Translation and evaluation of a comprehensive educational program for cardiac rehabilitation patients in Latin America: A multi-national, longitudinal study

Gabriela Lima de Melo Ghisi, Sherry L Grace, Claudia V Anchique, Ximena Gordillo, Rosalía Fernandez, Daniel Quesada, Blanca Arrieta Loaiciga, Patricia Reyes, Elena Chaparro, Renzo Soca Meza, Julia Fernandez Coronado, Marco Heredia Ñahui, Rocio Palomino Vilchez, Paul Oh
Patient Education and Counseling 2020 October 13

OBJECTIVES: To translate, cross-culturally adapt and validate a comprehensive evidence- and theoretically-based CR education intervention in Latin America.

METHODS: First, best practices in translation and cross-cultural adaptation were applied through 6 steps. Then, the Spanish version was delivered to CR participants from programs in Colombia, Costa Rica and Peru for validation, such that the evaluation was pre-post, uncontrolled, pragmatic, observational, and prospective in design. Participants completed surveys assessing knowledge, health literacy, self-efficacy, and health behaviours. All outcomes were assessed pre-, and post-CR, as well as 6 months after CR completion.

RESULTS: After translation of the patient guide from English to Spanish, 5 of the 9 booklets were culturally adapted. Two-hundred and forty-nine patients consented to participate, of which 184 (74 %) completed post-CR, and 121 (48 %) completed final assessments. There was a significant improvement in disease-related knowledge pre- to post-CR, as well as in health literacy, self-efficacy, and health behaviours (all p < 0.05). These gains were sustained 6 months post-program. With adjustment, CR attendance (i.e., exposure to the education) was associated with greater post-CR knowledge (ß = 0.026; p = 0.01).

CONCLUSION: A patient education intervention for CR patients in Latin America has been validated, and wider implementation is warranted.

PRACTICE IMPLICATIONS: Application of this first-ever validated CR education program for Spanish-speaking settings may result in secondary prevention.

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