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. 2014 Nov;10(6):319–333.

Table 1.

Characteristics of Studies Included in a systematic review

Author Sample size Design Purpose Content of intervention to increase self-efficacy Duration and type of physical activity/exercise Outcome measurement NYHA classification Findings included self-efficacy and exercise
Barkley and Fahrenwald.50 65 Int = 35 (20 male), Con = 40 ( 24 male) Quasi-experimental To determine the effect of an SCI in levels of exercise self-efficacy, levels of barrier self-efficacy, and independent exercise Attention to minute of exercise, reinforcement/using daily log/persuasion about successful exercise, barrier identify/goal setting, plan setting, overcome barrier/self-monitoring of symptom and exertion level 12 weeks structural exercise with the intensity of 4-5 metabolic equivalents (METs)/3 days/week - ESE - BARSE scale A self-report of daily independent exercise Not clear Patient’s self-efficacy for exercise increased from mean (SD) of 85.35 (17.54) to 86.64 (18.90) on ESE scale. BARSE scores increased from mean (SD) 67.69 (21.33) to 78.22 (20.97), and independent exercise increased from mean (SD) 42.59 (77.06) to 116.72 (80.78) min/week. Within group analysis was significant for change in BARSE (t = 2.347, P = 0.03) and independent exercise (t = 4.210, P < 0.001)
Brodie and Inoue46 ,Brodie et al.47 60 SC = 20 Int = 18 SC + Int = 22 Randomized three-group controlled intervention Design Examination of the effect of physical activity “lifestyle”‌ intervention, based on motivational interviewing, on improvement quality of life at 5 months from baseline, compared with routine care Motivational interviewing/client-centered counseling/problem-solving Regular physical activity such as walking - Leisure-time physical activity questionnaire expressed as kcal/kg/day - 3 day physical activity diary - Medical outcomes short form-36 health survey (SF-36) - MLHF questionnaire A visual tool to assess readiness-to-change II-III-IV Self-reported physical activity in the short-term increased (>2 kcal/kg/day). Self-efficacy and motivation scores improved after 5 months follow up in comparison with baseline that none of the patients were not in the stages mentioned above in preparation stage improvements in physical functioning (P < 0.07) and role physical (P < 0.02), on SF-36 were seen
Barnason et al.52 35 Int = 18 (14 male), Con = 17 (10 male) Randomized clinical trial repeated measures To determine the impact of a home communication intervention for HF Coronary Artery Bypass Graft (CABG) patients, self-efficacy, coronary artery disease risk factor modification and functioning Symptom self-management/risk factor modification education/self-care for CABG/positive reinforcement 6 weeks home communication intervention (tele health) providing: assessment of patient symptoms, CAD risk factor modification education, Education on CABG recovery, positive reinforcement to increase patients’ self-efficacy - Barnason Efï¬پcacy expectation scale - Cardiovascular Risk Factor Modiï¬پcation Adherence - Medical Outcomes Study Short - Form-36 I- II Patients’ self-efficacy increased over time [F(1,29) = 6.40, P <0.02] in the intervention group than in the control group
Collins et al.51 31 Int = 15 (15 male), Con = 16 (16 male) Randomizd controlled clinical trial To evaluate the effect of 12 weeks rehabilitation program on quality of life, aerobic fitness, difficulty with symptoms of HF, self-efficacy for exercise, and daily activity levels compare with control group Increasing gradually exercise 12 weeks Polestriding or/and treadmill walking Cardiac rehabilitation/duration of exercise gradually increased up to 45 to 50 min 3 days/week - Exercise cardiac self-efficacy - MHLF questionnaire - SF-36-questionnire Physical activity questionnaire II-III-I Self-efficacy improved after 12 weeks of training (55.3-12.1 to 63.0-10.9, P = 0.10); 17% improvement in the intervention group compare with the no change in the control group (52.5-16.3 to 52.9-14.7, P = 0.83). self-efficacy improved for patients who continued to exercise at 12 (22%, P = 0.01) and 36 (40%, P = 0.06) weeks. 14% improvement from baseline to 12 weeks on physical functioning score was seen in the intervention group. Difference in the change score on the MLHF was not statistically significant between the 2 groups. Overall activity level was not significantly increased (P = 0.94)
