, with ejection fraction < 45%), uncontrolled arrhythmias, severe chronic obstructive pulmonary disease, uncontrolled hypertension, symptomatic peripheral artery disease, unstable angina, uncontrolled diabetes, or are unable to wear an accelerometer due to disability, for example, if they are confined to a wheelchair.
Outcome results
None listed