Social ecological predictors of achieving physical activity guidelines in a sample of cardiac rehabilitation patients

Purpose: Research on physical activity (PA) in people with heart disease tends to emphasize intrapersonal correlates while largely ignoring the potential importance of higher-level correlates within the social ecological model. Thus, the purpose of this study was to determine the relative importance of several social ecological correlates in predicting whether or not PA guidelines were reached in a sample of cardiac rehabilitation (CR) patients.

Methods: To date, we have recruited 201 participants as part of a larger study examining PA in CR patients. For this submission, we report results based on 152 participants (mean age = 64 years; mean BMI = 29 kg/m2) who completed a questionnaire and wore an Actigraph accelerometer for nine days at the beginning of their CR program. The total time spent in bouts of at least 10 minutes was dichotomized into greater than or equal to 150 minutes (1) or less than 150 minutes (0).

Results: A logistic regression test yielded a model that included two intrapersonal predictors (BMI and self-efficacy) and four community-level predictors (neighbourhood characteristics and crime, access to a community center or fields), χ2 (6, N = 152) = 37, p<.05. Overall classification was impressive at 80%. In the context of the predictive model, BMI, self-efficacy and access to a community center significantly predicted whether or not PA guidelines had been reached, p<.05.

Conclusions: Results indicate that higher-level factors such as access to community activity spaces should be considered alongside intrapersonal factors as key correlates of PA in people with heart disease.