A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial
Open accessAbstract
Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions 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). Compared 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 intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.
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Positive psychology interventions are well accepted by patients.
“These interventions are well accepted by patients, require little staff training, and can be delivered remotely. 13-15”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [15]
Positive psychology interventions require little staff training.
“These interventions are well accepted by patients, require little staff training, and can be delivered remotely. 13-15”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [15]
Positive psychology-based programs have led to improvements in health behaviors in studies of patients with hypertension or heart disease.
“Positive psychology-based programs have also led to improvements in health behaviors in studies of patients with hypertension or heart disease, 15-17”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [15]
Positive psychology interventions can be delivered remotely.
“These interventions are well accepted by patients, require little staff training, and can be delivered remotely. 13-15”
From Feasibility and acceptability of a positive psychological intervention for patients with type 2 diabetes (2016) · cites this paper as [15]
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Mohammadi, N., Aghayousefi, A., Nikrahan, G. R., Adams, C. N., Alipour, A., Sadeghi, M., Roohafza, H., Celano, C. M., & Huffman, J. C. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.12.004 · Cited by 66 · see citing works
Self-citationTesting a Positive Psychological Intervention for Osteoarthritis
Hausmann, L. R. M., Youk, A. O., Kwoh, C. K., Ibrahim, S. A., Hannon, M. J., Weiner, D. K., Gallagher, R. M., & Parks, A. C. (2017) · Pain Medicine · doi:10.1093/pm/pnx141 · Cited by 59 · see citing works
Positive psychology interventions for patients with heart disease: a preliminary randomized trial
Nikrahan, G., Suarez, L., Asgari, K., Beach, S., Celano, C., Kalantari, M., Abedi, M., Etesampour, A., Abbas, R., & Huffman, J. (2016) · Psychosomatics · doi:10.1016/j.psym.2016.03.003 · Cited by 59 · see citing works
Self-citationHuffman, J. C., Adams, C. N., & Celano, C. M. (2017) · Psychosomatics · doi:10.1016/j.psym.2017.09.003 · Cited by 48 · see citing works
Self-citationDuBois, C. M., Millstein, R. A., Celano, C. M., Wexler, D. J., & Huffman, J. C. (2016) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.15m01902 · Cited by 45 · see citing works
Self-citationWęziak‐Białowolska, D., Białowolski, P., & Niemiec, R. M. (2022) · Journal of Research in Personality · doi:10.1016/j.jrp.2022.104338 · Cited by 45 · see citing works
Hausmann, L. R. M., Youk, A. O., Kwoh, C. K., Gallagher, R. M., Weiner, D. K., Vina, E. R., Obrosky, D. S., Mauro, G. T., McInnes, S., & Ibrahim, S. A. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.2533 · Cited by 44 · see citing works
Celano, C., Freedman, M., Beale, E., Gomez-Bernal, F., & Huffman, J. (2018) · Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000883 · Cited by 34 · see citing works
Self-citationHuffman, J. C., Albanese, A. M., Campbell, K. A., Celano, C. M., Millstein, R. A., Mastromauro, C. A., Healy, B. C., Chung, W., Januzzi, J. L., Collins, L. M., et al. (2017) · Clinical Trials · doi:10.1177/1740774516673365 · Cited by 36 · see citing works
Self-citationMagán, I., Casado, L., Barba, R. J., Barnum, H., Redondo, M. M., Hernández, A. V., & Bueno, H. (2020) · Psychological Medicine · doi:10.1017/s0033291720000598 · Cited by 36 · see citing works
A positive psychology intervention for patients with bipolar depression: a randomized pilot trial
Celano, C. M., Gomez-Bernal, F., Mastromauro, C. A., Beale, E. E., DuBois, C. M., Auerbach, R. P., & Huffman, J. C. (2018) · Journal of Mental Health · doi:10.1080/09638237.2018.1521942 · Cited by 36 · see citing works
Self-citationThe Effects of Positive Psychological Interventions on Medical Patients’ Anxiety: A Meta-analysis
Brown, L., Ospina, J. P., Celano, C. M., & Huffman, J. C. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000722 · Cited by 34 · see citing works
Self-citationTönis, K. J. M., Kraiss, J. T., Linssen, G. C. M., & Bohlmeijer, E. T. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111328 · Cited by 33 · see citing works
Psychological Well-Being and Type 2 Diabetes
Huffman, J. C. (2017) · Current Research in Diabetes & Obesity Journal · doi:10.19080/crdoj.2017.04.555641 · Cited by 32 · see citing works
Self-citationA strengths-based approach to chronic pain
Graziosi, M., Yaden, D. B., Clifton, J. D. W., Mikanik, N., & Niemiec, R. M. (2020) · The Journal of Positive Psychology · doi:10.1080/17439760.2020.1858337 · Cited by 29 · see citing works
Yin and Yang of Psychological Health in the Cancer Experience: Does Positive Psychology Have a Role?
