Peer support to promote physical activity after completion of centre-based cardiac rehabilitation: evaluation of access and effects.
BACKGROUND
Patients with heart disease receive little support for sustaining physical activity over the long-term. This study compared the characteristics of patients choosing to join a peer support program to promote use of physical activity and assessed its effects on physical activity.


OBJECTIVE
To compare characteristics of those choosing to join the peer support (PS) program versus those who did not, and to assess the effect on physical activity patterns at 12 months of the PS program.


METHODS
Based on health status from 225 people who completed centre-based cardiac rehabilitation, 109 patients with heart disease who had completed a program of hospital-based cardiac rehabilitation were suitable for the peer support program. Health status and characteristics of patients opting to join the program (n = 79) were compared to patients who did not wish to join (n = 30). A longitudinal study was then conducted to determine the objective effects on physical activity levels of program membership at 12 months as measured by self-report and pedometers.


RESULTS
Patients who joined the peer support program tended to be older (p < 0.001), and female compared to those who were eligible but did not join (p = 0.04). Over the next 12 months, those who did not participate in the peer support program reported a decline of 211 min in the total amount of physical activity accumulated in an average week (1382.5 ± 238.2 to 1171.5 ± 220.1 min week(-1) p = 0.003), whereas program members sustained similar levels of physical activity as was recorded at the completion of cardiac rehabilitation (1021.1 ± 141.9 to 1070 ± 127.8 min week(-1)). Objective measures of physical activity indicated that groups increased moderately total step count per week (p = 0.68 and p = 0.25) and in their average steps per day (p = 0.68 and p = 0.25 respectively) from baseline to 12 months.


CONCLUSIONS
Peer support programs have good potential to help people with heart disease maintain physical activity after cardiac rehabilitation. Importantly, they may offer particular benefits for older patients and females.
University of Alberta, Edmonton Clinic Health Academy, Canada. alex.clark@ualberta.ca
Alexander M
AM
Clark
Claire
C
Munday
David
D
McLaughlin
Sonda
S
Catto
Andy
A
McLaren
Paul D
PD
Macintyre
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis / Q000534:rehabilitation; D002170:Canada; D003266:Continuity of Patient Care / Q000458:organization & administration; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009203:Myocardial Infarction / Q000175:diagnosis / Q000534:rehabilitation; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010379:Peer Group; D015397:Program Evaluation; D011788:Quality of Life; D012047:Rehabilitation Centers / Q000458:organization & administration; D012657:Self-Help Groups / Q000458:organization & administration*