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Integrated Behavior Model in regards to readmission rate in HF patients…
Integrated Behavior Model
in regards to readmission rate in HF patients related to exercise training
Intention or Decision to Perform the Behavior
Attitude
Instrumental attitude
Belief that exercise improves physical and mental health
Exercise can lead to or aggravate injury
Exercise can increase independence in performing activities of daily living
Results from exercise may not be noticeable or timely
Improved physique and self esteem
Experiential attitude
Negative emotions and perceptions
Helplessness and frustration regarding diagnosis and prognosis
Feelings of inadequacy, shame, and embarrassment
Fear of being body shamed
Fear of mortality due to progression of disease
Fear of not reaching benchmarks or personal goals
Ultimatums and pressure from family, friends, and healthcare providers
Perceived Norm
Injunctive norm
Health related opinions from cfamily and friends
Recommendations from physicians and healthcare providers
Social and cultural inflence
Descriptive norm
Sees friends and family maintaining healthy habits and exercise regimes
People attending gym memberships and fitness classes
Depictions of health on social media
Personal Agency
Perceived control
Internal locus of control
Personal responsibility
Interest to set and accomplish goals
External locus of control
Belief that outcomes are a result of chance or fate
The belief, or lack thereof, that physical exercise can influence health outcomes
Salience of the Behavior
Exercise preferences
Positive and negative feelings about exercise
Positive and negative outcomes of exercising
Environmental constraint
Desirability of outcome
Underlying value system
Being part of health-related decision making
Trusted individuals
Belief Patterns
Behavioral
Normative
Efficacy
Control
Knowledge and Skill to Preform the Behavior
Knowledge
Where to exercise
Benefits of exercise
How often to exercise
When to seek medical attention
HF medications and exercise
Types of exercises
Skills
How to warm up and stretch to prevent injuries
How to perform strength training exercises
How to perform cardiovascular exercises
How to keep a exercise log
Environmental Constraints
System/Institutional
Discrimination and racism among people of colors have led to mistrust of medical system
Biases in clinical decision making
Referral-enrollment gap of cardiac rehabilitation services
Increased out of pocket cost for primary, secondary and tertiary interventions
Shortage of trained and experienced health professionals
Shifts in social and healthcare policies
Insurance approval to novel, more effective medications
Family
Lack of or limited family support system and resources
Family practices around regular exercise and healthy food options
Family's beliefs and cultures on cardiovascular diseases, treatments, and preventions
Various level of health literacy amongst family members
Community
Availability and access to places that promote exercise and recreational services
Safety concerns of neighborhoods impacts regularity of exercise
COVID-19 pandemic limits access to healthcare services, especially PCP and regular checkups
Access to fresh markets and higher cost of products that promote heart healthy diet
Access to public transportation
Limited office hours in primary care services
Relocation to different geographic location
Social
Pollution, noise
Social network
Socioeconomic status
Built environment increases stress, risk of obesity, and limit spaces to exercise
Nature
Season, more severe in winter for HF patients
Sunlight (vitamin D, UV light) as beneficial for HF patients
Circadian cycle (sleep/awake or day/night)
Altitude: adaptation if migration to new geographic locations
Greenspaces: beneficial for HF patients
Habit
Positive
build up exercise habit
makes decision making process less depends on considering
positive results enhance habitual action
Negative
Bad habit
prevent from building the new habit
Lack of habit
Forget to perform exercise
downplay exercise