Comparing exercise determinants between Black and White older adults with heart failure

Area of Science:

• Cardiology
• Geriatrics
• Behavioral Science

Background:

• Heart failure significantly impacts older adults' mortality.
• Regular exercise improves survival rates in heart failure patients.
• Racial disparities in exercise engagement among heart failure patients require investigation.

Purpose of the Study:

• To apply the Health Belief Model to understand racial differences in exercise behavior determinants.
• To compare exercise behavior predictors between Black and White older adults with heart failure.

Main Methods:

• Utilized data from the HF-ACTION Trial, a multi-site study promoting exercise in heart failure patients.
• Employed structural equation modeling to analyze changes in Health Belief Model constructs and exercise behavior over 12 months.
• Included 671 older adults (230 Black, 441 White) with heart failure and reduced ejection fraction.

Main Results:

• Perceived benefits, self-efficacy, perceived threats, and perceived barriers predicted exercise behavior in both racial groups.
• The intervention enhanced perceived benefits and self-efficacy for both Black and White participants.
• Intervention effectively addressed perceived barriers only in White participants; perceived threats did not change in either group.

Conclusions:

• The Health Belief Model highlights racial differences in exercise behavior determinants for heart failure patients.
• Interventions must consider race-specific barriers, particularly for Black older adults with heart failure.
• Future research should focus on addressing exercise barriers unique to Black older adults with heart failure.