Developing a positive psychology intervention to improve cardiac health behaviors

制定积极的心理干预措施以改善心脏健康行为

基本信息

批准号：
9212833
负责人：
Jeff C Huffman
金额：
$ 54.55万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-02-01 至 2020-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9212833
关键词：
Accelerometer Acute Adherence Affect American Applied Research Aspirin Basic Science Behavior Behavior Therapy Cardiac Cardiac health Cardiovascular system Clinical Cognition Communities Complex Data Development Developmental Process Diet Dose Emotions Enrollment Event Exercise Fat-Restricted Diet Feeling Frequencies Grant Happiness Health Health behavior Health behavior change Heart Heart Diseases Human Individual Intervention Intervention Studies Interview Link Measures Medical Mental Depression Methodology Myocardial Infarction Names Outcome Outcome Measure Outcome Study Patients Persons Pharmaceutical Preparations Phonation Physical activity Play Population Prevention Psychological Factors Psychology Public Health Qualitative Research Quality of life Randomized Recommendation Recurrence Regimen Research Risk Role Secondary Prevention Structure Telephone Testing Time Translating Treatment Step Work acute coronary syndrome arm attentional control base behavioral/social science cohort cost design diet and exercise efficacy trial emotional experience experience good diet gratitude improved innovation medication compliance mortality motivational enhancement therapy negative emotional state optimism pilot trial positive emotional state prevent primary outcome programs psychologic public health relevance success therapy development trial design

项目摘要

DESCRIPTION (provided by applicant): Preventing medical events is a critical public health concern, and adherence to recommended health behaviors can play a major role in such prevention. A key example of the importance of health behavior is in the secondary prevention of recurrent cardiovascular events in patients suffering an acute coronary syndrome (ACS). Despite the undeniable importance of health behaviors (e.g., physical activity, following a low-fat diet) in post-ACS patients, many are unable to follow these medical recommendations. Positive psychological states, especially optimism, have been linked to greater participation in healthy behaviors and superior cardiovascular outcomes in persons with and without heart disease. An emerging field of psychological interventions has focused on increasing the frequency and intensity of positive states, and these 'positive psychology' programs have consistently led to improvements in happiness, reductions in depression, and improvements in overall well-being in healthy individuals. However, such interventions have not been well-studied in ACS patients, and their effect on health behaviors has not been examined. Consistent with PA-11-063 (Translating Basic Behavioral and Social Science Discoveries into Interventions to Improve Health-Related Behaviors), we propose a multi-step treatment development project to utilize positive psychological interventions to improve specific health behaviors (physical activity, diet, and medication adherence) in patients initially hospitalized with ACS. We will perform qualitative research via semi-structured interviews to better understand the relationship between positive emotions and health behaviors in this cohort, and will design a positive psychological intervention that is suited to this population. We will then pilot test components of this intervention to assess initial feasibility/acceptability and understand the optimal components and 'dosing' of the intervention. Finally, we will end with a small randomized efficacy trial of our revised treatment in ACS patients. The trials in this grant will enroll a minimum of 208 subjects admitted with ACS, and will utilize a phone-based intervention to improve feasibility and reduce cost. The primary outcome measure for studies in this grant will be physical activity, as measured via an accelerometer. We selected this outcome because of the importance of this health behavior and the substantial difficulty that many ACS patients have in initiating and maintaining a physical activity regimen, and because positive emotions have been linked to greater physical activity. Given that the intervention may have broader effects, however, we will also measure the impact of our intervention on following a heart-healthy diet (evaluated via structured assessment) and adhering to medication (aspirin, as measured by cap openings). By the end of the grant period, we will have (in concordance with the PA) created a viable positive psychology- based intervention that will be ready for testing in a larger, multisite efficacy trial that is adequately powered to detect significant improvements in physical activity and other important health behaviors in ACS patients.

