# A Randomized Controlled Trial to Reduce Hopelessness through Enhanced Physical Activity in Adults with Ischemic Heart Disease

> **NIH NIH R01** · UNIVERSITY OF ILLINOIS AT CHICAGO · 2021 · $450,671

## Abstract

Abstract
 Hopelessness is associated with a 3.4 times increased risk of mortality or nonfatal myocardial infarction in
patients with ischemic heart disease (IHD), independent of depression. Hopelessness has been identified in
27–52% of patients with IHD and can persist for up to 12 months after hospital discharge. Hopelessness, a
negative outlook and sense of helplessness toward the future, can be a temporary response to an event (state)
or a habitual outlook (trait). Hopelessness is associated with decreased physical functioning and lower physical
activity (PA) levels in individuals with IHD. Low levels of PA independently contribute to increased death and
adverse events in patients with IHD. Rates of PA in IHD patients continue to be unacceptably low in both
hospital-based cardiac rehabilitation and home settings. Hopelessness frequently compounds this issue. The
links among hopelessness, PA, and mortality and morbidity for patients with IHD remain unknown. While
research has investigated strategies to increase PA among IHD patients in general, we are the only group to
design an intervention to promote PA specifically in hopeless IHD patients. Our work, based on Self
Determination Theory and Cohen’s Stress and Coping Social Support Theory, has shown feasibility and
preliminary efficacy for a motivational intervention that integrates social support from both the patient’s nurse
and significant other to promote increased PA. The purpose of this randomized controlled trial is to establish
the effectiveness of our 6-week mHealth intervention (Heart Up!) to promote increased PA in hopeless patients
with IHD. We will enroll 225 hopeless IHD patients from a large community teaching hospital in the Midwest.
Patients will be randomized (75 per group) to one of three groups: 1) motivational social support (MSS) from a
nurse, 2) MSS from a nurse with additional significant other support (SOS), or 3) attention control (AC). Data
will be collected at baseline, 8 and 24 weeks using an accelerometer for PA and valid and reliable instruments
of physical and emotional health and behaviors. The specific aims are to: 1) test the effectiveness of 6 weeks
of MSS and MSS with SOS on increasing mean minutes per day of moderate to vigorous PA, measured by an
ActiGraph accelerometer; 2) determine the effects of change in minutes per day of moderate to vigorous PA on
state hopelessness, measured by the State-Trait Hopelessness Scale; and 3): determine if social support
(measured by the ENRICHD Social Support Inventory) and motivation (measured by the Exercise Self-
Regulation Questionnaire) mediate the effects of the Heart Up! intervention on PA. The findings from this study
could transform care for IHD patients who are hopeless by promoting self-management of important PA goals
that can contribute to better health outcomes. This proposal supports NINR’s investment in self-management
to improve the quality of life for individuals with chronic illness.

## Key facts

- **NIH application ID:** 10155581
- **Project number:** 5R01NR017649-05
- **Recipient organization:** UNIVERSITY OF ILLINOIS AT CHICAGO
- **Principal Investigator:** SUSAN L DUNN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $450,671
- **Award type:** 5
- **Project period:** 2018-08-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10155581

## Citation

> US National Institutes of Health, RePORTER application 10155581, A Randomized Controlled Trial to Reduce Hopelessness through Enhanced Physical Activity in Adults with Ischemic Heart Disease (5R01NR017649-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10155581. Licensed CC0.

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