# Development of a Tailored Intervention to Increase Veteran Enrollment in Cardiac Rehabilitation

> **NIH VA IK2** · VETERANS HEALTH ADMINISTRATION · 2021 · —

## Abstract

Background: This Veterans Affairs (VA) Health Services Research & Development Career Development
Award resubmission is a five-year plan that will enable the candidate, a staff cardiologist and specialist in
cardiac rehabilitation (CR) at the VA Tennessee Valley Healthcare System, to develop and implement
interventions to increase CR enrollment in Veterans. CR is an outpatient program including prescriptive
exercise and cardiac risk factor education that is an essential therapy for patients with cardiovascular disease.
This proposal will develop a tailored intervention to increase Veteran enrollment in CR.
Significance/Impact: CR is widely underutilized, with less than 20% of eligible patients enrolling in CR
programs nationally. CR utilization is particularly low among Veterans, with only 10% of eligible Veterans
enrolling in CR programs. Though CR referral rates have risen substantially over the past decade, CR
enrollment has remained static. It is imperative to study barriers to CR enrollment among Veterans that have
already been referred to CR and develop interventions tailored to these individual barriers.
Innovation: The applicant will develop a tailored intervention for increasing CR enrollment using the Obesity-
Related Behavioral Intervention Trials model, a conceptual model for intervention development, as well as the
information-motivation-behavioral skills model, a theory of behavior change that allows individual tailoring.
Linking these models will produce new knowledge regarding behavioral intervention methodology as well as an
innovative clinical intervention that can be delivered by nurses and other clinical staff at VA facilities. The
proposed intervention aligns with current VA initiatives by supporting CR enrollment wherever is most
convenient for Veterans (including VA CR programs, non-VA CR programs, and home-based CR programs).
Specific Aims: Aims 1 and 2 comprise a sequential explanatory mixed methods study to evaluate barriers to
CR enrollment among Veterans. The purpose of Aim 1 is to quantify barriers to CR in 100 Veterans
hospitalized with ischemic heart disease using the previously validated Beliefs About Cardiac Rehabilitation
Scale (BACRS). The purpose of Aim 2 is to reveal additional barriers to outpatient CR enrollment through
qualitative interviews in 30 Veterans from Aim 1 who did not enroll in CR. Aim 3 focuses on the iterative
development of a tailored intervention to increase outpatient CR enrollment in 3 groups of 5 hospitalized
Veterans, characterizing the intervention’s feasibility and acceptability. In Aim 4, the tailored intervention will
undergo proof-of-concept testing in a non-randomized group of 25 Veterans hospitalized with ischemic heart
disease. The applicant hypothesizes that these Veterans will have a clinically significant improvement in
BACRS summary scores after the intervention, representing a decrease in perceived barriers to CR.
Methodology: Aim 1 will quantitate the burden of CR barriers am...

## Key facts

- **NIH application ID:** 10069920
- **Project number:** 1IK2HX003021-01A2
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** JUSTIN M BACHMANN
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-01-01 → 2025-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10069920

## Citation

> US National Institutes of Health, RePORTER application 10069920, Development of a Tailored Intervention to Increase Veteran Enrollment in Cardiac Rehabilitation (1IK2HX003021-01A2). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10069920. Licensed CC0.

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