描述（由申请人提供）：预防医疗事件是一个重要的公共卫生问题，遵守建议的健康行为可以在此类预防中发挥重要作用。健康行为重要性的一个关键例子是急性冠脉综合征 (ACS) 患者复发性心血管事件的二级预防。尽管健康行为（例如身体活动、低脂饮食）的重要性不可否认在 ACS 后患者中，许多人无法遵循这些医疗建议。积极的心理状态，尤其是乐观情绪，与患有或不患有心脏病的人更多地参与健康行为和改善心血管结局有关。一个新兴的心理干预领域专注于增加积极状态的频率和强度，这些“积极心理学”计划持续改善健康个体的幸福感，减少抑郁症并改善整体福祉。然而，此类干预措施尚未在 ACS 患者中得到充分研究，其对健康行为的影响也尚未得到检验。根据 PA-11-063（将基本行为和社会科学发现转化为改善健康相关行为的干预措施），我们提出了一个多步骤治疗开发项目，利用积极的心理干预措施来改善特定的健康行为（身体活动、饮食、和药物依从性）最初因 ACS 住院的患者。我们将通过半结构化访谈进行定性研究，以更好地了解该人群积极情绪与健康行为之间的关系，并设计适合该人群的积极心理干预措施。然后，我们将试点测试该干预措施的各个组成部分，以评估最初的可行性/可接受性，并了解干预措施的最佳组成部分和“剂量”。最后，我们将对 ACS 患者的改良治疗进行小型随机疗效试验。这笔拨款中的试验将招募至少 208 名 ACS 患者，并将利用基于电话的干预来提高可行性并降低成本。本次资助研究的主要结果指标将是通过加速度计测量的身体活动。我们选择这个结果是因为这种健康行为的重要性以及许多 ACS 患者在开始和维持身体活动方案方面遇到的巨大困难，并且因为积极的情绪与更大的身体活动有关。然而，鉴于干预措施可能产生更广泛的影响，我们还将衡量干预措施对遵循心脏健康饮食（通过结构化评估进行评估）和坚持药物治疗（阿司匹林，通过瓶盖开口测量）的影响。到资助期结束时，我们将（与 PA 一致）创建一种可行的基于积极心理学的干预措施，该干预措施将准备好在更大规模的多站点功效试验中进行测试它有足够的能力检测 ACS 患者身体活动和其他重要健康行为的显着改善。

项目成果

期刊论文数量（38）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Is it better to cultivate positive affect or optimism? Predicting improvements in medical adherence following a positive psychology intervention in patients with acute coronary syndrome.

培养积极情绪或乐观情绪哪个更好？

DOI：
10.1016/j.genhosppsych.2019.06.001
发表时间：
2019
期刊：
General hospital psychiatry
影响因子：
7
作者：
Duque,Laura;Brown,Lydia;Celano,ChristopherM;Healy,Brian;Huffman,JeffC
通讯作者：
Huffman,JeffC

Depression and cardiac disease: epidemiology, mechanisms, and diagnosis.

DOI：
10.1155/2013/695925
发表时间：
2013
期刊：
Cardiovascular psychiatry and neurology
影响因子：
0
作者：
Huffman JC;Celano CM;Beach SR;Motiwala SR;Januzzi JL
通讯作者：
Januzzi JL

State Gratitude for One's Life and Health after an Acute Coronary Syndrome: Prospective Associations with Physical Activity, Medical Adherence and Re-hospitalizations.

急性冠状动脉综合征后对一个人的生命和健康的感激之情：与身体活动、医疗依从性和再住院的前瞻性关联。

DOI：
10.1080/17439760.2017.1414295
发表时间：
2019
期刊：
The journal of positive psychology
影响因子：
0
作者：
Legler,SeanR;Beale,EleanorE;Celano,ChristopherM;Beach,ScottR;Healy,BrianC;Huffman,JeffC
通讯作者：
Huffman,JeffC

The Effects of Mindfulness and Meditation on Vagally Mediated Heart Rate Variability: A Meta-Analysis.