Hopelessness is associated with a 3.4 times increased risk of mortality or nonfatal myocardial infarction in patients with ischemic heart disease, independent of depression. Hopelessness has been identified in 27–52% of patients with ischemic heart disease and can persist for up to 12 months after hospital discharge. Hopelessness, a negative outlook and sense of helplessness toward the future, can be a temporary response to an event (state) or a habitual outlook (trait). Hopelessness is associated with decreased physical functioning and lower physical activity levels in individuals with ischemic heart disease. Low levels of physical activity independently contribute to increased death and adverse events in patients with ischemic heart disease.

The purpose of this randomized controlled trial is to establish the effectiveness of our 6-week mHealth intervention (Heart Up!) to promote increased physical activity in hopeless patients with ischemic heart disease. We will enroll 225 hopeless ischemic heart disease patients from a large community teaching hospital in the Midwest.

The findings from this study could transform care for ischemic heart disease patients who are hopeless by promoting self-management of important physical activity goals that can contribute to better health outcomes. This proposal supports the National Institute of Nursing Research’s investment in self-management to improve the quality of life for individuals with chronic illness.