A randomized trial of an optimism training intervention in patients with heart disease

Optimism is prospectively and independently associated with superior cardiac outcomes, but there has been minimal study of optimism-specific interventions in persons with cardiovascular illness. We aimed to examine the feasibility and impact of an optimism-promoting program among patients with heart disease in a randomized controlled trial.

Participants (N=61) were outpatients, age 35-60, with coronary artery disease who were randomized to an 8-week in-person group-based optimism training intervention or an attention-matched educational control condition. Feasibility was assessed via rates of session attendance and exercise completion, and acceptability was assessed via weekly participant ratings of exercise ease, utility, and likelihood of continuation. The impact of the intervention was assessed via between-group differences in change from baseline optimism (Life Orientation Test-Revised [LOT-R]) and other psychological self-report outcomes at 8weeks (primary time point) and 16weeks, using random effects regression models.

Participants completed a mean of 6.8 (SD 1.2) sessions and 13.9 (SD 2.4) exercises, with mean ratings all >3.5/5 on measures of acceptability. The intervention was associated with greater improvement in optimism at 8weeks (β=5.13; 95% confidence interval [CI]=3.55, 6.70; p<0.001) and 16weeks; the intervention was also associated with greater improvements in life satisfaction, hope, and anxiety at both time points, though not with positive or negative affect.

A group-based optimism training program was feasible, acceptable, and associated with improvements in optimism and other psychological measures in cardiac patients. Future larger studies should examine effects on major clinical outcomes.