Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program

Burton, Nicola W.; Pakenham, Kenneth I.; Brown, Wendy J.
January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p427
Academic Journal
Background: Depression and poor social support are significant risk factors for coronary heart disease (CHD), and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY) to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. Methods/Design: In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 × 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial wellbeing and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective indicators of CHD risk (blood glucose, cholesterol [mmol·L-1], triglycerides, blood pressure). Process measures of attendance, engagement and fidelity will also be conducted. Linear analyses will be used to examine group differences in the outcome measures, and the product of coefficients method will be used to examine mediated effects. Discussion: If successful, this program will provide an innovative means by which to promote psychosocial wellbeing for heart health in the general population. The program could also be adapted to promote well-being in other at risk population subgroups. Trial registration: ACTRN12608000017325.


Related Articles

  • Anhedonia is associated with poor health status and more somatic and cognitive symptoms in patients with coronary artery disease. Pelle, Aline; Pedersen, Susanne; Erdman, Ruud; Kazemier, Marten; Spiering, Marquita; Domburg, Ron; Denollet, Johan // Quality of Life Research;Jun2011, Vol. 20 Issue 5, p643 

    Purpose: The effectiveness of cardiac rehabilitation (CR) in patients with coronary artery disease (CAD) is moderated by negative emotions and clinical factors, but no studies evaluated the role of positive emotions. This study examined whether anhedonia (i.e. the lack of positive affect)...

  • Depression as a non-causal variable risk marker in coronary heart disease. Meijer, Anna; Zuidersma, Marij; De Jonge, Peter // BMC Medicine;2013, Vol. 11 Issue 1, p1 

    Background: After decades of investigations, explanations for the prospective association between depression and coronary heart disease (CHD) are still incomplete. Discussion: Depression is often suggested to be causally related to CHD. Based on the available literature, we would rather argue...

  • Lack of a close confidant, but not depression, predicts further cardiac events after myocardial infarction. Dickens, C. M.; McGowan, L.; Percival, C.; Douglas, J.; Tomenson, B.; Cotter, L.; Heagerty, A.; Creed, F. H. // Heart;May2004, Vol. 90 Issue 5, p518 

    Objective: To assess the role of depression and lack of social support before myocardial infarction (MI) in determining outcome in a large representative sample of patients admitted after MI in the UK. Design: Prospective cohort design. Patients: 1034 consecutive patients were screened 3-4 days...

  • Depression and Social Support Impact Myocardial Outcomes. Wellbery, Caroline // American Family Physician;2/1/2004, Vol. 69 Issue 3, p633 

    Discusses the study "Effects of Treating Depression and Low Perceived Social Support on Clinical Events After Myocardial Infarction. The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial," from the June 18, 2003 issue of the "Journal of the American Medical...

  • Dimensions of Social Support and Depression in Patients at Increased Psychosocial Risk Recovering from Myocardial Infarction. Lett, Heather S.; Blumenthal, James A.; Babyak, Michael A.; Catellier, Diane J.; Carney, Robert M.; Berkman, Lisa F.; Burg, Matthew M.; Mitchell, Pamela; Jaffe, Allan S.; Schneiderman, Neil // International Journal of Behavioral Medicine;Sep2009, Vol. 16 Issue 3, p248 

    There is considerable evidence that depression and low social support are associated with increased morbidity and mortality for patients with coronary heart disease (CHD). However, there is a lack of consensus regarding the measurement of social support and its relation to depression. The...

  • Depression, stress, and the heart. Strike, P.C.; Steptoe, A. // Heart;Nov2002, Vol. 88 Issue 5, p441 

    Editorial. Explores the medical evidences on the association between depression and coronary artery diseases. Immunological abnormalities; Hematological abnormalities; Vascular endothelial dysfunction; Antidepressant treatment.

  • Treating low perceived social support and depression after myocardial infarction does not increase event-free survival. Price Jonathan R // Evidence Based Mental Health;Feb2004, Vol. 7 Issue 1, p22 

    In this article, the author discusses the randomized trial on Enhanced Recovery in Coronary Heart Disease (ENRICHD) patients in treating low perceived social support (LPSS) and depression on myocardial infarction (MI.). The author mentions the interventions by the investigators on the reduce of...

  • Psychosocial Aspects of Coronary Artery Disease Related to Military Patients. Grenier, Jodi L.; Swenson, Robert; Fitzgibbon, G. M.; Leach, Alan J. // Canadian Journal of Psychiatry;Mar1997, Vol. 42 Issue 2, p176 

    Objective: Coronary artery disease (CAD) is a major cause of nontraumatic morbidity and mortality in military personnel. Most studies of the psychosocial impact of CAD have dealt with civilian populations. The purpose of this paper is to highlight differences between military and civilian...

  • Heart Rate Variability at Rest and During Mental Stress in Patients With Coronary Artery Disease: Differences in Patients With High and Low Depression Scores. Sheffield, David; Krittayaphong, Rungroj; Cascio, Wayne E.; Light, Kathleen C.; Golden, Robert N.; Finkel, Jerry B.; Glekas, George; Koch, Gary G.; Sheps, David S. // International Journal of Behavioral Medicine;1998, Vol. 5 Issue 1, p31 

    This study tested the hypothesis that coronary artery disease (CAD) patients with high depressed mood scores differ in sympatho-vagal balance during mental stress compared to patients with low depressed mood scores. Using electrocardiographic monitoring, heart variability data from spectral...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics