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社区导向的虚拟世界为基础的心脏康复计划作为中心为基础的心脏康复的延伸:多中心试点研究的混合方法分析。

A Community-Informed Virtual World-Based Cardiac Rehabilitation Program as an Extension of Center-Based Cardiac Rehabilitation: MIXED-METHODS ANALYSIS OF A MULTICENTER PILOT STUDY.

机构信息

Departments of Cardiovascular Medicine (Drs Brewer, Squires, Thomas, and Kopecky and Ms Leth) and Internal Medicine (Dr Abraham), Mayo Clinic College of Medicine, Rochester, Minnesota; Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, Minnesota (Drs Brewer, and Penheiter); Global Products and Services, Mayo Clinic Center for Innovation, Rochester, Minnesota (Mr Kaihoi); Center for the Science of Health Care Delivery, Mayo Clinic College of Medicine, Rochester, Minnesota (Mr Egginton); Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota (Messrs Slusser and Scott); Center for Health Equity and Community Engagement Research, Mayo Clinic, Jacksonville, Florida (Ms Albertie); Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Scottsdale, Arizona (Dr Scales); and Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Jacksonville, Florida (Dr Trejo-Gutierrez).

出版信息

J Cardiopulm Rehabil Prev. 2023 Jan 1;43(1):22-30. doi: 10.1097/HCR.0000000000000705. Epub 2022 Jul 25.

Abstract

PURPOSE

Innovative methods for delivering cardiac rehabilitation (CR) that provide strategies to circumvent the mounting barriers to traditional CR have the potential to widen access to a well-established secondary prevention strategy. Our study assesses the feasibility and acceptability of a novel virtual world-based CR (VWCR) program, Destination Rehab , as an extension of a conventional center-based CR program.

METHODS

Adult cardiac patients hospitalized at Mayo Clinic hospitals with a diagnosis for CR and ≥1 modifiable, lifestyle risk factor target-sedentary lifestyle (<3 hr physical activity/wk), unhealthy diet (<5 servings fruits and vegetables/d), or current smoking (>1 yr)-were recruited. Patients participated in an 8-wk health education program using a virtual world (VW) platform from a prior proof-of-concept study and a post-intervention focus group. Primary outcome measures included feasibility and acceptability. Secondary outcome measures included changes from baseline to post-intervention in cardiovascular (CV) health behaviors and biometrics, CV health knowledge, and psychosocial factors.

RESULTS

Of the 30 enrolled patients (age 59.1 ± 9.7 yr; 50% women), 93% attended ≥1 session and 71% attended ≥75% of sessions. The overall VWCR experience received an 8 rating (scale 0-10) and had high acceptability. Clinically relevant trends were noted in CV health behaviors and biometrics, although not statistically significant.

CONCLUSIONS

The VWCR program is a feasible, highly acceptable, and innovative platform to potentially influence health behaviors and CV risk and may increase accessibility to disadvantaged populations with higher CV disease burdens.

摘要

目的

创新的心脏康复(CR)传递方法提供了规避传统 CR 日益增加的障碍的策略,有可能扩大广泛应用这一既定二级预防策略的机会。我们的研究评估了基于虚拟世界的新型 CR(VWCR)项目 Destination Rehab 的可行性和可接受性,该项目是传统中心式 CR 项目的延伸。

方法

在梅奥诊所住院的患有 CR 诊断且有≥1 个可修正的生活方式风险因素目标(久坐生活方式<3 小时/周)、不健康饮食(<5 份水果和蔬菜/天)或当前吸烟(>1 年)的成年心脏病患者被招募入组。患者使用来自先前概念验证研究的虚拟世界(VW)平台参加了 8 周的健康教育计划,并在干预后参加了焦点小组。主要结局指标包括可行性和可接受性。次要结局指标包括从基线到干预后的心血管(CV)健康行为和生物标志物、CV 健康知识和心理社会因素的变化。

结果

在纳入的 30 名患者(年龄 59.1±9.7 岁;50%为女性)中,93%的患者参加了≥1 次课程,71%的患者参加了≥75%的课程。整体 VWCR 体验获得了 8 分(评分范围为 0-10),具有很高的可接受性。尽管没有统计学意义,但在 CV 健康行为和生物标志物方面观察到了临床相关的趋势。

结论

VWCR 项目是一种可行的、高度可接受的、创新的平台,有可能影响健康行为和 CV 风险,并且可能增加对具有更高 CV 疾病负担的弱势人群的可及性。

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