Procedures

The lead author reviewed the charts of potential participants to identify eligible patients, introduced the study, and invited them to participate in the study. Those who agreed were consented and screened for cognitive impairment (Figure 2). Those who passed the cognitive screening were enrolled into the quantitative arm of the study and completed the survey using paper and pencil. Completion of the survey required 15 to 30 minutes.

Consort flowchart of enrollment

Flow diagram of participant enrollment showing exclusion criteria

We selected participants for interview based on their Self-Care Maintenance scores because self-care maintenance includes behaviors that reflect HF treatment adherence. Once a participant completed the survey, the scale was scored before offering the opportunity to be interviewed. We also ensured that the poor and excellent self-care maintenance groups included an approximately equal distribution of participants by race and gender. Those who agreed to the interview consented to audiotaping of the interview.