Interventions supporting cardiac rehabilitation completion: Process evaluation investigating theory-based mechanisms of action.
Bibliographic record
Abstract
OBJECTIVE: A randomized trial informed by the Health Action Process Approach evaluated interventions to improve cardiac rehabilitation completion following myocardial infarction. We investigated indirect effects of the interventions on completion via targeted constructs. METHODS: In this theory-based process evaluation, participants in all 3 trial arms (usual care; mailouts; mailouts plus telephone support) completed a questionnaire 12 months after their myocardial infarction assessing intention, goal priority, outcome expectancies, risk perception, self-efficacy, social support, action planning, and coping planning. Consecutive sampling was used until the target sample size (167 per trial arm) was met. Cardiac rehabilitation completion was self-reported at the same time point. We used multiple regression mediation models to explore indirect effects. RESULTS: In total, 594 participants completed the cardiac rehabilitation questionnaire; 588 were analyzed (6 excluded due to missing data). For mailouts alone, there were no significant indirect effects. There were small indirect effects of mailouts plus telephone support on intention via goal priority, outcome expectancies, and self-efficacy, with a negative effect via severity risk perception. There were also small indirect effects on cardiac rehabilitation completion via self-efficacy and action planning. CONCLUSIONS: Findings help explain the trial results, suggesting that mailouts plus telephone support increased the likelihood of completing cardiac rehabilitation by enhancing self-efficacy and action planning, and increased intention by enhancing goal priority, self-efficacy, and outcome expectancies, with an unintended consequence of a negative effect via risk perceptions. Conducting theory-based process evaluations alongside trials of behavior change interventions can clarify mechanisms of action, which can inform efforts to refine interventions and to replicate and generalize findings to other jurisdictions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.045 | 0.067 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".