Abstract
More than 8 million Americans will have heart failure (HF) by 2030. Regular physical activity as a self-care strategy can contribute to lower health care costs, and improve health outcomes and quality of life. Patients with HF are not engaging in physical activity at recommended levels, and this may be improved by effective patient education. Physical therapists (PTs) are poised to be the health care providers who will interact with most patients with HF and are professionals trained to promote physical activity and provide patient education. However, to be able to educate effectively, PTs must first understand their own behavior in treating patients with HF and the potential patient factors that may impact physical activity behaviors. PTs must also recognize that patient-practitioner interaction can positively or negatively influence patient behavior and that inequities due to race, gender and representation in the health professions may all contribute to determining patient success in adoption of and adherence to a physically active lifestyle.
The study purpose was to identify factors related to adherence to physical activity recommendations in community-dwelling patients with HF and to identify disparities in factors that contribute to physical activity behavior. This study used a three-part approach to answer the research questions by first surveying PTs regarding management of patients with HF. Second, Black patients with HF were interviewed to gain insight on their perspectives on the issue. Third, a wider demographic of patients were surveyed on several factors using validated, standardized outcome measures.
This study revealed that there is significant variability in the delivery of physical activity interventions and patient education by physical therapists for patients with HF. We showed that Black people with HF are influenced by health literacy, health beliefs, barriers and facilitators and by medical mistrust, which impact physical activity. Finally, several associations between physical activity and modifiable and nonmodifiable factors were identified.