Designing a theory- and evidence-based tailored eHealth rehabilitation aftercare program in Germany and the Netherlands: study protocol

Dominique Reinwand, Tim Kuhlmann, Julian Wienert, Hein de Vries, Sonia Lippke, Dominique Reinwand, Tim Kuhlmann, Julian Wienert, Hein de Vries, Sonia Lippke

Abstract

Background: Cardiac rehabilitation programs aim to improve health status and to decrease the risk of further cardiac events. Persons undergoing rehabilitation often have difficulties transferring the learned health behaviors into their daily routine after returning home and maybe to work. This includes physical activity as well as fruit and vegetable consumption. Computer-based tailored interventions have been shown to be effective in increasing physical activity as well as fruit and vegetable consumption. The aim of this study is, to support people in transferring these two learned behavior changes and their antecedents into their daily life after cardiac rehabilitation.

Methods: The study will have a randomized controlled design and will be conducted among German and Dutch people who participated in cardiac rehabilitation. The study will consist of one intervention group which will be compared to a waiting list control group. During the eight week duration of the intervention, participants will be invited to participate in the online after-care program once per week. The intervention encourages participants to define individual health behavior goals as well as action, and coping plans to reach these self-determined goals. The effectiveness of the program will be compared between the intervention condition and the control group in terms of behavior change, antecedents of behavior change (e.g., self-efficacy), ability to return to work and increased well-being. Further, subgroup-differences will be assessed including differences between the two countries, socioeconomic inequalities and across age groups.

Discussion: The present study will make a contribution to understanding how such an online-based tailored interventions enables study participants to adopt and maintain a healthy lifestyle. Implications can include how such an online program could enrich cardiac rehabilitation aftercare further.

Trial registration: NTR 3706, NCT01909349.

Figures

Figure 1
Figure 1
Ipsative feedback pieces of fruit and vegetable consumption.