Amonoo, H. L., El-Jawahri, A., Deary, E. C., Traeger, L. N., Cutler, C. S., Antin, J. H., Huffman, J. C., & Lee, S. J. (2022) · Journal of Clinical Oncology · doi:10.1200/jco.21.02507 · Cited by 28 · see citing works
Self-citationKaar, J. L., Luberto, C. M., Campbell, K. A., & Huffman, J. C. (2017) · World Journal of Cardiology · doi:10.4330/wjc.v9.i5.396 · Cited by 28 · see citing works
Self-citationThe Undoing Effect of Positive Emotions: A Meta-Analytic Review
Behnke, M., Pietruch, M., Chwiłkowska, P., Wessel, E., Kaczmarek, L. D., Assink, M., & Gross, J. J. (2022) · Emotion Review · doi:10.1177/17540739221104457 · Cited by 27 · see citing works
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Positive psychological experiences in allogeneic hematopoietic stem cell transplantation
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Self-citationvan Montfort, E., Denollet, J., Widdershoven, J. W. M. G., & Kupper, N. H. M. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.06.009 · Cited by 24 · see citing works
Positive Psychological well-being and Health in Patients With Heart Disease: A Brief Review
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Self-citationRandomized controlled trial of a well-being intervention in cardiac patients
Nikrahan, G. R., Eshaghi, L., Massey, C. N., Hemmat, A., Amonoo, H. L., Healy, B. C., & Huffman, J. C. (2019) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2019.06.005 · Cited by 22 · see citing works
Self-citationPositive psychology in health care: defining key stakeholders and their roles
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Self-citationReprint of: Positive Psychological Well-Being and Cardiovascular Disease
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Self-citationDoes timeframe adjustment of the Life Orientation Test-Revised assess optimism as a state?
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Self-citationWęziak‐Białowolska, D., Lee, M. T., Białowolski, P., Chen, Y., VanderWeele, T. J., & McNeely, E. (2022) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-022-02344-5 · Cited by 18 · see citing works
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Being good, doing good: The role of honesty and integrity for health
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Self-citationThe use of mixed methods to advance positive psychology: A methodological review
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Positive psychological well-being and clinical characteristics in IBS: A systematic review
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Self-citationLeclaire, K. N., Cecil, A., LaRussa, A., Stuart, F., Hemond, C. C., Healy, B. C., Chitnis, T., Weiner, H. L., Huffman, J. C., & Glanz, B. I. (2017) · International Journal of MS Care · doi:10.7224/1537-2073.2017-002 · Cited by 17 · see citing works
Self-citationDuque, L., Brown, L., Celano, C. M., Healy, B. C., & Huffman, J. C. (2019) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2019.06.001 · Cited by 17 · see citing works
Self-citationLegler, S. R., Celano, C. M., Beale, E. E., Hoeppner, B. B., & Huffman, J. C. (2018) · Current Psychology · doi:10.1007/s12144-018-9785-y · Cited by 16 · see citing works
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Self-citationThe Effect of State Gratitude on Cognitive Flexibility: A Within-Subject Experimental Approach
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Huffman, J. C., Feig, E. H., Zambrano, J., & Celano, C. M. (2022) · Affective Science · doi:10.1007/s42761-022-00137-2 · Cited by 17 · see citing works
Self-citationZhu, Q., Wang, Q., & Yang, S. (2023) · The Journal of Positive Psychology · doi:10.1080/17439760.2023.2257678 · Cited by 15 · see citing works
Millstein, R. A., Huffman, J. C., Thorndike, A. N., Freedman, M. E., Scheu, C. F., Kim, S., Amonoo, H. L., Barclay, M. E., & Park, E. R. (2020) · Journal of Physical Activity and Health · doi:10.1123/jpah.2019-0295 · Cited by 15 · see citing works
