Healthy Heart Habits-2

NCT ID: NCT06440278

Last Updated: 2026-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-13

Study Completion Date

2026-07-15

Brief Summary

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Sixty adults who have experienced acute coronary syndrome within the past 2-12 months from three states (Rhode Island, North Carolina, Minnesota) will be randomized to either (1) a coaching program for depressed mood and health behavior change (Behavioral Activation for Health and Depression; BA-HD), or (2) Enhanced Usual Care. This study will evaluate the feasibility and acceptability of study procedures and BA-HD, and establish protocol and measurement harmonization across three sites in preparation for a future multi-site efficacy trial.

Detailed Description

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Acute coronary syndrome (ACS) represents a significant public health burden, with the most recent estimates suggesting that over 1 million U.S. adults experience ACS per year. As individuals are acutely surviving ACS more often, the associated disease burden is increasing for both the healthcare system and the individual living post-ACS.

Poor engagement in health behaviors post-ACS contributes to risk for recurrent ACS and mortality. Modifiable behavioral contributors include smoking, medication non-adherence, physical inactivity, and poor diet. Approximately 20% of post-ACS adults experience depression and depression is associated with worse engagement in critical health behaviors, which in turn, increases subsequent progression of cardiovascular disease. Treatment of depression alone improves, but does not eliminate, behavioral nonadherence. Behavioral Activation is a robust counseling treatment for depression with evidence of improvements in depressive symptoms across varied populations (including those with medication conditions). BA seeks to improve mood by increasing environmental reinforcement through collaborative, values-guided setting of "activation goals." The goal setting focus and structure of BA allows for seamless integration of health behavior targets and thus offers a potential framework to integrate depression and health behavior treatment. BA-HD may be a useful strategy to depression and multiple health behavior improvement post-ACS. However, this possibility requires further testing.

The purpose of this study is to examine the feasibility and acceptability of a multisite pilot randomized controlled trial and test the initial potential effects of the intervention (BA-HD) on cardiovascular health and depressive symptoms relative to an Enhanced Usual Care control condition. Participants will be randomly assigned to either 12 weeks of tele-delivered BA-HD) or Enhanced Usual Care (i.e., one session of depression and heart disease education and provision of community mental health resources).

Primary endpoints are feasibility of multisite recruitment procedures (e.g., recruitment rates at each site), feasibility of intervention and control procedures (e.g., percent of enrolled participants who complete the study), study retention (e.g., percent of participants who complete 3 month follow-up), and acceptability of intervention content and intervention delivery and control procedures. The investigators hypothesize that the intervention content and delivery will be 1) feasible and 2) acceptable. The investigators will also examine changes in cardiovascular health, depressive symptoms, medication adherence, affect, and quality of life.

Conditions

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Acute Coronary Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Behavioral Activation for Health and Depression

Group Type EXPERIMENTAL

Behavioral Activation for Health and Depression (BA-HD)

Intervention Type BEHAVIORAL

BA-HD includes 8 - 10 sessions delivered over 10-12 weeks. Sessions use behavioral activation techniques to connect patient core values with goal-setting targeting activities that improve mood, alongside personalized adjustments to cardiovascular health behaviors (i.e., tobacco cessation, medication adherence, physical activity, diet, and sleep). Educational materials and commercially available tools like activity trackers, pillboxes, and portion control aids will accompany the goal-setting process to facilitate behavior change.

Enhanced Usual Care

Group Type ACTIVE_COMPARATOR

Enhanced Usual Care

Intervention Type OTHER

Patients will receive depression and heart disease education, as well as a list of local mental health resources.

Interventions

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Behavioral Activation for Health and Depression (BA-HD)

BA-HD includes 8 - 10 sessions delivered over 10-12 weeks. Sessions use behavioral activation techniques to connect patient core values with goal-setting targeting activities that improve mood, alongside personalized adjustments to cardiovascular health behaviors (i.e., tobacco cessation, medication adherence, physical activity, diet, and sleep). Educational materials and commercially available tools like activity trackers, pillboxes, and portion control aids will accompany the goal-setting process to facilitate behavior change.

Intervention Type BEHAVIORAL

Enhanced Usual Care

Patients will receive depression and heart disease education, as well as a list of local mental health resources.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Medical chart-documented ACS (diagnosis of unstable angina, ST or non-ST elevation myocardial infarction) occurrence within the past 2-12 months.
* Post-ACS depressed mood defined as a Patient Health Questionnaire(PHQ)--9 score ≥ 10 upon screening,
* Non-adherence to and willingness to implement changes to ≥1 health behavior based on screening of:

1. Smoking/Tobacco exposure,
2. Physical Activity,
3. Diet,
4. Sleep health,
5. Medication adherence
* English-language fluency
* Resides within 90 minutes (driving time) of each site with no plans to relocate beyond that range during study participation
* Access to a telephone and/or videoconferencing capability
* Has primary care provider
* Address at which packages can be received

Exclusion Criteria

* Chart indication of significant cognitive impairment (e.g., chart-documented dementia), Current exacerbation of serious mental illness,
* Suicidality,
* Hearing impairment that prevents telephone/video communication for intervention and assessment purposes,
* Current hospice care, and
* Current engagement in cardiac rehabilitation or other regular counseling treatment targeting depression or health behavior change
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Miriam Hospital

OTHER

Sponsor Role lead

Responsible Party

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Emily C. Gathright, PhD

Research Scientist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Emily Gathright, PhD

Role: PRINCIPAL_INVESTIGATOR

The Miriam Hospital

Andrew Busch, PhD

Role: PRINCIPAL_INVESTIGATOR

Hennepin Healthcare Research Institute

Locations

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Hennepin Healthcare Research Institute

Minneapolis, Minnesota, United States

Site Status

ECU Health

Greenville, North Carolina, United States

Site Status

The Miriam Hospital

Providence, Rhode Island, United States

Site Status

Countries

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United States

Other Identifiers

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R34HL165716-01A1

Identifier Type: NIH

Identifier Source: org_study_id

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