References

    1. Yusuf S, Reddy S, Ôunpuu S, Anand S. Global burden of cardiovascular diseases. Circulation. 2001;104(23):2855–2864.
    1. Factsheet cardiovascular diseases (CVD) [< ]
    1. Allender S, Scarborough P, Peto V, Rayner M. European Cardiovascular Disease Statistics 2008. British Heart Foundation Health Promotion Research Group Department of Public Health, University of Oxford; 2008.
    1. Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JAM, Franklin B, Sanderson B, Southard D. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. J Cardiopulm Rehabil Prev. 2007;27(3):121–129.
    1. Revalidatiecommissie, NVVC, NHS, PAAHR p. Multidisicplinaire Richtlijn Hartrevalidatie 2011. Utrecht: Nederlandse Vereniging Voor Cardiology; 2011.
    1. Vidal-Perez R, Otero-Raviña F, Franco M, Rodríguez Garcia JM, Stolle RL, Díaz CI, López EO, Vázquez López MJ, Gonzalez-Juanatey JR. Determinants of cardiovascular mortality in a cohort of primary care patients with chronic ischemic heart disease. BARBANZA Ischemic Heart Disease (BARIHD) study. Int J Cardiol. 2012;2(31):442–450.
    1. Perk J, De Backer G, Gohlke H, Graham I, Reiner Ž, Verschuren WMM, Albus C, Benlian P, Boysen G, Cifkova R. et al.European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by Representatives of Nine Societies and by Invited Experts) Atherosclerosis. 2012;223(1):1–68.
    1. Houle J, Doyon O, Vadeboncoeur N, Turbide G, Diaz A, Poirier P. Effectiveness of a pedometer-based program using a socio-cognitive intervention on physical activity and quality of life in a setting of cardiac rehabilitation. Can J Cardiol. 2012;28(1):27–32.
    1. Guiraud T, Granger R, Gremeaux V, Bousquet M, Richard L, Soukarié L, Babin T, Labrunée M, Sanguignol F, Bosquet L. et al.Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. Arch Phys Med Rehabil. 2012;93(12):2141–2147.
    1. Swift DL, Lavie CJ, Johannsen NM, Arena R, Earnest CP, O’Keefe JH, Milani RV, Blair SN, Church TS. Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention. Circ J. 2013;77(2):281–292.
    1. Eades M, Chasen M, Bhargava R. Rehabilitation: long-term physical and functional changes following treatment. Semin Oncol Nurs. 2009;25(3):222–230.
    1. Pavy B, Iliou M-C, Vergès-Patois B, Brion R, Monpère C, Carré F, Aeberhard P, Argouach C, Borgne A, Consoli S. et al.French Society of Cardiology guidelines for cardiac rehabilitation in adults. Arch Cardiovasc Dis. 2012;105(5):309–328.
    1. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. ACC Curr J Rev. 2002;11(4):33–34.
    1. Taylor RS, Brown A, Ebrahim S, Jolliffe J, Noorani H, Rees K, Skidmore B, Stone JA, Thompson DR, Oldridge N. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med. 2004;116(10):682–692.
    1. Manson JE, Tosteson H, Ridker PM, Satterfield S, Hebert P, Oconnor GT, Buring JE, Hennekens CH. Medical progress - the primary prevention of myocardinal-infarction. N Engl J Med. 1992;326(21):1406–1416.
    1. Bazzano LA, He J, Ogden LG, Loria CM, Vupputuri S, Myers L, Whelton PK. Fruit and vegetable intake and risk of cardiovascular disease in US adults: the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Am J Clin Nutr. 2002;76(1):93–99.
    1. Nicklett EJ, Semba RD, Xue Q-L, Tian J, Sun K, Cappola AR, Simonsick EM, Ferrucci L, Fried LP. Fruit and vegetable intake, physical activity, and mortality in older community-dwelling women. J Am Geriatr Soc. 2012;60(5):862–868.
    1. Zhang X, Shu X-O, Xiang Y-B, Yang G, Li H, Gao J, Cai H, Gao Y-T, Zheng W. Cruciferous vegetable consumption is associated with a reduced risk of total and cardiovascular disease mortality. Am J Clin Nutr. 2011;94(1):240–246.
    1. Ness AR, Powles JW. Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol. 1997;26(1):1–13.
    1. Dauchet L, Amouyel P, Dallongeville J. Fruits, vegetables and coronary heart disease. Nat Rev Cardiol. 2009;6(9):599–608.
    1. Mirmiran P, Noori N, Zavareh MB, Azizi F. Fruit and vegetable consumption and risk factors for cardiovascular disease. Metabolism. 2009;58(4):460–468.
    1. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B. et al.European Guidelines on Cardiovascular Disease Prevention in Clinical Practice: executive summary. Eur Heart J. 2007;28(19):2375–2414.
    1. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, Franklin B, Kris-Etherton P, Harris WS, Howard B. et al.Diet and lifestyle recommendations revision 2006. Circulation. 2006;114(1):82–96.
    1. Ades PA, Huang D, Weaver SO. Cardiac rehabilitation participation predicts lower rehospitalization costs. Am Heart J. 1992;123(4):916–921.
    1. Lavie CJ, Milani R. Benefits of cardiac rehabilitation in the elderly. CHEST Journal. 2004;126(4):1010–1012.
    1. Bock BC, Albrecht AE, Traficante RM, Clark MM, Pinto BM, Tilkemeier P, Marcus BH. Predictors of exercise adherence following participation in a cardiac rehabilitation program. Int J Behav Med. 1997;4(1):60–75.
