Hopelessness in heart patients study to factor in COVID-19

A University of Illinois Chicago research study on how to improve care for heart disease patients struggling with hopelessness has been supplemented by the National Institutes of Health, or NIH, to determine whether the study intervention called "Heart Up!" limits the negative impact of COVID-19 shelter-in-place and physical distancing measures on health outcomes.

Prior to the COVID-19 pandemic, 43 patients had been enrolled in UIC's "Heart Up!" study aimed at motivating heart disease patients suffering from hopelessness to be more physically active.

The grant's supplement will allow researchers to evaluate the impact of the study by comparing the patients enrolled before COVID-19 shelter-in-place/physical distancing measures began with patients enrolled after the start of the pandemic. The supplement allows for followup with all patients for a longer period—one year.

The funds also will support adding two COVID-19-related questionnaires for patients:

• Multi-Ethnic Study of Atherosclerosis COVID-19 Questionnaire to assess COVID-19 symptoms, diagnosis, testing and social distancing.
• Coronavirus Impact Scale to quantify how COVID-19 has changed the participant's life via routine; income/employment; access to food, medical care, mental health care, extended family; and stress/discord.

Susan Dunn, UIC associate professor of nursing and the study's principal investigator, said they will continue to measure multiple key variables—hopelessness, depression, suicidal ideation, anxiety, perceived social support, motivation, quality of life, well-being and physical activity—that may improve understanding of how the "Heart Up!" intervention may change the impact of the shelter-in-place/physical distancing measures on health outcomes. Since the onset of the COVID-19 pandemic, the research project transitioned to remote delivery, so participants are not exposed to the virus.

Hopelessness is a negative outlook and sense of helplessness toward the future. It can be a temporary response to an event or a habitual outlook. Hopelessness is associated with decreased physical functioning and lower physical activity in individuals with heart disease. Researchers have been trying to understand the links between hopelessness and physical activity, as well as a number of other mental, social and behavioral health outcomes in patients with heart disease.

"We are not focused on the virus itself, but on the effects of the COVID-19 shelter-in-place and physical distancing efforts on physical activity and other health outcomes. If physical activity is decreased, that puts heart disease patients at higher risk for complications and future development of heart disease and other chronic illnesses," said Dunn, who noted that the study's results can inform interventions during this and future pandemics.

Dunn is joined by co-investigators Ulf Bronas and Eileen Collins from the UIC College of Nursing.

The original project is funded by the National Institute of Nursing Research of the NIH (R01NR017649). The new funding, $200,000 over two years, is in addition to the $2.4 million research grant from NIH.