title: A theory-based exercise intervention in patients with heart failure: A protocol for randomized, controlled trial.
abstract: BACKGROUND
  Regular exercise has been associated with improved quality of life (QoL) in patients with heart failure (HF). However, less is known on the theoretical framework, depicting how educational intervention on psychological, social, and cognitive variables affects physical activity (PA). The purpose of this study is to assess the effectiveness of a social cognitive theory-based (SCT-based) exercise intervention in patients with HF.
  
  
  METHODS
  This is a randomized controlled trial, with measurements at baseline, immediately following the intervention, and at 1, 3, and 6 months follow-up. Sixty patients who are referred to the cardiac rehabilitation (CR) unit and meet the inclusion criteria will be randomly allocated to either an intervention group or a usual-care control group. Data will be collected using various methods (i.e., questionnaires, physical tests, paraclinical tests, patients' interviews, and focus groups). The patients in the intervention group will receive eight face-to-face counseling sessions, two focus groups, and six educational sessions over a 2-month period. The intervention will include watching videos, using book and pamphlets, and sending short massage services to the participants. The primary outcome measures are PA and QoL. The secondary outcome measures will be the components of SCT, heart rate and blood pressure at rest, body mass index, left ventricular ejection fraction, exercise capacity, and maximum heart rate.
  
  
  CONCLUSIONS
  The findings of this trial may assist with the development of a theoretical model for exercise intervention in CR. The intervention seems to be promising and has the potential to bridge the gap of the usually limited and incoherent provision of educational care in the CR setting.
authors.affiliation: Department of Public Health, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Rajati
authors.affiliation: Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Firoozeh
authors.initials: F
authors.lastname: Mostafavi
authors.affiliation: Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Sharifirad
authors.affiliation: Department of Cardiology, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: School of Medicine, University of Maryland, Baltimore, MD, USA.
authors.forename: Kamran
authors.initials: K
authors.lastname: Tavakol
authors.affiliation: Department of Biostatistic, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Awat
authors.initials: A
authors.lastname: Feizi
authors.affiliation: Department of Public Health, Kurdistan University of Medical Sciences, Sanandaj, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Pashaei
keywords: Cardiac rehabilitation; exercise; heart failure; quality of life; randomized controlled trial; social cognitive theory