# Evaluation of a mHealth Cardiac Rehabilitation Intervention in Older Veterans

> **NIH NIH R36** · EMORY UNIVERSITY · 2022 · $50,060

## Abstract

PROJECT SUMMARY/ABSTRACT
 Cardiovascular disease (CVD) is the leading cause of death and a substantial source of morbidity for
adults ≥ 65 years old. Cardiac rehabilitation (CR) is a secondary prevention strategy proven to reduce death
and recurrent CVD events, as well as improve physiological and psychological functioning. Veterans constitute
a unique patient population with complex, elevated CVD risk profiles that could significantly benefit from CR.
Frequently cited barriers for veteran participation in traditional, center-based CR programs are rooted in social
and economic drivers of health disparities, such as geographic distance to CR centers, transportation
limitations, and patient priorization. Technology-enhanced CR (TECR), an adapted home-based CR program
with technological supplements (e.g., video-enabled visits, remote heart monitoring, fitness trackers) has been
promoted as a potential solution. TECR has seen early success with engaging VA patients but presents new
challenges for older adults. However, aging-related challenges that must be considered include physical and
cognitive limitations, reduced programmatic social support for behavior change, and anxiety and frustration
with learning and operating new technologies. Evaluations of TECR interventions among older veterans is
limited, and COVID-19 operational restrictions and safety protections underscore the urgency for
understanding alternative CR strategies for vulnerable populations. This project will build on an existing
pragmatic trial evaluating CR in a veteran population and employ a mixed-methods sequential design to
examine intersectional determinants of TECR participation. Using a multi-ecological, theory-driven framework,
the project seeks to achieve three aims. The first aim will identify contextual, interpersonal, and individual-level
predictors of enrollment for older veterans in a TECR program using secondary data from the parent study.
Similarly, the second aim involves a secondary analysis to identify multilevel correlates of active engagement
among veterans who enroll in TECR. Building on the results of the first two aims, a two-stage qualitative study
will be conducted to a) examine TECR perceived ease of use, perceived usefulness, and attitudes towards
TECR among eligible veterans who select or decline TECR enrollment; and b) examine barriers and facilitators
of engagement for older adults enrolled in TECR. The proposed research is timely and directly aligns with the
strategic directions for the National Institute on Aging. By using a theory-based framework to evaluate TECR
participation, this study will identify strengths and opportunities for increasing enrollment and adherence to an
effective CVD behavior change intervention. Understanding how these factors work mechanistically is crucial
for increasing CR uptake and reducing health disparities for older veterans.

## Key facts

- **NIH application ID:** 10354835
- **Project number:** 1R36AG075455-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Phenesse Dunlap
- **Activity code:** R36 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $50,060
- **Award type:** 1
- **Project period:** 2022-06-15 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10354835

## Citation

> US National Institutes of Health, RePORTER application 10354835, Evaluation of a mHealth Cardiac Rehabilitation Intervention in Older Veterans (1R36AG075455-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10354835. Licensed CC0.

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