Related Experiment Video
Updated: Jun 5, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Effectiveness of behavior change techniques in eHealth-based cardiac rehabilitation in patients with coronary artery
Emma R Douma1, Tom Roovers1, Mirela Habibović1
1Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, The Netherlands.
Insights
Action planning is an effective behavior change technique in eHealth cardiac rehabilitation (CR). Reducing prompts/cues is not effective, and feedback effectiveness varies by behavior, highlighting the need for tailored interventions in eHealth CR.
Area of Science:
- Cardiology
- Digital Health
- Behavioral Science
Background:
- Cardiac rehabilitation (CR) improves outcomes for coronary artery disease (CAD) patients.
- eHealth-based CR can increase participation but requires research into effective components.
- Behavior change techniques (BCTs) are crucial for optimizing eHealth CR interventions.
Purpose of the Study:
- To systematically review and identify effective BCTs used in eHealth-based CR interventions.
- To synthesize evidence on the effectiveness of various BCTs in improving patient adherence and outcomes.
- To guide the development of more effective digital health strategies for cardiovascular disease management.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from four databases until January 2023.
- Included RCTs focused on eHealth interventions for patients with CAD.
- BCTs were coded using the Behavior Change Taxonomy, and a best-evidence synthesis was performed.
Main Results:
- 88 studies involving 25,007 participants used 31 distinct BCTs.
- Common BCTs included instructions, social support, and information on health consequences.
- Action planning showed strong evidence (A+) for medication adherence and diet; reducing prompts/cues showed mixed results (A-).
Conclusions:
- Action planning is a highly effective BCT in eHealth CR.
- Reducing prompts/cues is not consistently effective.
- Feedback on behavior effectiveness is behavior-dependent, emphasizing the importance of BCT-behavior matching in eHealth CR.
Background:
Participation in cardiac rehabilitation (CR) reduces risk of cardiovascular mortality, improves functional capacity and enhances quality of life in patients with coronary artery disease (CAD). eHealth-based CR can increase participation rates, but research into effective components is necessary. The objective of this systematic review was to identify effective behavior change techniques (BCTs) used in eHealth-based CR interventions.
Methods:
A search of four databases (CINAHL, PubMed, PsychINFO, and MEDLINE) was conducted until January 10, 2023. Randomized controlled trials investigating eHealth-based interventions for patients with CAD were included. Risk of bias was assessed using the Effective Public Healthcare Practice Project tool. BCTs were coded following the Behavior Change Taxonomy. A best-evidence synthesis was conducted to determine the effectiveness of BCTs, with ratings ranging from A (strong evidence indicating either a positive effect (+) or no effect (-)) to D (no data collected).
Results:
A total of 88 studies (25,007 participants) met the eligibility criteria. The interventions in these studies used 31 different BCTs. The most common BCTs were instructions on how to perform the behavior (k = 86), social support (k = 69) and and information about health consequences (k = 56). The evidence for action planning was rated as A+ for medication adherence and diet. Conversely, for systematically decreasing the number of prompts/cues sent during an intervention, the evidence was rated as A- for physical activity, medication adherence and smoking cessation. The evidence for feedback on behavior was rated as A+ for medication adherence and A- for smoking cessation.
Conclusions:
Action planning is effective as a BCT in eHealth-based CR, whereas reducing prompts/cues is not. Feedback on behavior may, depending on the behavior targeted, exert both positive and no effect, suggesting that BCT-behavior matching is important to optimize effectiveness of eHealth-based CR.
Related Concept Videos
01:30Stress Prevention and Stress Management Techniques VI
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:17Exercise and Cardiac Output
Sustained exercise increases the muscles' oxygen demand, which can be...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:26Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
01:26Stress Prevention and Stress Management Techniques I
Conscientiousness
Conscientious individuals tend to be organized, responsible, and disciplined. They prioritize completing tasks and following structured routines,...