Changes in physical activity behaviors and influencing factors among children and adolescents with heart disease after hospital discharge: a 3-month follow-up study.

Physical activity levels significantly decreased at 3 months post-discharge in children and adolescents with heart disease.

• The decline was statistically significant (Z = -9.940, p < 0.001).
• The study recruited 217 children and adolescents aged 6-18 years with heart disease.
• A prospective, two-time-point follow-up design was used, assessing participants at discharge and 3 months post-discharge.
• Both patients who underwent cardiac surgery and those receiving conservative management were included.

Intention and self-efficacy significantly and positively predicted physical activity levels in the longitudinal generalized linear mixed-effects model.

• Intention positively predicted physical activity (β = 0.074, p < 0.001).
• Self-efficacy positively predicted physical activity (β = 0.223, p < 0.001).
• These findings were derived from generalized linear mixed-effects models fitted to identify longitudinal effects.

Time, intention-behavior gap, and kinesiophobia showed significant negative correlations with physical activity levels.

• Time was negatively associated with physical activity (β = -0.665, p < 0.001), reflecting the decline over the follow-up period.
• Intention-behavior gap was negatively associated with physical activity (β = -0.401, p < 0.05).
• Kinesiophobia was negatively associated with physical activity (β = -0.043, p < 0.001).
• Kinesiophobia is described as 'a prominent and independent barrier to physical activity among children and adolescents with heart disease.'

The interaction between time and parental support had a significant positive influence on physical activity levels, indicating that the role of parental support strengthened over time.

• The interaction term between time and parental support was significant (β = 0.028, p = 0.037).
• Parental support is described as 'a key and stable facilitator, exhibiting a strengthening protective effect against the characteristic post-discharge decline in physical activity.'
• The role of parental support increased after 3 months post-discharge.

The proportion of participants in the 'intention-behavior gap' group increased from 39.2% to 43.3% between discharge and 3-month follow-up.

• The McNemar-Bowker test was used to analyze how intention-behavior quadrant membership shifted between the two time points.
• The intention-behavior gap group increased from 39.2% at discharge to 43.3% at 3-month follow-up.
• Higher baseline physical activity levels helped prevent complete inactivity but did not effectively predict whether an individual would enter the 'intention-behavior gap' group at follow-up.
• Multinomial logistic regression was applied to determine if baseline physical activity levels could predict quadrant membership at follow-up.

Previously identified determinants of physical activity in children and adolescents with heart disease account for less than 15% of the variance in physical activity behavior.

• Known determinants encompass both familial factors and individual-level factors.
• This limited explained variance was noted as a gap in the existing literature motivating the study.
• The study sought to explore how intention, intention-behavior gap, self-efficacy, kinesiophobia, and parental support affect physical activity longitudinally.