Efficacy and Adherence Rates of a Novel Community-Informed Virtual World-Based Cardiac Rehabilitation Program:...

Area of Science:

• Cardiovascular Medicine
• Digital Health
• Implementation Science

Background:

• Cardiac rehabilitation (CR) delivery needs innovative restructuring to overcome barriers and enhance access for diverse populations.
• Destination Cardiac Rehab (DCR) is a novel virtual world technology-based CR program, previously found acceptable as an extension of traditional center-based CR.
• This study employs an implementation science framework to assess DCR's efficacy and adherence compared to center-based CR.

Purpose of the Study:

• To evaluate the efficacy and adherence of the virtual world-based DCR program compared to traditional center-based CR.
• To assess the potential of DCR as a scalable model for improving CR participation and advancing health equity.
• To inform the use of effective virtual CR programs for expanding equitable access to diverse patient populations.

Main Methods:

• A noninferiority, hybrid type 1 effectiveness-implementation, randomized controlled trial involving 150 patients from 6 diverse US CR centers.
• Participants randomized 1:1 to 12-week DCR or center-based CR, with outcomes assessed at 3 and 6 months.
• Primary efficacy outcome: composite cardiovascular health score (American Heart Association Life's Essential 8); adherence outcomes: CR session attendance and exercise participation.

Main Results:

• The study is ongoing, with results to be published upon completion of data collection and analysis.
• The trial design incorporates a patient/caregiver/stakeholder advisory board to guide implementation and contextualize findings.
• Recruitment and randomization occur in 3 waves per year over 3 years for the institutional review board-approved trial.

Conclusions:

• The Destination Cardiac Rehab randomized controlled trial investigates an innovative, scalable model to boost CR participation and promote health equity.
• Findings will guide the implementation of virtual CR programs to broaden equitable access for varied patient groups.
• This research addresses the critical need for accessible and effective cardiac rehabilitation solutions.