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