Conceptualization and development of a novel behavioral intervention to promote adherence in heart failure: Reach for Health

Audrey Kelly, BA

Massachusetts General Hospital – Research Assistant

Scientific Abstract

Background: Despite the benefits of adherence to cardiovascular health behaviors, including physical activity, a low-sodium diet, and taking medications, most patients with heart failure (HF) struggle to adhere to these behaviors. Existing health behavior interventions for HF patients have substantial limitations: most do not focus on the promotion of well-being constructs that have been linked to both adherence and cardiovascular health. We developed a 12-week, phone- and text message-based, combined positive psychology-motivational interviewing (PP-MI) intervention to promote well-being and health behavior adherence in patients with HF. In this randomized, single-blind trial, we aim to examine the efficacy of this program—compared to an MI-based educational condition—to promote physical activity, a low-sodium diet, and medication adherence in 280 patients with New York Heart Association class I-III HF and suboptimal adherence to these behaviors.

Methods: Following baseline measures, participants are randomized to the PP-MI or MI-based educational conditions. Participants in the PP-MI condition attend weekly phone sessions with a study trainer, then complete a PP-activity (e.g., recalling positive events) and work towards health behavior goals between sessions. Those in the control condition will similarly complete phone sessions with MI and education related to HF self-care. Both groups will receive twice weekly text messages for 24 weeks. Outcomes will be measured at 12, 24, and 48 weeks. The primary outcome will be objectively measured adherence: a composite of overall physical activity (accelerometer), sodium intake (urine sodium excretion), and medication adherence (MEMS electronic pill bottles) at 12 weeks. However, we will measure additional behavioral, psychological, functional, and cardiovascular outcomes as well.

Results: Recruitment began in December 2021 and is ongoing.

Conclusions: This study will provide information about the intervention’s impact on three cardiovascular health behaviors. If effective, we will examine this intervention’s impact on cardiovascular health outcomes and determine methods to implement this in clinical settings.

Live Zoom Session – March 9th

research Areas


Audrey C. Kelly, B.A., Christina N. Massey, Ph.D., Wei-Jean Chung, Ph.D, Rachel A. Millstein, Ph.D., M.H.S., Alba Carrillo, Ph.D., Jeff C. Huffman, M.D., and Christopher M. Celano, M.D.

Principal Investigator

Christopher Celano, MD

Affiliated Website