    1. Halm M, Penque S, Doll N, Beahrs M. Women and Cardiac Rehabilitation: Referral and Compliance Patterns. Nursing: Journal of Cardiovascular; 1999. p. 13(3).
    1. Reuter T, Ziegelmann JP, Lippke S, Schwarzer R. Long-term relations between intentions, planning, and exercise: a 3-year longitudinal study after orthopedic rehabilitation. Rehabil Psychol. 2009;54(4):363–371.
    1. Korsukéwitz C, Falk J, Lindow B. Kardiologische rehabilitation in Deutschland: Erfolgsmodell mit Perspektive - cardiac rehabilitation in Germany: a successful model with promising prospects. Herz. 2012;37(1):12–21.
    1. Kordy H, Theis F, Wolf M. Moderne informations- und Kommunikationstechnologie in der rehabilitation. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011;54(4):458–464.
    1. Brug J, Oenema A, Campbell M. Past, present, and future of computer-tailored nutrition education. Am J Clin Nutr. 2003;77(4):1028–1034.
    1. Ritterband LM, Thorndike FP, Cox DJ, Kovatchev BP, Gonder-Frederick LA. A behavior change model for internet interventions. Ann Behav Med. 2009;38(1):18–27.
    1. Noar SM, Benac CN, Harris MS. Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychol Bull. 2007;133(4):673–693.
    1. Krebs P, Prochaska JO, Rossi JS. A meta-analysis of computer-tailored interventions for health behavior change. Prev Med. 2010;51(3–4):214–221.
    1. Smit ES, Evers SM, de Vries H, Hoving C. Cost-effectiveness and cost-utility of internet-based computer tailoring for smoking cessation. J Med Internet Res. 2013;15:3.
    1. van Keulen HM, Bosmans JE, van Tulder MW, Severens JL, de Vries H, Brug J, Mesters I. Cost-effectiveness of tailored print communication, telephone motivational interviewing, and a combination of the two: results of an economic evaluation alongside the Vitalum randomized controlled trial. Int J Behav Nutr Phy. 2010;7(1):64.
    1. Fleig L, Lippke S, Pomp S, Schwarzer R. Promoting exercise maintenance: How interventions with booster sessions improve long-term rehabilitation outcomes. Rehabilitation Psychology. 2013; : .
    1. Fleig L, Lippke S, Pomp S, Schwarzer R. Intervention effects of exercise self-regulation on physical exercise and eating fruits and vegetables: a longitudinal study in orthopedic and cardiac rehabilitation. Prev Med. 2011;53(3):182–187.
    1. Kreuter MW, Farrell D, Olevitch L, Brennan L. Tailoring Health Messages: Customizing Communication with Computer Technology. Mahwah, NJ: Erlabum; 2000.
    1. Bental DS, Cawsey A, Jones R. Patient information systems that tailor to the individual. Patient Educ Couns. 1999;36(2):171–180.
    1. Dijkstra A, De Vries H. The development of computer-generated tailored interventions. Patient Educ Couns. 1999;36(2):193–203.
    1. Schulz DN, Schneider F, de Vries H, van Osch LA, van Nierop PW, Kremers SP. Program completion of a web-based tailored lifestyle intervention for adults: differences between a sequential and a simultaneous approach. J Med Internet Res. 2012;14:2.
    1. Brug J, Campbell M, van Assema P. The application and impact of computer-generated personalized nutrition education: a review of the literature. Patient Educ Couns. 1999;36(2):145–156.
    1. Lustria MLA, Cortese J, Noar SM, Glueckauf RL. Computer-tailored health interventions delivered over the web: review and analysis of key components. Patient Educ Couns. 2009;74(2):156–173.
    1. Weinstein ND, Sandman PM. Health Behavior and Health Education: Theory, Research and Practice. San Francisco: Jossey-Bass; 2002. The precaution adoption process model; pp. 121–143.
    1. van Engen-Verheul M, de Vries H, Kemps H, Kraaijenhagen R, de Keizer N, Peek N. Cardiac rehabilitation uptake and its determinants in the Netherlands. Eur J Prev Cardiol. 2012;20(2):349–356.
    1. Revalidatie Nederland. Brancherapport Revalidatie 2010. Utrecht: Revalidatie Nederland; 2011.
    1. Karoff M, Held K, Bjarnason-Wehrens B. Cardiac rehabilitation in Germany. Eur J Cardiovasc Prev Rehabil. 2007;14(1):18–27.
    1. DRB. Reha-Bericht. Die medizinische und berufliche Rehabilitation der Rentenversicherung im Licht der Statistik. Berlin: Deutsche Rentenversicherung Bund; 2012.
    1. Hahmann HW. Kardiologische Rehabilitation. Aktueller Stand und zukünftige Anforderungen. Herz. 2012;37(1):22–29.
    1. Bjarnason-Wehrens B. Kardiologische Rehabilitation in Europa; wann ambulante, wann stationäre kardiologische Rehabilitation aus der Sicht der European Association for Cardiovascular Prevention and Rehabilitation. Clin Res Cardiol Suppl. 2009;4(2):82.
    1. Schwarzer R. Modeling health behavior change: how to predict and modify the adoption and maintenance of health behaviors. Appl Psychol. 2008;57(1):1–29.
    1. Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA) Rehabil Psychol. 2011;56(3):161–170.
    1. Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008;27(3):379–387.
