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An examination of factors that influence long-term adherence to structured exercise in individuals with established heart disease

Martin, Antonia (2013) An examination of factors that influence long-term adherence to structured exercise in individuals with established heart disease. Master of Science thesis, Dublin City University.

Background: Long-term adherence to physical activity (PA) following a cardiac event is uncommon. Interventions aiming to address this issue must take into account the influences and motivations of successful long-term adherers and strive to utilise available resources to ensure cost-effectiveness and sustainability. The purpose of this study was to examine factors influencing sustained adherence to an established Phase IV community-based cardiac rehabilitation programme: HeartSmart. This information was used to design, implement and evaluate an intervention to increase adherence among programme newcomers. Methods: Twenty-four long-term adherers of HeartSmart (N=15 men, 9 women; aged 67.7 years ± 16.7) took part in focus group discussions to determine factors assisting adherence. Results influenced the development of a Peer Mentor (PM) training programme. Eight long-term adherers (100% male, 64-77yrs) completed PM training (8 hours) covering social support, self-efficacy, benefits and barriers of PA adherence and goal setting. The PM role was to provide support, during 2 weekly exercise sessions, to programme newcomers (Mentees). Mentees (N=13, 82% male, 50-77yrs), who had recently experienced a cardiac event were recruited and paired with a PM. Outcome measures included focus groups with PMs and 1-1 interviews with Mentees. Attendance rates, psychosocial correlates (Mentees only) and PA levels were also measured. Results: Social support, elements of the structured class, health benefits and self-efficacy were the strongest influences of long-term adherers of HeartSmart. PMs rated training highly and reported a positive experience in the role. Challenges identified included assistance with exercise mastery and gauging support required by the Mentees. Mentees: Eight Mentees (7 male) were still attending HeartSmart at 6-weeks (mean 67% adherence) and reported positive experiences of the PM intervention. Reasons for dropout included injury (N=2), illness (1), pace too challenging (N=1) and feeling too young for the class (N=1). Conclusion: The intervention demonstrated positive results for both PMs and Mentees. It helped newcomers ‘fit in’ to an ‘old programme’. However, peer mentoring alone was insufficient to address adherence issues for all participants; future research needs to examine this problem further.
Item Type:Thesis (Master of Science)
Date of Award:February 2013
Supervisor(s):Woods, Catherine
Uncontrolled Keywords:Exercise; Cardiovascualr disease
Subjects:Medical Sciences > Health
DCU Faculties and Centres:DCU Faculties and Schools > Faculty of Science and Health > School of Health and Human Performance
Use License:This item is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 License. View License
ID Code:17726
Deposited On:05 Apr 2013 13:39 by Catherine Woods . Last Modified 05 Apr 2013 13:39

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