Human-Centered Design to Tailor Telehealth Cardiac Rehabilitation to Diverse Populations: The
MCNAIR Study
Abstract Body (Do not enter title and authors here): Background: Delivering cardiac rehabilitation (CR) by telehealth may increase participation and promote equitable access to CR. Our objective was to tailor a patient-centered telehealth CR program to diverse populations.
Methods: We recruited participants with varying CR experience (e.g. attended >1 session, did not attend CR, and caregivers) between January and September 2023 from four US academic medical centers. Participants engaged in human-centered design sessions on CR perspectives and a proposed telehealth CR program. Sessions were qualitatively analyzed using rapid template analysis with pre-selected behavioral science constructs and other emergent codes. Based on participant feedback, we iteratively revised the telehealth CR program and created an implementation toolkit.
Results: Among 21 participants (76% ≥65 years, 50% female, 60% non-Hispanic White; 90% attended >1 session, 10% caregiver of a CR participant, 5% prefer not to answer), CR was overall regarded as valuable. Benefits included accountability, confidence, and feeling better. Social support was appreciated from family, friends, program co-participants, and CR staff. Participants emphasized the importance of early goal setting, accountability, and program individualization. Participants thought that using technology for telehealth CR could be helpful for accountability, facilitating relationships, and convenience. However, some participants had concerns about safety, especially at the start of their telehealth program, and desired checks such as a monitoring device or observation of exercise over video. Through human-centered design, safety protocols and technology training were developed, which participants thought addressed their concerns about participating in telehealth CR. The implementation toolkit informed by human-centered design included a participant journey, safety plan, home exercise plan for use during and after CR, and scripts for technology training and telehealth visits. Selected quotes are presented in Figure 1.
Conclusions: We developed a patient-centered telehealth CR program and implementation toolkit. Future research will test the comparative effectiveness of in-person and telehealth CR on patient-centered outcomes.
Oanesa, Rae Denise
( UCSF
, San Francisco
, California
, United States
)
Spaulding, Erin
( Johns Hopkins School of Nursing
, Baltimore
, Maryland
, United States
)
Brewer, Laprincess
( MAYO CLINIC
, Rochester
, Minnesota
, United States
)
Golbus, Jessica
( UNIVERSITY OF MICHIGAN
, Ann Arbor
, Michigan
, United States
)
Martin, Seth
( Johns Hopkins School of Medicine
, Baltimore
, Maryland
, United States
)
Nallamothu, Brahmajee
( UNIVERSITY OF MICHIGAN
, Ann Arbor
, Michigan
, United States
)
Beatty, Alexis
( UCSF
, San Francisco
, California
, United States
)
Atluri, Namratha
( UNIVERSITY OF MICHIGAN
, Ann Arbor
, Michigan
, United States
)
Z Ali, Yehia
( UNIVERSITY OF PITTSBURGH
, Pittsburgh
, Pennsylvania
, United States
)
Khoury, Shireen
( Johns Hopkins School of Medicine
, Baltimore
, Maryland
, United States
)
Lageza, Vanessa
( UNIVERSITY OF PITTSBURGH
, Pittsburgh
, Pennsylvania
, United States
)
Mcnair, Patricia
( Patient partner
, North Andover
, Massachusetts
, United States
)
Merritt, Greg
( Patient is Partner, LLC
, Brighton
, Michigan
, United States
)
Mishra, Sonali
( UNIVERSITY OF MICHIGAN
, Ann Arbor
, Michigan
, United States
)
Forman, Daniel
( UNIVERSITY OF PITTSBURGH
, Pittsburgh
, Pennsylvania
, United States
)
Author Disclosures:
Rae Denise Oanesa:DO NOT have relevant financial relationships
| Erin Spaulding:DO have relevant financial relationships
;
Consultant:Corrie Health:Active (exists now)
| LaPrincess Brewer:DO NOT have relevant financial relationships
| Jessica Golbus:DO NOT have relevant financial relationships
| Seth Martin:DO have relevant financial relationships
;
Ownership Interest:Corrie Health:Active (exists now)
; Consultant:89bio:Past (completed)
; Consultant:Sanofi:Past (completed)
; Consultant:Premier:Past (completed)
; Consultant:Novo Nordisk:Past (completed)
; Consultant:Novartis:Past (completed)
; Consultant:NewAmsterdam:Past (completed)
; Consultant:Kaneka:Past (completed)
; Consultant:Chroma:Past (completed)
; Consultant:BMS:Past (completed)
; Consultant:AstraZeneca:Past (completed)
; Consultant:Amgen:Past (completed)
; Research Funding (PI or named investigator):Merck:Active (exists now)
; Research Funding (PI or named investigator):Apple:Active (exists now)
; Research Funding (PI or named investigator):Google:Active (exists now)
| Brahmajee Nallamothu:DO have relevant financial relationships
;
Consultant:AngioInsight:Active (exists now)
| Alexis Beatty:DO NOT have relevant financial relationships
| Namratha Atluri:DO NOT have relevant financial relationships
| Yehia Z Ali:DO NOT have relevant financial relationships
| Shireen Khoury:DO NOT have relevant financial relationships
| Vanessa Lageza:No Answer
| Patricia McNair:No Answer
| Greg Merritt:No Answer
| Sonali Mishra:No Answer
| Daniel Forman:DO NOT have relevant financial relationships