The goal of the proposed project is to determine if providing an intervention for women who decline the invitation to participate in standard cardiac rehabilitation programs (CRPs) will ultimately result in an increase their participation in CRPs.This study will evaluate outcomes of patients randomized to the FHHS STEP Program versus by non-STEP Program participants. The overall goal is to provide an alternate, introductory program that will engage, educate, and empower women following a cardiac event. Providing these women with the necessary personal resources will encourage and enable these women to take the step towards a cardiac rehabilitation program, which, in turn will ideally lead to a life-long commitment to heart health.
Cardiac rehabilitation programs (CRPs) have been shown to improve outcomes following a cardiac event. Referrals to the CRP are a standard part of the community-based continuing care process within the Winnipeg region, to include automatic referrals for hospitalized patients, based on specific criteria, physician referrals and self-referrals. However, fewer women than men are referred to and participate in CRPs in Winnipeg. The investigators' study is unique in that the investigators plan to capture those women who may not be ready to change or participate in a traditional CRP. While women who are in the pre-contemplative or contemplative stages of change may not be ready to participate in a standard CRP, they may be willing to explore a complementary opportunity: the FHHS STEP Program. The overall goal of this project is to provide a collaborative team environment that will engage women; educate, and empower women; and provide women with the necessary personal resources to enable them to take the step towards a cardiac rehabilitation program and a life-long commitment to heart health. The investigators' 2-group randomized clinical trial will compare physiological and psychosocial outcomes among women completing a 12-week gender specific introduction to cardiac rehabilitation with non-program attenders.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Intervention: The 12-week STEP Program will include: initial individual consult/goal setting; weekly 90 minute information/interactive sessions; individualized patient centred care; journaling
Cardiac Rehabilitation Program Enrolment
3 yes/no questions: have you contacted a CRP; have you joined a CRP; do you plan to contact a CRP. if not, why not
Time frame: 12 months
Short-Form-36
36 items re 8 dimensions: physical functioning (10 items), role limitations - physical (4 items), bodily pain (2 items), social functioning (2 items), general mental health (5 items), role limitations - emotional (3 items), vitality (4 items), general health perceptions, 5 items); coded to 0-100 score, with higher values representing more favourable states
Time frame: baseline, 3, 6 and 12 months
Brief Symptom Inventory
53 items; 5-point Likert scale (1-5); operationalizes concepts of anxiety, depression and hostility; 9 symptom domains, with higher scores indicating greater levels of distress.
Time frame: baseline, 3, 6 and 12 months
General Self-Efficacy Scale
10 items; scoring based on 4-point Likert scale (1-4), with higher scores reflecting higher perceived self-efficacy
Time frame: baseline, 3, 6, 12 months
Multidimensional Self-Efficacy for Exercise Scale
9 items; 11-point Likert scale (0-10), with higher scores reflecting higher task efficacy (3 items), coping efficacy (3 items) and scheduling efficacy (3 items
Time frame: baseline, 3, 6 and 12 months
Enhancing Recovery in Coronary Heart Disease Social Support Instrument
7 item scale is scored by totalling the six 5-point Likert scale items and a 7th item, which is scored 4 for 'yes' and 2 for 'no'. The scale captures structural, emotional and instrumental support
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Time frame: baseline, 3, 6 and 12 months
Stages of Change Questionnaire
12 5-point-Likert scale (1-5) questions; Stages of readiness to change for each of the listed behaviors include 5 response items representing each of the stages of change (i.e., precontemplation, contemplation, preparation, action, and maintenance).
Time frame: baseline, 3, 6 and 12 months
Health Resource Utilization Questionnaire
4-items: self-reported number of contacts/visits with primary care provider, cardiologist, emergency department/Walk-in Clinic visits and hospital admissions.
Time frame: 3, 6 and 12 months
International Physical Activity Questionnaire
9-item, subjective 7 day recall of physical activity patterns
Time frame: baseline, 3, 6 and 12 months
Client Satisfaction Questionnaire
intervention group only; 8 items; 4-point Likert scale; assesses general satisfaction with the health care services received; higher scores reflect higher satisfaction
Time frame: 3 months
6-Minute Walk Test
total distanced walked in 6 minutes
Time frame: baseline, 3, 6 and 12 months
Accelerometry
accelerometers monitor/measure physical activity/sedentary behaviours for a specified period of time (7 days).
Time frame: baseline, 3, 6 and 12 months