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Community SES, perceived environment, and physical activity during home-based cardiac rehabilitation: is there a need to consider the urban vs. rural distinction?

https://arctichealth.org/en/permalink/ahliterature126295
Source
J Urban Health. 2012 Apr;89(2):285-95
Publication Type
Article
Date
Apr-2012
Author
Chris Blanchard
Daniel Rainham
Jill McSweeney
John Spence
Lisa McDonnell
Ryan Rhodes
Robert Reid
Kerry McGannon
Nancy Edwards
Author Affiliation
Dalhousie University, Halifax, Nova Scotia, Canada. chris.blanchard@dal.ca
Source
J Urban Health. 2012 Apr;89(2):285-95
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Canada
Environment
Exercise
Female
Home Care Services - statistics & numerical data
Humans
Male
Middle Aged
Motor Activity
Patient Satisfaction - statistics & numerical data
Questionnaires
Rural Population - statistics & numerical data
Social Class
Urban Population - statistics & numerical data
Abstract
Physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) remain problematic. Consequently, the present study examined the association between MVPA and urban vs. rural residential status and the perceived environment in patients attending home-based CR. A total of 280 patients completed a questionnaire assessing demographic, clinical, MVPA, and perceived environmental variables measured at baseline and 3 months later. Patient addresses were geocoded and linked to the 2006 Canadian census to establish the urban/rural distinction. Results showed that urban and rural patients had similar baseline MVPA and improvements in MVPA by 3 months. Several perceived environmental variables were significantly related to MVPA throughout home-based CR that were common and urban/rural-specific. Therefore, although there does not appear to be an urban vs. rural advantage in MVPA levels during home-based CR, there does appear to be environmental/MVPA-specific relationships specific to urban and rural patients that may warrant attention.
Notes
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PubMed ID
22402918 View in PubMed
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Randomized trial of an internet-based computer-tailored expert system for physical activity in patients with heart disease.

https://arctichealth.org/en/permalink/ahliterature131457
Source
Eur J Prev Cardiol. 2012 Dec;19(6):1357-64
Publication Type
Article
Date
Dec-2012
Author
Robert D Reid
Louise I Morrin
Louise J Beaton
Sophia Papadakis
Jana Kocourek
Lisa McDonnell
Monika E Slovinec D'Angelo
Heather Tulloch
Neville Suskin
Karen Unsworth
Chris Blanchard
Andrew L Pipe
Author Affiliation
University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada. breid@ottawaheart.ca
Source
Eur J Prev Cardiol. 2012 Dec;19(6):1357-64
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Actigraphy - instrumentation
Acute Coronary Syndrome - diagnosis - physiopathology - psychology - rehabilitation
Aged
Emotions
Exercise Therapy - adverse effects - methods
Expert Systems
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Health status
Humans
Internet
Male
Mental health
Middle Aged
Motor Activity
Ontario
Patient compliance
Patient Discharge
Quality of Life
Secondary Prevention - methods
Self Report
Therapy, Computer-Assisted
Time Factors
Treatment Outcome
Abstract
The CardioFit Internet-based expert system was designed to promote physical activity in patients with coronary heart disease (CHD) who were not participating in cardiac rehabilitation.
This randomized controlled trial compared CardioFit to usual care to assess its effects on physical activity following hospitalization for acute coronary syndromes.
A total of 223 participants were recruited at the University of Ottawa Heart Institute or London Health Sciences Centre and randomly assigned to either CardioFit (n?=?115) or usual care (n?=?108). The CardioFit group received a personally tailored physical-activity plan upon discharge from the hospital and access to a secure website for activity planning and tracking. They completed five online tutorials over a 6-month period and were in email contact with an exercise specialist. Usual care consisted of physical activity guidance from an attending cardiologist. Physical activity was measured by pedometer and self-reported over a 7-day period, 6 and 12 months after randomization.
The CardioFit Internet-based physical activity expert system significantly increased objectively measured (p?=?0.023) and self-reported physical activity (p?=?0.047) compared to usual care. Emotional (p?=?0.038) and physical (p?=?0.031) dimensions of heart disease health-related quality of life were also higher with CardioFit compared to usual care.
Patients with CHD using an Internet-based activity prescription with online coaching were more physically active at follow up than those receiving usual care. Use of the CardioFit program could extend the reach of rehabilitation and secondary-prevention services.
PubMed ID
21903744 View in PubMed
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Understanding physical activity during home-based cardiac rehabilitation from multiple theoretical perspectives.

https://arctichealth.org/en/permalink/ahliterature132640
Source
J Cardiopulm Rehabil Prev. 2011 May-Jun;31(3):173-80
Publication Type
Article
Author
Chris M Blanchard
Robert D Reid
Louise I Morrin
Lisa McDonnell
Kerry McGannon
Ryan E Rhodes
John C Spence
Nancy Edwards
Author Affiliation
Centre for Clinical Research, Halifax, Nova Scotia, Canada.
Source
J Cardiopulm Rehabil Prev. 2011 May-Jun;31(3):173-80
Language
English
Publication Type
Article
Keywords
Behavior Control - psychology
Behavior Therapy - methods
Behavioral Symptoms - etiology - physiopathology - therapy
Canada
Female
Health Promotion - methods
Home Care Services - organization & administration
Humans
Male
Middle Aged
Motor Activity
Myocardial Infarction - complications - psychology - rehabilitation
Program Evaluation
Psychological Theory
Risk assessment
Self Efficacy
Social Support
Socioeconomic Factors
Treatment Outcome
Abstract
: Previous studies have shown that moderate-to-vigorous physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) have been problematic. Consequently, the present study examined the utility of the theory of planned behavior, protection motivation theory, and social cognitive theory in explaining physical activity (PA) during a Canadian home-based CR program.
: Patients (N = 280, mean age 62.8 years; 95.4% white, 72.5% male, 78.9% married, 52.3% retired, 48.0% income more than $60000; and 33.8% postmyocardial infarction) completed a questionnaire at program onset and a MVPA assessment at 3-month followup.
: Path analyses showed that each theory accounted for 28% to 34% of the variance in PA. The theory of planned behavior showed that perceived behavior control was the key predictor of 3-month MVPA (ß = .36), whereas protection motivation theory showed that intention (ß = .30) was the key predictor. Finally, barrier self-efficacy (ß = .21) and the availability of home PA equipment (ß = .15) were the key predictors of 3-month MVPA within social cognitive theory.
: All 3 theories appeared to be viable options to inform the development of a MVPA intervention during home-based CR. However, the key constructs to target within each theory varied, suggesting the need to potentially use multiple theories to inform intervention development.
PubMed ID
21796061 View in PubMed
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