Cardiac rehabilitation (CR) is a program of exercise training, risk factor modification, and counseling that reduces mortality and hospitalizations and improves health status in patients with heart disease. However, only 10% of eligible Veterans receive this guideline-recommended treatment. Most CR programs require patients to travel to a facility for rehabilitation sessions three times per week for twelve weeks, which represents a significant barrier for many patients. Home CR is an acceptable alternative to facility-based CR, but has other challenges related to patient and provider communication. Mobile technology can provide access to health interventions, motivate patients to engage in healthy behaviors, and facilitate patient-provider communication. The awardee partnered with the VA Office of Connected Care to develop a patient mobile application for CR (VA FitHeart) and corresponding provider mobile application for viewing patient-generated data (CR Pro).
Specific aims were to: 1) Identify barriers and facilitators to use of a mobile application for CR among Veterans. (2) Determine provider-level adaptations for the intervention. (3) Pilot test a home CR intervention that uses mobile technology.
Aim 1: Veterans enrolled in home CR will use the mobile application at home for 1 month, complete questionnaires, and participate in interviews about their experience. Aim 2: Providers and key stakeholders will participate in interviews about integrating the use of mobile technology into clinical care and develop strategies for integrating mobile technology into workflow. Aim 3: Veterans enrolled in home CR will be randomized to receive home CR either with or without an intervention that is facilitated by mobile technology for 12 weeks. The primary goal will be to determine the feasibility of enrolling Veterans in a study of the intervention. The secondary goal will be to determine whether the intervention leads to greater participation in CR.
Not yet available.
Staff at 4 VA sites (Puget Sound, West Haven, Dayton, and Northern California) were trained to introduce VA FitHeart to Veterans. Approximately 20 Veterans used the VA FitHeart app during Field Testing. VA FitHeart and CR Pro are both expected to enter Field Testing in Summer 2018 at 3 VA sites (San Francisco, Iowa City, and Indianapolis). It is anticipated the mobile applications will be nationally deployed in FY2019 and may be used by all Veterans to aid participation in CR and improve cardiovascular disease health.
- Beatty AL, Magnusson SL, Fortney JC, Sayre GG, Whooley MA. VA FitHeart, a Mobile App for Cardiac Rehabilitation: Usability Study. JMIR human factors. 2018 Jan 15; 5(1):e3.
- Beatty AL, Truong M, Schopfer DW, Shen H, Bachmann JM, Whooley MA. Geographic Variation in Cardiac Rehabilitation Participation in Medicare and Veterans Affairs Populations: Opportunity for Improvement. Circulation. 2018 May 1; 137(18):1899-1908.
- Beatty AL, Bradley SM, Maynard C, McCabe JM. Referral to Cardiac Rehabilitation After Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Valve Surgery: Data From the Clinical Outcomes Assessment Program. Circulation. Cardiovascular quality and outcomes. 2017 Jun 1; 10(6).
- Park LG, Beatty A, Stafford Z, Whooley MA. Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease. Progress in Cardiovascular Diseases. 2016 May 1; 58(6):639-50.
- Beatty AL. VA FitHeart: a mobile application for cardiac rehabilitation. VA BETA App Store: U.S. Department of Veteran Affairs; 2017 Sep 1. Available from: https://mobile.va.gov/app/beta/fitheart.
Technology Development and Assessment