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HSR&D 2004 National Meeting Abstracts


2007. Developing a Patient-Derived Intervention to Increase Adherence to Exercise
Barbara F Sharf, PhD, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, PN Krueger, Houston Center for Quality of Care and Utilization Studies and Baylor College of Medicine, Tl Knoll, Texas A&M University, BF Sharf, Texas A&M University

Objectives: We explored patientsí perceptions of the role of exercise for treating peripheral arterial disease (PAD) in order to design a communication intervention.

Methods: We conducted qualitative interviews involving 36 patients with objective evidence of PAD. Of the 36 patients (20 men and 16 women), there were 14 whites, 12 African Americans, and 10 Hispanics. Using Atlas TI software, we analyzed verbatim transcripts to identify significant dimensions of patientsí perceptions of doctor-patient communication that would increase their use of exercise (i.e., walking).

Results: Based on 30 emerging codes, we identified the main factors that summarized patientsí perceptions of the causes and outcomes of PAD, the importance of doctor-patient communication, and the factors that would lead to their use of exercise to treat PAD. From this information, our conceptual model focuses on an intervention plan that includes addressing a patientís behavior prior to the diagnosis of PAD, patientís perceptions of PAD, and those factors that shape a patientís overall assessment of the role of exercise for PAD. We also include the impact of the physicianís perception of PAD coupled with the patientís perception to shape the intervention Ė a partnership between the clinician and patient- that we posit is likely to lead to behavior change.

Conclusions: Based on qualitative data analysis, we developed a patient derived model to influence the use of exercise for PAD. This model will be used to develop a communication primer for use within a randomized trial of unsupervised exercise therapy for patients with PAD.