    1. Schulz DN, Kremers SP, van Osch LA, Schneider F, van Adrichem MJ, de Vries H. Testing a Dutch web-based tailored lifestyle programme among adults: a study protocol. BMC Public Health. 2011;11(1):108.
    1. Oenema A, Brug J, Dijkstra A, de Weerdt I, de Vries H. Efficacy and use of an internet-delivered computer-tailored lifestyle intervention, targeting saturated fat intake, physical activity and smoking cessation: a randomized controlled trial. Ann Behav Med. 2008;35(2):125–135.
    1. Sniehotta F, Scholz U, Schwarzer R. Action plans and coping plans for physical exercise: a longitudinal intervention study in cardiac rehabilitation. Br J Health Psychol. 2006;11(1):23–37.
    1. DiClemente CC, Marinilli AS, Singh M, Bellino LE. The role of feedback in the process of health behavior change. Am J Health Behav. 2001;25(3):217–227.
    1. van Keulen HM, Mesters I, Ausems M, van Breukelen G, Campbell M, Resnicow K, Brug J, de Vries H. Tailored print communication and telephone motivational interviewing are equally successful in improving multiple lifestyle behaviors in a randomized controlled trial. Ann Behav Med. 2011;41(1):104–118.
    1. Reips U-D, Funke F. Interval-level measurement with visual analogue scales in internet-based research: VAS generator. Behav Res Methods. 2008;40(3):699–704.
    1. Funke F, Reips U-D. Why semantic differentials in web-based research should be made from visual analogue scales and not from 5-point scales. Field Methods. 2012;24(3):310–327.
    1. Mäder URS, Martin BW, Schutz Y, MartiI B. Validity of four short physical activity questionnaires in middle-aged persons. Med Sci Sports Exerc. 2006;38(7):1255–1266.
    1. Rafferty AP, Anderson JV, McGee HB, Miller CE. A healthy diet indicator: quantifying compliance with the dietary guidelines using the BRFSS. Prev Med. 2002;35(1):9–15.
    1. Lippke S, Ziegelmann JP, Schwarzer R, Velicer WF. Validity of stage assessment in the adoption and maintenance of physical activity and fruit and vegetable consumption. Health Psychol. 2009;28(2):183–193.
    1. Nigg CR. There is more to stages of exercise than just exercise. Exerc Sport Sci Rev. 2005;33(1):32–35.
    1. Luszczynska A, Sutton S. Physical activity after cardiac rehabilitation: evidence that different types of self-efficacy are important in maintainers and relapsers. Rehabil Psychol. 2006;51(4):314–321.
    1. Schulz DN, Schneider F, de Vries H, van Osch LADM, van Nierop PWM, Kremers SPJ. Program completion of a web-based tailored lifestyle intervention for adults: differences between a sequential and a simultaneous approach. J Med Internet Res. 2012;14(2):e26.
    1. Perloff LS, Fetzer BK. Self-other judgments and perceived vulnerability to victimization. J Pers Soc Psychol. 1986;50(3):502–510.
    1. Lippke S, Schwarzer R, Ziegelmann JP, Scholz U, Schüz B. Testing stage-specific effects of a stage-matched intervention: a randomized controlled trial targeting physical exercise and its predictors. Health Educ Behav. 2010;37(4):533–546.
    1. Fuchs R, Schwarzer R. Selbstwirksamkeit zur sportlichen Aktivität: Reliabilität und Validität eines neuen Messinstrumentes. Zeitschrift für differentielle und diagnostische Psychologie. 1994;15(3):141–154.
    1. Jackson J, Lippke S, Gray CD. Stage-specific prediction of physical activity in orthopaedic patients after rehabilitation treatment. Int J Sport Psychol. 2011;42(6):586–609.
    1. Verplanken B, Orbell S. Reflections on past behavior: a self-report index of habit strength. J Appl Soc Psychol. 2003;33(6):1313–1330.
    1. Groupt WHOQOL. Study Protocol for the World Health Organization Project to Develop a Quality of Life Assessment Instrument (WHOQOL) Qual Life Res. 1993;2(2):153–159.
    1. Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H. Australian WHOQOL-100, WHOQOL-BREF and CA-WHOQOL instruments. User’s Manual and Interpretation Guide. Melbourne, Australia: University of Melbourne Department of Psychiatry St Vincent’s Mental Health Service; 2000.
    1. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D. Am J Prev Med. 1994;10(2):77–84.
    1. Boehmer S. Relationships between felt age and perceived disability, satisfaction with recovery, self-efficacy beliefs and coping strategies. J Health Psychol. 2007;12(6):895–906.
    1. Knauper B, Rabiau M, Cohen O, Patriciu N. Compensatory health beliefs: scale development and psychometric properties. Psychol Health. 2004;19(5):607–624.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
    1. Rothwell PM. Subgroup analysis in randomised controlled trials: importance, indications, and interpretation. Lancet. 2005;365(9454):176–186.
    1. Cui Y, Blumenthal RS, Flaws JA, Whiteman MK, Langenberg P, Bachorik PS, Bush TL. Non-high-density lipoprotein cholesterol level as a predictor of cardiovascular disease mortality. Arch Intern Med. 2001;161(11):1413–1419.

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