Physical activity after cardiac events (PACES)

INTERVENTION: Eligible participants will be randomised, apart from those in the same household, using a block design and stratified by gender (men; women), and ethnicity (White European; other) to one of two groups. Control group: Participants will be provided with general health advice in the form of a British Heart Foundation standard information leaflet and will be returned to standard care delivered by their general practitioner. Intervention group: Participants will receive the British Heart Foundation standard information leaflet and will be invited to attend two group‐based structured education sessions. Theses education sessions will be delivered by trained facilitators approximately two weeks apart and will receive subsequent reinforcement via text message support thereafter (section 3.2). These structured education sessions have been developed and refined in conjunction with PPI work and through the use of existing infrastructure consisting of Diabetes Education and Self‐Management in on‐going and Newly Diagnosed (DESMOND) groups and a network of trained facilitators. The participants will receive 82 physical activity related text messages at different weekly frequencies following the second education session to the 12 month follow‐up assessment. Participants in both groups will be followed up after 6 and 12 months. CONDITION: Specialty: Diabetes, Primary sub‐specialty: Both; UKCRC code/ Disease: Cardiovascular/ Other forms of heart disease ; Circulatory System ; Coranry Heart Disease PRIMARY OUTCOME: Average daily physical activity is assessed using an accelerometer (Average daily physical activity ‐ Milligravities [mg]) worn for eight days at baseline, 6 and 12 months. SECONDARY OUTCOME: 1. Aerobic fitness is assessed using an Incremental Shuttle walk test (metres) at baseline and 12 months; 2. Anthropometric measures of height, body mass, BMI, waist circumference, hip circumference and waist to hip ratio are measured using standard techniques at baseline and 12 months; 3. Blood pressure (mmHg) & resting heart rate (bpm) are measured using standard techniques at baseline and 12 months; 4. Lipid profile (Cholesterol, HDL, LDL, Triglycerides) is measured via venepuncture at baseline and 12 months ; 5. HbA1c (mmol/mol, %) is measured via venepuncture at baseline and 12 months ; 6. Self‐efficacy for exercise expectations is measured using the Jenkins self‐efficacy for exercise expectations scale at baseline, 6 and 12 months; 7. Anxiety and depression is measured using the Hospital Anxiety and Depression scale (HADS) at baseline, 6 and 12 months; 8. Self‐reported physical activity is measured using the Recent Physical Activity Questionnaire (RPAQ) at baseline, 6 and 12 months; 9. Quality of life is measured using the EuroQoL EQ‐5D‐5L at baseline, 6 and 12 months; 10. Chronotype is measured using the Morningness‐ Eveningness Questionnaire at baseline, 6 and 12 months; 11. Biomarkers of inflammation, proteomics, metabolomics and novel markers of cardiovascular health are measured via venepuncture at baseline and 12 months INCLUSION CRITERIA: 1. Aged 18 years or older 2. 12‐36 months post confirmed diagnosis of a cardiac event (myocardial infarction, angina or acute coronary syndrome) 3. Able to speak and read English to participate effectively in a group education programme 4. Willing and able to attend the education sessions and clinic visits 5. Willing and able to give informed consent 6. Access to a mobile phone in order to receive text messages 7. Willingness to allow GP notification of their participation in study and access to patient records for purpose of study 8. Able to take part in moderate physical activity as assessed using Incremental Shuttle Walk Test (ISWT) (Level three or above)