Exploring Factors Associated With Adherence in a Positive Psychology Intervention

Abstract

Background and method. Positive psychological constructs (e.g., optimism) are associated with greater adherence to cardiac health behaviors. No study has assessed if positive psychology (PP) interventions, which boost positive emotions, promote physical activity in post-acute coronary syndrome (ACS) patients. There is little data on which patients may benefit most from PP interventions. The Positive Emotions after Acute Cardiac Events III (PEACE III) study compared intervention components to optimize a PP intervention for ACS patients. PEACE III recruited 128 patients admitted for an ACS at Massachusetts General Hospital or Brigham and Women’s Hospital, all of whom were provided a core PP intervention for 8 weeks. This manuscript assesses if any baseline patient characteristics are associated with improved intervention adherence. Pairwise correlations were used to assess correlation between continuous baseline variables and the number of weeks completed, and Pearson’s Chi2 tests were used with dichotomous baseline variables to assess for increased odds of early dropout. Results. Overall, over 70% of participants completed more than 2 weeks. The majority of dropout occurred during the first two weeks. A majority of participants completed 7 or more phone sessions. No individual baseline patient characteristic was associated with increased adherence. Similarly, no baseline characteristic was associated with an decreased odds of early dropout. Conclusion. The intervention overall was feasible and well-accepted. No patient characteristic was associated with number of phone sessions completed, suggesting that this intervention may be applicable to a broad range of post-ACS patients. Given that the majority of dropout occurred in the first two weeks, additional retention strategies should be considered during that timeframe.