title: Behavior determinants among cardiac rehabilitation patients receiving educational interventions: an application of the health action process approach.
abstract: OBJECTIVE
  To (1) test the effect of a health action process approach (HAPA) theory-based education program in cardiac rehabilitation (CR) compared to traditional education on patient knowledge and HAPA constructs; and, (2) investigate the theoretical correlates of exercise behavior among CR patients receiving theory-based education.
  
  
  METHODS
  CR patients were exposed to an existing or HAPA-based 6 month education curriculum in this quasi-experimental study. Participants completed a survey assessing exercise behavior, HAPA constructs, and knowledge pre and post-program.
  
  
  RESULTS
  306 patients consented to participate, of which 146 (47.7%) were exposed to the theory-based educational curriculum. There was a significant improvement in patients' overall knowledge pre- to post-CR, as well as in some HAPA constructs and exercise behavior, regardless of curriculum (p < 0.05). Path analysis revealed that knowledge was significantly related to intention formation, and intentions to engage in exercise were not directly related to behavior, which required action planning.
  
  
  CONCLUSIONS
  The theoretically-informed education curriculum was not associated with greater knowledge or exercise behavior as expected. Education in CR improves knowledge, and theoretical constructs related to exercise behavior.
  
  
  CONCLUSIONS
  Educational curricula should be designed to not only increase patients' knowledge, but also enhance intentions, self-efficacy, and action planning.
authors: Exercise Sciences Department, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada; Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada. Electronic address: gabriella.meloghisi@uhn.ca.
authors: Gabriela Lima de Melo
authors: GL
authors: Ghisi
authors: Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada; School of Kinesiology and Health Science, York University, Toronto, Canada.
authors: Sherry L
authors: SL
authors: Grace
authors: Exercise Sciences Department, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada.
authors: Scott
authors: S
authors: Thomas
authors: Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.
authors: Paul
authors: P
authors: Oh
mesh_terms: D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000523:psychology; D003479:Curriculum; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: Cardiac rehabilitation; Health behavior theory; Knowledge; Patient education; Physical exercise