# HL-132: Increasing Adherence to Guideline-Based Exercise Therapy For Chronic Heart Failure

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2022 · $752,365

## Abstract

PROJECT SUMMARY/ABSTRACT
This proposal is in response to NHLBI Topics of Interest: HL-132 Advancing Research in Exercise Therapy for
Chronic Heart Failure (R01). This proposal aims to optimize adherence to exercise regimens in heart failure
(HF), improve physical functioning and quality of life, and reduce morbidity. HF is a major public health
concern, and while survival has improved over the decades the absolute mortality rate for HF remains high at
approximately 50% within 5 years of initial diagnosis. Numerous studies show that regular physical activity /
exercise significantly improves exercise tolerance as well as clinical outcomes in HF. Exercise as a reliable
adjunctive intervention, however, remains limited due to poor short- as well as long-term adherence. This
proposed study will examine the effectiveness of the Heart Exercise And Resistance Training – Peer Lead
ActivitY (HEART–PLAY) intervention to significantly sustain exercise adherence in HF patients, as compared
to a more standard exercise intervention. The HEART–PLAY intervention will be adapted from previous
NHLBI-funded R01 work shown to have a sustained impact on moderate physical activity in the elderly. This
proposed study will adapt the intervention to be safe for HF patients, deliver the intervention in cardiology
clinics, and test adherence to the program over 18 months. Clinic staff and HF patients who are appropriate
role models will be trained to teach the intervention activities with trained health educators. They will then be
responsible for maintaining the program in the cardiology clinics. The HEART–PLAY program and behavior
change will be sustainable because of the presence of peer and staff leadership and because it employs
proven strategies from social cognitive theory and ecological models including self monitoring, social support,
role modeling, and relapse prevention. In contrast to exercise classes that have a fixed schedule and limited
evidence for adherence, HEART-PLAY teaches patients how to accumulate meaningful physical activity across
the day and provides a supportive social infrastructure to maintain motivation. In a rigorous cluster randomized
controlled trial at cardiology clinics at the University of California, San Diego (UCSD) hospitals and at the VA
San Diego Healthcare System (VASDHS), we will develop and assess the HEART–PLAY intervention program
in 264 socioeconomically and ethnically diverse women and men 60+ years old with either HF with preserved
Ejection Fraction (HFpEF) or HF with reduced Ejection Fraction (HFrEF). Participants in the HEART–PLAY
and in the STANDARD exercise programs will receive self-monitoring tools for aerobic plus resistance training
as well as group education and materials. Participants in HEART–PLAY will additionally receive peer and staff
leadership. We will demonstrate that the peer-led HEART–PLAY program based in the clinic setting will
significantly enhance the primary study endpoint of adherence to 150 min/week...

## Key facts

- **NIH application ID:** 10357590
- **Project number:** 5R01HL136407-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Paul J Mills
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $752,365
- **Award type:** 5
- **Project period:** 2018-01-15 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10357590

## Citation

> US National Institutes of Health, RePORTER application 10357590, HL-132: Increasing Adherence to Guideline-Based Exercise Therapy For Chronic Heart Failure (5R01HL136407-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10357590. Licensed CC0.

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