Title: Mechanisms leading to sedentary behavior in patients with coronary heart disease: A structural equation modeling guided by the capability, opportunity, motivation behavior model
Abstract:
Background: Sedentary behavior is highly routinized in the daily lives of patients with coronary heart disease (CHD). However, the factors and their mechanistic pathways remain unclear. This study evaluated sedentary behavior in patients with CHD and explored potential mechanisms leading to sedentary behavior based on the Capability, Opportunity, and Motivation to Behavior model.
Methods: This cross-sectional study employed a convenience sampling method to recruit adults with CHD from three communities located in Hangzhou, China. We collected self-reported survey data on demographic information, clinical characteristics, capability (physical function and knowledge of sedentary behavior), opportunity (social support and walking environment), and motivation (depression, sedentary behavior habit, fear of movement, and intention to reduce sedentary behavior), and sedentary behavior. Descriptive statistical analysis and path analysis were conducted to analyze and interpret the data.
Results: The analysis included 323 patients with CHD (mean age 63.60 ± 11.28 years) who reported an average of 9.52 ± 1.89 daily hours of sedentary behavior. The path analysis showed that the model had acceptable fit indices: χ²/df = 1.703, RMSEA = 0.047, CFI = 0.996, NFI = 0.991, TLI = 0.977. Physical function, knowledge of sedentary behavior, social support, and walking environment had direct and indirect effects on sedentary behavior in patients with CHD (total effects: β = -0.195, β = -0.223, β = -0.331, and β = -0.194, respectively), and depression, sedentary behavior habit, fear of movement, and intention to reduce sedentary behavior had direct effects on sedentary behavior in patients with CHD (total effects: β = 0.158, β = 0.099, β = 0.113, and β = -0.150, respectively).
Conclusions: The high levels of sedentary behavior among our sample of participants warrant awareness among healthcare professionals. Capability, opportunity, and motivation were effective factors of sedentary behavior in patients with CHD. Healthcare professionals should design targeted interventions to decrease sedentary behavior in this population.
