Sex Differences in Barriers and Predictors of Physical Activity Participation During and Following Cardiac Rehabilitation - PROJECT SUMMARY This K01 Career Development Award will inform the design and development of an R01-level intervention utilizing health coaching and precision-level strategies to cultivate PA maintenance as women transition from CR into the real world. Cardiovascular disease is the leading cause of death for women in the United States. Cardiac rehabilitation (CR) can play an important role in attenuating cardiovascular disease progression, reducing morbidity and mortality, and improving quality of life. Unfortunately, CR programs have limited success in producing sustained behavior change beyond the structured program, especially among women, mitigating long-term health benefits. Given women appear to participate in less PA during and following CR, there is a critical need to understand whether they have different barriers and thus different predictors of PA participation and maintenance. Prior research investigating barriers and predictors of PA participation during and after CR has been limited by the study population, which has been predominately male. Thus, the proposed project will utilize an observational study design to assess the following aims: 1) among individuals enrolled in CR, identify sex differences in PA participation during CR and PA maintenance after CR completion; 2) identify sex differences in patient-level barriers to PA participation during CR and PA maintenance after CR completion; 3) identify key predictors of PA participation during CR and PA maintenance after CR; and Sub-Aim 3a) determine whether identified predictors of PA participation and maintenance differ by sex. My central hypothesis is that 1) sex differences in PA participation, barriers to, and predictors of PA during and following CR will be identified; and 2) qualitative experiences of men and women will provide a mechanism to tailor a PA transition program to better support women in improving cardiovascular health and CR recurrence. The proposed research plan will advance the applicant’s career, Katherine A. Collins, PhD facilitating her transition to independent investigator status over the five years of K01 support. A team of highly productive, multidisciplinary scientists (Drs. William Kraus, Jennifer Gierisch, and Valerie Smith) will collectively serve as mentors to Dr. Collins during the proposed research at Duke University. This team of mentors has the expertise to train Dr. Collins in 1) qualitative and mixed methods research; 2) predictive analytics, longitudinal data analysis, and sex differences; and 3) grantsmanship and professional development. The proposed training and expert mentoring team will provide Dr. Collins with the skillset, preliminary data necessary to compete for R01 funding, and protected time to establish an independent laboratory. In sum, this award will serve as a catalyst for making Dr. Collins a leader in the field of precision lifestyle and exercise medicine.
