Dr. Nancy Artinian and her research team members, Dr. Steven Keteyian, Dr. Amy Pienta, Dr. Melissa Franks, Dr. Barry Franklin and Dr. Lynne Martire are currently conducting the Exploring Changes in Experiences and Lifestyles (EXCEL) Study, one of the studies funded by the National Institute of Environmental Health Sciences/National Institute of Health at Wayne State University's Center for Urban and African American Health (CUAAH) http://www.med.wayne.edu/intmed/CUAAH/cuaah.htm. The overall mission of the Center for Urban and African American Health is to support cutting-edge research to create knowledge that will help health care professionals better understand and reduce differences in health care, health care access, and health outcomes. The EXCEL study is focused on generating knowledge that will help health professionals better understand disparities in cardiovascular health outcomes.
Compared to Whites, African Americans have increased cardiovascular morbidity and mortality. Unfortunately, maintenance of new healthier behaviors gained through cardiac rehabilitation is limited-an estimated 50% abandon recommendations within the first year. There is a need to identify factors that enhance the success of cardiac rehabilitation among African Americans. Meaningfully involving patient support partners in cardiac rehabilitation may enhance patients' health and survival benefits of cardiac rehabilitation.
The purposes of the EXCEL project are to: (a) determine whether African American dyads (patient and their support partner) receiving a psychosocial intervention report more effective support exchanges than do those receiving conventional cardiac rehabilitation; (b) determine whether dyads receiving a psychosocial intervention demonstrate better cardiovascular self-care behaviors (i.e., better adherence to diet, better weight management, and greater physical functioning), as well as experience fewer cardiac symptoms and a higher quality of life than patients receiving conventional rehabilitation; and (c) identify gender differences in the effectiveness of a psychosocial intervention.
The EXCEL project is a randomized controlled trial with one pre-intervention and three post-intervention (i.e., six weeks, six months, and one year) assessments. One hundred dyads are being randomly assigned to the experimental intervention plus conventional rehabilitation and 100 dyads are being assigned to conventional rehabilitation only. The psychosocial intervention consists of educating and counseling patients and their partners to work together and support one another to incorporate lifestyle modifications into their daily routine. Participants are recruited from cardiac rehabilitation programs in the Detroit metropolitan area including programs at Henry Ford Hospital and Medical Center (main campus and Livonia sites), St. John Hospital and Providence Hospital. African Americans enrolled in cardiac rehabilitation (those with Stage IV heart failure are excluded) and who have a support partner (could be a spouse, family member, friend or neighbor) who agrees to be interviewed with them, as well as participate in the psychosocial intervention should they be randomly assigned to that group, are eligible.
