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Mediators of exercise maintenance after cardiac rehabilitation
Pinto BM, Dunsiger SI
Journal of Cardiopulmonary Rehabilitation and Prevention 2015 Jan-Feb;35(1):13-20
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSE: Exercise maintenance after completing phase II cardiac rehabilitation (CR) is challenging for many patients. A telephone-based maintenance intervention improved exercise participation compared with a control group at 12 months post-CR discharge. We examined the 6-month mediators of intervention effects on exercise. METHODS: In a randomized controlled trial, 130 patients who had completed CR (mean age 63.6 (SD 9.7) years, 20.8% female) were randomized to maintenance counseling (n = 64) or contact control (n = 66). Putative mediators examined the following: self-efficacy, behavioral processes of change, decisional balance index, social support for exercise, and enjoyment of exercise. RESULTS: Multiple mediation analyses showed that the intervention significantly increased social support from friends at 6 months but not the other constructs. Decreasing support from friends mediated greater exercise participation in maintenance counseling than in contact control at 12 months. CONCLUSIONS: Social support from friends functioned as a suppressor mediator for exercise maintenance among cardiac patients.
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