Self-citationHausmann, L. R. M., Ibrahim, S. A., Kwoh, C. K., Youk, A. O., Obrosky, D. S., Weiner, D. K., Vina, E. R., Gallagher, R. M., Mauro, G. T., & Parks, A. C. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.09.001 · Cited by 12 · see citing works
Perceived benefits of the disease: A qualitative study of patients' experiences of heart failure
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Huffman, J. C., Millstein, R. A., Celano, C. M., Healy, B. C., Park, E. R., & Collins, L. M. (2019) · Annals of Behavioral Medicine · doi:10.1093/abm/kaz035 · Cited by 11 · see citing works
Self-citationKupper, N. H. M., Post, N., Kop, W. J., & Widdershoven, J. W. M. G. (2025) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2025.02.008 · Cited by 15 · see citing works
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Self-citationCommunity‐Based Evaluation of the Associations Between Well‐Being and Cardiovascular Disease Risk
McLeish, A. C., Smith, T., Riggs, D. W., Hart, J. L., Walker, K. L., Keith, R. J., Anderson, L. B., Sithu, I. D., Pinilla‐Baquero, J., Srivastava, S., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.122.027095 · Cited by 9 · see citing works
Pilot Test of an Appreciative Inquiry Intervention in Hypertension Self-management
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Self-citationAn At-home Positive Psychology Intervention for Individuals with Multiple Sclerosis
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Self-citationHuffman, J. C., Harnedy, L. E., Massey, C. N., Carrillo, A., Feig, E. H., Chung, W., & Celano, C. M. (2022) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2022.2049796 · Cited by 8 · see citing works
Self-citationPark, J. W., Dulin, A., Needham, B. L., Sims, M., Loucks, E. B., Fava, J. L., Dionne, L. A., Scarpaci, M. M., Eaton, C. B., & Howe, C. J. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2021.788194 · Cited by 8 · see citing works
Millstein, R. A., Thorndike, A. N., Kim, S., Park, E. R., & Huffman, J. C. (2020) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2020.100626 · Cited by 8 · see citing works
Self-citationAli, S. H., Pio, C. S. D. A., Chaves, G., Britto, R. R., Cribbie, R. A., & Grace, S. L. (2018) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2018.03.006 · Cited by 7 · see citing works
Minhua, L., Shen, T., Cui, H., Lin, L., Ran, P., Huo, P., Chen, L., & Li, J. (2021) · Journal of International Medical Research · doi:10.1177/0300060521990984 · Cited by 8 · see citing works
Emotion Analysis in Hospital Bedside Infotainment Platforms Using Speeded up Robust Features
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Shang, X., Gu, F., Bian, Q., Wang, M., & Lin, Z. (2021) · Gastroenterology Nursing · doi:10.1097/sga.0000000000000594 · Cited by 6 · see citing works
Tabernero, C., Gutiérrez‐Domingo, T., Steca, P., Castillo‐Mayén, R., Cuadrado, E., Rubio, S. J., Farhane‐Medina, N. Z., & Luque, B. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12121953 · Cited by 6 · see citing works
Celano, C. M., Healy, B. C., Jacobson, L. H., Bell, M., Carrillo, A., Massey, C. N., Chung, W., Legler, S. R., & Huffman, J. C. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111583 · Cited by 6 · see citing works
Self-citationFeig, E. H., Celano, C. M., Massey, C. N., Chung, W., Romero, P. M., Harnedy, L. E., & Huffman, J. C. (2020) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.psym.2020.06.002 · Cited by 6 · see citing works
Self-citationPositive Psychological Well-Being in Hematopoietic Stem Cell Transplantation Survivors
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Self-citationA novel health behaviour intervention to promote adherence in kidney failure
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Self-citationHuang, T., & Chen, Y. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.812793 · Cited by 5 · see citing works
