The nominee for this VA Career Development Award is Alexis Beatty, MD MAS, a Staff Cardiologist at the VA Puget Sound Health Care System and Assistant Professor at the University of Washington. The primary goal of this award is to facilitate the development of the nominee into an independent health services investigator with the training and experience necessary to conduct research on innovative patient-centered interventions to improve cardiovascular health. This research will develop and test a multi-component intervention for home cardiac rehabilitation that uses mobile technology. Cardiac rehabilitation is a program of exercise training, risk factor modification, and psychosocial counseling that reduces mortality and hospitalizations and improves health status in patients with heart disease. However, only 19% of eligible Medicare patients and 8% of eligible Veterans receive this guideline-recommended treatment. Most cardiac rehabilitation programs require patients to travel to a facility for rehabilitation sessions three times per week for twelve weeks, which represents a significant barrier for many patients. Home cardiac rehabilitation is an acceptable alternative to facility-based cardiac rehabilitation, but has other challenges related to patient and provider communication. Mobile technology can provide access to health interventions, motivate patients to engage in healthy behaviors, and facilitate patient-provider communication. The nominee partnered with the VA Office of Connected Care to develop a patient mobile application for cardiac rehabilitation and corresponding provider mobile application for viewing patient- generated data. However, little is known about whether using mobile technology for home cardiac rehabilitation will improve outcomes or how to integrate the use of mobile technology into the health care system. The specific aims of this research are: (1) Identify barriers and facilitators to use of a mobile application for cardiac rehabilitation among Veterans. Veterans enrolled in home cardiac rehabilitation will use the mobile application at home for 1 month, complete questionnaires, and participate in interviews about their experience. (2) Determine provider-level adaptations for the intervention. Providers and key stakeholders will participate in interviews about integrating the use of mobile technology into clinical care and develop strategies for integrating mobile technology into workflow. (3) Pilot test a home cardiac rehabilitation intervention that uses mobile technology. Veterans enrolled in home cardiac rehabilitation will be randomized to receive home cardiac rehabilitation either with or without an intervention that is facilitated by mobile technology. The primary goal will be to determine the feasibility of enrolling Veterans in a study of the intervention. The secondary goal will be to determine whether the intervention leads to greater participation in cardiac rehabilitation. In addition to the experienc...