Annals of Behavioral Medicine

, Volume 31, Issue 1, pp 53–62 | Cite as

Effects of a CHANGE intervention to increase exercise maintenance following cardiac events

  • Shirley M. Moore
  • Jacqueline M. Charvat
  • Nahida H. Gordon
  • Beverly L. Roberts
  • Fredric Pashkow
  • Paul Ribisl
  • Michael Rocco


Background: Despite participation in a cardiac rehabilitation program, there is a downward trajectory of exercise participation during the year following a cardiac event.Purpose: The purpose of this study was to test the effectiveness of CHANGE (Change Habits by Applying New Goals and Experiences), a lifestyle modification program designedto increase exercise maintenance in the year following a cardiac rehabilitation program. The CHANGE intervention consists of 5 small-group cognitive-behavioral change counseling sessions in which participants are taught self-efficacy enhancement, problem-solving skills, and relapse prevention strategies to address exercise maintenance problems.Method: Participants (N = 250) were randomly assigned to the CHANGE intervention (supplemental to usual care) or a usual-care-only group. Exercise was measured using portable wristwatch heart rate monitors worn during exercise for 1 year. Cox proportional hazards regression was used to determine differences in exercise over the study year between the study groups.Results: Participants in the usual-care group were 76% more likely than those in the CHANGE group to stop exercising during the year following a cardiac rehabilitation program (hazard ratio = 1.76, 95% confidence interval = 1.08–2.86, p = .02) when adjusting for the significant covariates race, gender, comorbidity, muscle and joint pain, and baseline motivation. Most participants, however, had less than recommended levels of exercise amount and intensity.Conclusions: Counseling interventions that use contemporary behavior change strategies, such as theCHANGEintervention, can reduce the number of individuals who do not exercise following cardiac events.


Cardiac Rehabilitation Behavioral Medicine Cardiorespiratory Fitness Cardiac Rehabilitation Program Exercise Frequency 
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Copyright information

© The Society of Behavioral Medicine 2006

Authors and Affiliations

  • Shirley M. Moore
    • 1
  • Jacqueline M. Charvat
    • 1
  • Nahida H. Gordon
    • 1
  • Beverly L. Roberts
    • 1
  • Fredric Pashkow
    • 2
  • Paul Ribisl
    • 3
  • Michael Rocco
    • 4
  1. 1.Associate Dean and Professor of NursingCase Western Reserve UniversityCleveland
  2. 2.Sanofi~SynthelaboBridgewaterNew Jersey
  3. 3.Wake Forest UniversityUSA
  4. 4.Cleveland Clinic FoundationUSA

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