Vet-Harts Pilot Intervention for Veterans With Coronary Heart Disease

Study Overview
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Brief Summary
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The purpose of this research study is to survey patients to learn about their beliefs and behaviors related to the management of heart disease and to discuss options for making healthy lifestyle changes. From the information the investigators get from patients, the investigators hope to develop better methods for taking care of patients who have heart disease.

Detailed Description
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Coronary heart disease (CHD) is a significant health threat among veterans. Compared to their civilian counterparts, veterans experience greater disability, reinfarction, and mortality following myocardial infarction (MI) and other acute coronary syndromes (ACS). High rates of hypertension, diabetes, and cardiac risk behaviors (e.g., smoking) and low socioeconomic status (SES) further increase veterans' CHD-related morbidity and mortality. The proposed pilot project will establish the feasibility of a telehealth nursing intervention for veterans with CHD who are recovering from MI/ACS. The Veterans Heart Attack Representations Telehealth (Vet-HART) intervention is designed to promote adaptive conceptual change in veterans' beliefs (common sense models or representations) about CHD etiology and self-management and facilitate health behavior changes (e.g., smoking cessation, medication adherence, diet management, and increased physical activity). The long-term goal of this research program is to improve veterans' quality of life (QoL) and reduce their CHD-related morbidity/mortality. The proposed project is the requisite next step in attaining that goal.

Official Title
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Representational Telehealth Nursing Intervention for Veterans With CHD

Conditions
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Heart Disease

Intervention / Treatment
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* Behavioral: Motivational Interview


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admission to an inpatient medicine unit for MI, ACS, and coronary angiography Age Exclusion Criteria: Altered mental status Language barriers Dementia or Cognitive Impairment Diagnostic Study Resident in long-term care facility prior to the present admission Planned discharge to a skilled or intermediate care facility or hospice Lack of access to a functioning phone

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Motivational Interview<br>For those subjects randomly assigned to the treatment group, information from their MIHART assessment interview and medical record review will be used to select intervention scripts optimally tailored to each subjects' unique configuration of beliefs and risk factors and they will be re-contacted by telephone at 2-weeks post-hospital discharge to deliver the Vet-HART intervention. The intervention will be administered by a trained research assistant via telephone, working from a semi-structured script tailored to each subject's representations and risk factors, the call will last about 15-30 minutes. | Behavioral: Motivational Interview<br>* For those subjects randomly assigned to the treatment group, information from their MIHART assessment interview and medical record review will be used to select intervention scripts optimally tailored to each subjects' unique configuration of beliefs and risk factors and they will be re-contacted by telephone at 2-weeks post-hospital discharge to deliver the Vet-HART intervention. The intervention will be administered by a trained research assistant via telephone, working from a semi-structured script tailored to each subject's representations and risk factors, the call will last about 15-30 minutes.<br>|
| No Intervention: Usual Care<br>For those randomly assigned to the usual care group, they will receive standard-of-care by their regular primary care provider. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| SF-36v Physical Function Scale | Physical Functioning Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v Role Limitations Due to Physical Health Scale | Role Limitations Due to Physical Health Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v Role Limitations Due to Emotional Problems Scale | Role Limitations Due to Emotional Problems Scale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v Energy-Fatigue Scale | Energy-Fatigue Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v Emotional Well-Being Scale | Emotional Well-Being Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v Social Functioning Scale | Social Functioning Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v Pain Scale | Pain Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| SF-36v General Health Scale | General Health Subscale from the SF-36v. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| Seattle Angina Questionnaire Physical Limitations Scale | Physical Limitations Subscale from the Seattle Angina Questionnaire. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| Seattle Angina Questionnaire Angina Stability Scale | Angina Stability Subscale from the Seattle Angina Questionnaire. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| Seattle Angina Questionnaire Angina Frequency Scale | Angina Frequency Subscale from the Seattle Angina Questionnaire. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| Seattle Angina Questionnaire Treatment Satisfaction Scale | Treatment Satisfaction Subscale from the Seattle Angina Questionnaire. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 
| Seattle Angina Questionnaire Disease Perception Scale | Disease Perception Subscale from the Seattle Angina Questionnaire. Possible scores range from 0 to 100, with higher scores indicating a better level of functioning. | Change from baseline to 3-months post hospital discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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coronary heart disease (CHD), myocardial infarction (MI), acute coronary syndromes (ACS)