Effectiveness of Interventions Based on Social Cognitive Theory in Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.

BACKGROUND

Cardiovascular disease (CVD) is a leading cause of mortality and disability worldwide, posing significant challenges to the quality of healthcare services. Social Cognitive Theory (SCT) provides a framework for understanding individual behaviors and guides the development of intervention programs aimed at promoting health-enhancing behaviors.

AIMS: To evaluate the effectiveness of interventions based on SCT in improving health outcomes among patients with CVD.

METHODS

From the creation of the databases until September 2024, we searched six databases and manually searched the references included in the study. The outcomes included cardiovascular risk factors (weight, blood pressure, blood lipids), physical capacity (6-min walk test, physical activity, daily steps, exercise self-efficacy), psychological states (anxiety, depression), and health behaviors (self-management, self-efficacy, quality of life). The quality of randomized controlled trials was evaluated with the Cochrane RoB 2 tool, and quasi-experimental studies were assessed using the JBI critical appraisal tool.

RESULTS

A total of 10 studies, involving 1140 participants, were included in the review. Compared to conventional cardiovascular care, interventions based on SCT were able to lower systolic blood pressure (MD = -6.36; 95% CI [-11.30, -1.41]; p = 0.012), total cholesterol (MD = -0.29; 95% CI [-0.49, -0.09]; p = 0.004), and low-density lipoprotein levels (MD = -0.21; 95% CI [-0.38, -0.04]; p = 0.015) in CVD patients. They also increased the 6-min walk test distance (MD = 33.87, 95% CI [5.40, 62.34], p = 0.02) and daily steps (SMD = 0.77; 95% CI [0.46, 1.09]; p < 0.001), improved physical activity (SMD = 0.65; 95% CI [0.25, 1.06]; p = 0.002) and exercise self-efficacy (SMD = 1.23, 95% CI [0.23, 2.23], p = 0.016), and enhanced quality of life (SMD = 0.75, 95% CI [0.06, 1.43], p = 0.032).

LINK EVIDENCE TO ACTION: Social cognitive theory-based interventions hold promise for improving health outcomes in patients with cardiovascular disease. This study provides further insights into the application of SCT in clinical practice. However, given the limited number of included studies and the potential risk of bias, further high-quality research is required to validate these findings.