Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interven- tions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of- concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d ). The PP intervention and treatment manual were successfully created. In the proof-of- concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease ( M = 7.4/10; SD = 2.1) and utility ( M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements ( d s = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism ( d = .08). Com- pared to TAU participants ( n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression ( d s = . 47–.71), but not optimism. A PP inter- vention was feasible, well-accepted, and associated with improvements in most psycho- logical measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.