Pozehl et al.48 Duncan and Pozehl49 42 Int = 22 (12 male), Con = 20 (12 male) Randomized experimental repeated measures To assess the effects of a 12 weeks multicomponent exercise training intervention (HF Exercise And Training Camp Heart Camp) on self-efficacy Exercise accomplishment, goal setting, graphic feedback, and problem-solving, role modeling overcome barrier, self-monitoring about heart rate, rating of perceived exercise, and symptom 12 weeks structured aerobic exercise with 40-60% Max HR, 3 days/week in a hospital-based rehabilitation setting, and resistance training 2 days/week at home - Self-efï¬پcacy for exercise MOS SF-36 physical function subscale, KCCQ II-III Heart Camp intervention improved patient self-efficacy for exercise over 12 weeks [F(1,2) = 31.25, P = 0.03] compared with a non-significant change [F(1,2) = 2.33, P = 0.27] in control group. The group × time interaction was not significant for the physical function subscale of the SF-36 [F(1,4) = 0.96, P = 0.39] or the physical limitations subscale of the KCCQ [F(1,4)= 0.54, P = 0.50]
Gary6 32 Int =16 (0 male), Con= 16 (0 male) Randomized controlled two-group experimental design The effect of home-based exercise combined walking and education program on exercise self-efficacy in older women with HF Increasing gradually exercise 12 weeks Walking with intensity at 40-60% Max HR, 30 min/day, 3 days/week - Exercise Self-Efficacy, - Outcome expectancy 6-minWT-test - MLHF - A monitor heart rate polar beat watch II-III Improving self-efficacy for exercise that resulted in improved functioning on the 6 min Walk Test (203 feet increase in the intervention group via 93 feet decline in the control) increasing physical function on MLHF
Maddison et al.54 20 (15 male) Int =10 Con = 10 Randomized controlled trial To examine the effect of a modeling intervention on increase PVO2 and self-efficacy in people diagnosed with CHF Role model presentation (DVD) Exercise test using ramp protocol increasing periods of time (i.e., 2, 4, 6, 8, 10, and 12 min) at three intensities (i.e., easy, moderate, and hard) - Standardized exercise testing (ramp), - Self-efficacy scale II-III The effect of modeling (DVD) intervention on PVO2 F(1,19) = 4.38, P = 0.05 and self-efficacy F(1,19) = 5.80, P < 0.05 was statistically significant
Yeh et al.55 100 Int = 50 (28 male), Con = 50 (36 male) Single-blind, multisite, parallel-group, randomized controlled trial To investigate the effect of Tai Chi exercise on improving functional capacity and quality of life in patients with HF Skill mastery/showing videotape/encouragement 12 weeks Tai Chi with intensity at 50-74% Max HR, 60 min/day, 2 days/week - Standardized exercise testing (ramp) - 6-min walk test - Metabolic cart - Cardiac Exercise Self-efficacy questionnaire II-III QoL improved on MLHF (-19 [-23, -3] in the intervention group versus 1 [-16, 3], P = 0.02 control group). Self-efficacy enhanced on cardiac exercise self-efficacy (0.1 [0.1, 0.6] in the intervention versus -0.3 [-0.5, 0.2], P 0.001) in the control group)
Oka et al.56 24 Int = 12 (12 male), Con = 12 (12 male) Randomized controlled trial To evaluate the effect of performance of a single treadmill exercise test and participation in a 3-month program of walking and resistance exercise on self-efficacy in HF patients Exercise performance/skill mastery 12 weeks aerobic walking with intensity at 70% Max HR, 40-60 min/day, 3 days/week - Exercise test - Borg ratings of perceived exertion scale - Self-efficacy expectations scales II Self-efficacy scores for walking improved after 3 months of walking and resistance exercise program (P = 0.04). The relationship between self-efficacy for climbing with physical fitness (r = 0.51, P = 0.01) and walking with physical fitness (r = 0.48, p = 0.02) (measured by PVO2) was significant
Smeulders et al.53 317 Int = 131 (89 male), Con= 186 (141 male) Randomized, controlled trial To assess the effects of the CDSMP on health behavior and healthcare utilization in HF Skills mastery, goal setting, group sessions reinterpretation of symptoms, modelling, and social persuasion 6 weeks exercise which was not clear duration, frequency, or type - Physical Activities Scale of (a) walking; (b) swimming; (c) cycling; (d) other physical activity II-III Physical activity for walking improved at 6 but not 12 months. differences between intervention and control group patients for swimming or bicycling were not significant

SC: Standard care, Int: Intervention group; Con: Control group; PVO2: Peak oxygen consumption; CABG: Coronary artery bypass graft; Max HR: Maximum heart rate; SCI: Self-efficacy coaching intervention; ESE: Self-efficacy scale; BARSE: Barriers to self-efficacy for exercise; MLHF: Minnesota living with heart failure questionnaire; KCCQ: Kansas City Cardiomyopathy Questionnaire; CDSMP: Chronic disease management program; SD: Standard deviation; NYHA: New York Heart Association; HF: Heart failure