The proposed research seeks to determine whether virtual coaching and social supportfocusing on key social cognitive factors will be an effective strategy for maintainingphysical activity (PA) after completing cardiac rehabilitation (CR). Despite thewell-documented benefits of CR, only 15-50% of individuals continue to exercise 6 monthsafter completing CR.4-6 Thus, after 36 sessions (typically 12 weeks), many patients areleft without the support necessary to sustain physical activity (PA) and prevent adversesecondary cardiac events. Though previous research has explored interventions to sustainPA after CR, many studies have been lacking in a theoretical basis, objective measurementof PA, measurement, and analysis of psychosocial and social cognitive factors, andlong-term impact on clinical outcomes. Low-cost, pragmatic approaches to maintaining PAafter CR is urgently needed for older adults, and virtual technologies offer promisingsolutions to promote adherence to PA. The three specific aims of the project are to: 1)determine the effect of virtual coaching and social support on adherence to PA (measuredby objective step counts) in the intervention vs. control groups; secondary measures willbe amount of sedentary time, functional fitness, and self-reported exercise; 2) determinethe effect of virtual coaching and social support on psychosocial and social cognitivefactors in the intervention vs. control groups; 2a) evaluate the extent to whichpsychosocial and social cognitive factors mediate the effect of the intervention on PAadherence; 3) examine differences in CVD risk factors (blood pressure, lipids, HbA1c,BMI) between groups.
Not Provided
Behavioral: Virtual Coaching
The intervention group will receive Virtual coaching: a) tailored weekly coaching through
text messages with a weekly summary of progress and tailored messages on goals based on
self-reported exercise through the app, challenges, and self-management of PA. b)
Individual, tailored monthly coaching will be delivered by the exercise physiologist via
video or phone meetings with a focus on self-efficacy building, problem-solving skills,
and relapse.
Inclusion Criteria:
1. ≥ 60 years of age
2. History of CVD that qualified patient for Phase II CR (MI, percutaneous coronary
intervention, coronary artery bypass grafting, heart failure, valve replacement,
etc.)
3. Adherence to CR ( ≥ 50% sessions for ≥ 1 month)
Exclusion Criteria:
1. Participation in Phase III CR (optional extended CR after outpatient CR for those
who pay out-of-pocket)
2. Cognitive impairment (score 0-2 per Mini-Cog)
3. Lack of English or Spanish proficiency/literacy
4. Unstable clinical conditions
1. Unstable arrhythmias, aortic stenosis, thrombophlebitis, dissecting aneurysm or
symptomatic anemia
2. Active infection
3. Uncontrolled hypertension: resting systolic >180 mmHg, diastolic >100
mmHg
4. Decompensated heart failure, NYHA Class III-IV
5. Current unstable angina
6. 2nd or 3rd degree heart block or exercise induced arrhythmias
University of California, San Francisco
San Francisco, California, United States
Investigator: Julia von Oppenfeld
Contact: 415-676-1153
julia.vonoppenfeld@ucsf.edu
Julia von Oppenfeld
415-676-1153
julia.vonoppenfeld@ucsf.edu
Linda Park, PhD, NP, Principal Investigator
University of California, San Francisco