Enhancing Cardiac Rehabilitation Through Behavioral Nudges



Status:Not yet recruiting
Conditions:Peripheral Vascular Disease, Cardiology, Cardiology, Cardiology
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:18 - 100
Updated:3/16/2019
Start Date:April 1, 2019
End Date:September 30, 2023
Contact:Sarah E Leslie, MPH
Email:sarah.leslie@dhha.org
Phone:303-602-3805

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Enhancing Cardiac Rehabilitation Adherence Through Home-based Rehabilitation and Behavioral Nudges: ERA Nudge

Adherence to cardiac rehabilitation is poor, and worse for minorities, women, and those with
lower levels of education. Patients less likely to be referred to and complete cardiac rehab
are at highest risk of adverse outcomes and thus have the most to gain from participation in
cardiac rehab. To improve participation, healthcare systems need to limit barriers to
enrollment and promote adherence to rehabilitation.

This study aims to (1) Iteratively develop and program a theoretically informed
technology-based nudge message library for a diverse patient population using multiple and
iterative N of 1 within subject studies. Investigators will also engage patient, provider and
health systems stakeholders in designing and refining the messages; (2)Develop a one-page
decision aid tool to present information designed with principles of shared decision making
including pros and cons of hospital and home-based rehabilitation. Investigators will engage
patients, providers, and health systems stakeholders to provide feedback on the information
sheet (3) Conduct a 2x2 factorial design randomized trial of a) choice and b) nudge messaging
to improve primary outcome of CR adherence. Secondary outcomes will include enrollment and
completion of CR, exercise capacity, patient engagement, quality of life, hospitalizations
and healthcare utilization.Evaluate the intervention using a mixed methods approach and
applying the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance)
framework.

Inclusion Criteria:

- Diagnosis of acute myocardial infarction, percutaneous coronary intervention, coronary
artery bypass graft, valvular heart surgery, chronic stable angina, and/or chronic
stable heart failur ewith left ventricular systolic dysfunction.

- 18 year of age or older

- access to a cell phone with text messaging capability

- English or Spanish speaking

Exclusion Criteria:

- medical director's decision based on high-risk assessment

- enrolled in hospice or palliative care

- being intoxicated or otherwise unable to consent to participate
We found this trial at
1
site
Denver, Colorado 80204
Principal Investigator: Pamela Peterson, MD, MPH
Phone: 303-602-3805
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from
Denver, CO
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