title: Behaviour change techniques in home-based cardiac rehabilitation: a systematic review.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice.
  
  
  OBJECTIVE
  To identify and describe the use of BCTs in home-based CR programmes.
  
  
  METHODS
  Randomised controlled trials of home-based CR between 2005 and 2015 were identified by searching MEDLINE(®), Embase, PsycINFO, Web of Science, and Cochrane Database.
  
  
  METHODS
  Reviewers independently screened titles and abstracts for eligibility. Relevant data, including BCTs, were extracted from included studies. A meta-analysis studied risk factor change in home-based and comparator programmes.
  
  
  RESULTS
  From 2448 studies identified, 11 of good methodological quality (10 on post-myocardial infarction, one on heart failure, 1907 patients) were included. These reported the use of 20 different BCTs. Social support (unspecified) was used in all studies and goal setting (behaviour) in 10. Of the 11 studies, 10 reported effectiveness in reducing CVD risk factors, but one study showed no improvement compared to usual care. This study differed from effective programmes in that it didn't include BCTs that had instructions on how to perform the behaviour and monitoring, or a credible source.
  
  
  CONCLUSIONS
  Social support and goal setting were frequently used BCTs in home-based CR programmes, with the BCTs related to monitoring, instruction on how to perform the behaviour, and credible source being included in effective programmes. Further robust trials are needed to determine the relative value of different BCTs within CR programmes.
authors.affiliation: NIHR clinical academic fellow in GP/sport and exercise medicine, Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Heron
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Donnelly
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cardwell
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Tully
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Cupples
mesh_terms: D001521:Behavior Therapy; D000072038:Cardiac Rehabilitation / Q000379:methods*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D012944:Social Support
keywords: GPs; coronary artery bypass grafting; heart failure; myocardial infarction; review, systematic; secondary prevention