# Improving cardiac rehabilitation outcomes using data from daily life: A novel, multi-method ambulatory assessment approach

> **NIH NIH F32** · BROWN UNIVERSITY · 2020 · $64,554

## Abstract

PROJECT SUMMARY / ABSTRACT
Cardiac rehabilitation (CR) is widely recognized as an effective and life-prolonging treatment for cardiovascular
disease (CVD), yet many patients do not benefit from treatment. More than half of patients who begin,
ultimately dropout. Even among treatment adherent patients, one third are “non-responders”, and past
investigations into the demographic and biological profiles of responders and non-responders have been
unable to identify reliable differences that can explain why. Prior research on treatment adherence and
responsiveness in CR has been limited by reliance on methodological approaches that only allow for a small
number of assessments taken in medical environments that have limited generalizability to actual experiences
during normal daily life. Building on the large body of research indicating that cardiovascular events and
psychosocial distress share a common epidemiology, and by emerging evidence that transdiagnostic
psychosocial processes (e.g., emotion regulation, daily behaviors and social interactions) are predictive of key
cardiovascular outcomes, the present study employs a novel assessment approach to collect data from
patients enrolled in CR as they go about their normal daily lives. N = 50 patients who are enrolling in a typical
12-week cardiac rehabilitation program will undergo two weeks of daily life assessments (the first during week
1 and the second during week 12 of the program). Assessments will include: 1) Ecological Momentary
Assessment (EMA) for the collection of subjective data about patients’ cognitive and emotion regulation
strategies in daily life, 2) behavioral observation using the Electronically Activated Recorder (EAR) for passive
assessment of patients’ daily behaviors and social interactions, and 3) an Actiwatch, for passive assessment of
accelerometry, heartrate and heartrate variability during daily life. Participant burden is minimal due to the use
of passive assessment approaches. We will use advanced longitudinal, person-centered modeling approaches
to identify specific, treatment-modifiable factors that affect treatment adherence and response to CR. We
hypothesize that cognitive and emotion regulation strategies (Aim 1), daily activity pacing and social
interactions (Aim 2), and patterns in continuously assessed cardiovascular biomarkers (Aim 3, Exploratory) will
each predict treatment adherence and responsiveness outcomes. The study is innovative in that it is the first
study to integrate these three cutting-edge methods, and is among the very first to apply “high resolution” daily
life research approaches to improving treatment outcomes for patients with CVD. Results will be used as pilot
data to inform a K or R application focused on developing and testing a precision-medicine informed
intervention that further leverages ambulatory technologies such as mobile adaptive interventions to increase
patient responsiveness to CR through daily life treatment targets identified ...

## Key facts

- **NIH application ID:** 10067922
- **Project number:** 1F32HL154751-01
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Deanna M Kaplan
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $64,554
- **Award type:** 1
- **Project period:** 2020-09-21 → 2022-09-20

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10067922

## Citation

> US National Institutes of Health, RePORTER application 10067922, Improving cardiac rehabilitation outcomes using data from daily life: A novel, multi-method ambulatory assessment approach (1F32HL154751-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10067922. Licensed CC0.

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