Chirinos, D. A., Vargas, E. A., Kamsickas, L., & Carnethon, M. R. (2022) · Health Psychology · doi:10.1037/hea0001191 · Cited by 5 · see citing works
Feig, E. H., Healy, B. C., Celano, C. M., Nikrahan, G. R., Moskowitz, J. T., & Huffman, J. C. (2019) · International Journal of Wellbeing · doi:10.5502/ijw.v9i2.795 · Cited by 5 · see citing works
Self-citationPlys, E., Law, M., Seward, M., Levy, C. R., Lopez, R. P., & Vranceanu, A. (2025) · Aging & Mental Health · doi:10.1080/13607863.2025.2499026 · Cited by 2 · see citing works
Celano, C. M., Golden, J., Healy, B. C., Longley, R. M., & Huffman, J. C. (2021) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217421989830 · Cited by 2 · see citing works
Self-citationKanellakis, K., Papadimitriou, A., Karakasidou, E., & Stalikas, A. (2022) · Psychology · doi:10.4236/psych.2022.131002 · Cited by 2 · see citing works
Holistic Health: Integrating Psychological Factors for a Balanced Life
Locsin, B. (2024) · Journal of Asian Multicultural Research for Medical and Health Science Study · doi:10.47616/jamrmhss.v4i3.452 · Cited by 2 · see citing works
Stallman, H. M., Lushington, K., & Varcoe, T. J. (2023) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2023.101230 · Cited by 1 · see citing works
Magán, I., Barba, R. J., Moreno, G., Sanz-Ayan, P., Izquierdo-García, J., Corradi, G. B., Tello, R., & Bueno, H. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1420137 · Cited by 1 · see citing works
Hernández, R., Chen, J., Kwon, S., Martinez, L., Martínez, Á., Alemañy, G. M., Romero, D., Addington, E. L., Huffman, J. C., & Moskowitz, J. T. (2025) · Journal of Happiness Studies · doi:10.1007/s10902-024-00854-4 · Cited by 1 · see citing works
Self-citationMadva, E. N., Huffman, J. C., Castillo, C., Harnedy, L. E., Franklin, T., Song, M., Murray, H. B., Healy, B. C., Staller, K. D., Bartels, S., et al. (2025) · Neurogastroenterology & Motility · doi:10.1111/nmo.70146 · Cited by 1 · see citing works
Self-citationPositive Psychology Interventions and Cardiovascular Health
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Best-Practice Mental Health Interventions Following Acute Cardiovascular Events
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Positive Psychological Well-Being and Cardiovascular Disease
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Huffman, J. C., Healy, B. C., Jacobson, L. H., Harnedy, L. E., Bell, M., Carrillo, A., & Celano, C. M. (2023) · Current Psychology · doi:10.1007/s12144-023-05267-9 · Cited by 1 · see citing works
Self-citationPhysical and Medical Disorders and Character Strengths
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Zeinali, N., Akbari, M., & Ghezelbash, S. (2026) · BMC Psychology · doi:10.1186/s40359-025-03900-9
- Authors
- Huffman, J. C., Millstein, R. A., Mastromauro, C. A., Moore, S. V., Celano, C. M., Bedoya, C. A., Suarez, L., Boehm, J. K., & Januzzi, J. L.
- Affiliations
- Harvard University (US)
- Chapman University (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Huffman, Jeff C.
- ORCID
- Venue
- Journal of Happiness Studies
- Published
- 2015-10-19
- Volume
- 17
- Issue
- 5
- Pages
- 1985-2006
- ISSN
- 1389-4978 (ISSN-L)
- 1573-7780
- PMC
- PMC5222616
- OpenAlex
- W1759267738
- Cited by
- 102
- References
- 76
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 10 · 2022: 16 · 2021: 7 · 2020: 14 · 2019: 11 · 2018: 11 · 2017: 13 · 2016: 3
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Happiness Studies (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- National Institutes of Health (R01HL113272)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- positive psychology interventions, acute coronary syndrome, cardiac patients, telephone-delivered intervention, intervention development, feasibility and acceptability, positive affect, anxiety, depression, dispositional optimism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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