Long-term maintenance of lifestyle changes to reduce cardiovascular risk factors after coronary artery bypass graft (CABG) surgery is essential to positively influence health outcomes. Despite proven efficacy of cardiac rehabilitation (CR) in helping patients initiate lifestyle changes, less than 50 percent of CABG patients maintain lifestyle changes by 6 months post-CABG. It is also known that the spouse is the main source of social support for the recovering cardiac patient and frequently attends cardiac rehabilitation with the patient to provide transportation, emotional support, or attend educational classes. In spite of these supportive behaviors, however;adherence still drops off after CR. Lifestyle interventions that specifically target the marital partners as a unit may be more efficacious than current individually-oriented education strategies. The objective of the proposed feasibility study, using an experimental, two-group (n = 30 couples in each group) repeated measures design, will be to pilot test the effects of the Partners Together in Health (PaTH) Intervention versus usual care in improving the following outcomes: a) physical activity and healthy eating behaviors, b) quality of life (physical, psychological, and relational), and c) risk level for heart disease.
The specific aims are to: a) Assess the feasibility of implementing the PaTH Intervention (by assessing number of contacted/ recruited participants [both patients and partners], number of drop-outs, time for delivery of the intervention and by conducting qualitative interviews with patients, partners and the cardiac rehabilitation program staff about the intervention and the study) and of the proposed data collection plan (by assessing percent of questionnaires completed, amount of missing data, amount of time required for data collection);and b) generate pilot data on all outcome variables in both the CABG patient and the partner to estimate effect sizes needed to determine the sample size requirements for the larger study. Partners in the PaTH Intervention group will formally join CR with the patient to participate in exercise sessions and educational classes to undertake comprehensive risk reduction for themselves, and to make the same positive physical activity/exercise and healthy eating lifestyle changes as the patient. Partners in the usual care group will be invited to attend the educational sessions with the patient;however, only about 10 percent of partners typically attend these sessions. The primary variables will be change in outcomes from baseline to 3 and 6 month time points in both the CABG patient and his/her partner. The PaTH intervention is innovative because it allows the couple to build new habits together so they can motivate and support one another on their journey toward health, it uses an existing, well-established treatment method (cardiac rehab) to deliver cost-effective care, it provides self-efficacy and social support for both members of the dyad in making behavioral changes, and no other studies testing the effects of including the partner in CR were found. Public Health Relevance: The objective of the proposed feasibility study, using an experimental, two-group (n = 30 couples in each group) repeated measures design, will be to pilot test the effects of the Partners Together in Health (PaTH) Intervention versus usual care in improving the following outcomes: a) physical activity and healthy eating behaviors, b) quality of life (physical, psychological and relational), and c) risk level for heart disease.
The specific aims are to assess the feasibility of implementing the PaTH Intervention and of the proposed data collection plan, and to generate pilot data on all outcome variables in both the coronary artery bypass surgery patient and his/her partner to estimate effect sizes needed to determine the sample size requirements for the larger study.
The objective of the proposed feasibility study, using an experimental, two-group (n = 30 couples in each group) repeated measures design, will be to pilot test the effects of the Partners Together in Health (PaTH) Intervention versus usual care in improving the following outcomes: a) physical activity and healthy eating behaviors, b) quality of life (physical, psychological and relational), and c) risk level for heart disease. The specific aims are to assess the feasibility of implementing the PaTH Intervention and of the proposed data collection plan, and to generate pilot data on all outcome variables in both the coronary artery bypass surgery patient and his/her partner to estimate effect sizes needed to determine the sample size requirements for the larger study.
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