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The evaluation of a brief motivational intervention to promote intention to participate in cardiac rehabilitation:  A randomized controlled trial.

Rouleau CR, King-Shier KM, Tomfohr-Madsen LM, Bacon SL, Aggarwal S, Arena R, Campbell TS.

Patient Educ Couns. 2018 Jun 26. pii: S0738-3991(18)30311-2. doi: 10.1016/j.pec.2018.06.015. [Epub ahead of print]

OBJECTIVES: Cardiac rehabilitation (CR) is an effective treatment for cardiovascular disease, yet many referred patients do not participate. Motivational interviewing could be beneficial in this context, but efficacy with prospective CR patients has not been examined. This study investigated the impact of motivational interviewing on intention to participate in CR.

METHODS: Individuals recovering from acute coronary syndrome (n = 96) were randomized to motivational interviewing or usual care, following CR referral but before CR enrollment. The primary outcome was intention to attend CR. Secondary outcomes included CR beliefs, barriers, self-efficacy, illness perception, social support, intervention acceptability, and CR participation.

RESULTS: Compared to those in usual care, patients who received the motivational intervention reported higher intention to attend CR (p = .001), viewed CR as more necessary (p = .036), had fewer concerns about exercise (p = .011), and attended more exercise sessions (p = .008). There was an indirect effect of the intervention on CR enrollment (b = 0.45, 95% CI 0.04-1.18) and CR adherence (b = 2.59, 95% CI 0.95-5.03) via higher levels of intention. Overall, patients reported high intention to attend CR (M = 6.20/7.00, SD = 1.67), most (85%) enrolled, and they attended an average of 65% of scheduled CR sessions.

CONCLUSION: A single collaborative conversation about CR can increase both intention to attend CR and actual program adherence.

PRACTICE IMPLICATIONS: The findings will inform future efforts to optimize behavioral interventions to enhance CR participation.

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