The Use of Virtual World-Based Cardiac Rehabilitation to Encourage Healthy Lifestyle Choices Among Cardiac Patients
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Abstract
Background
Despite proven benefits through the secondary prevention of cardiovascular disease (CVD) and reduction of mortality, cardiac rehabilitation (CR) remains underutilized in cardiac patients. Underserved populations most affected by CVD including rural residents, low socioeconomic status patients and racial/ethnic minorities have the lowest participation rates due to access barriers. Internet-and mobile-based lifestyle interventions have emerged as potential modalities to complement and increase accessibility to CR. A web-based outpatient CR program using virtual world technology may provide an effective alternative to conventional CR by overcoming patient access limitations such as geographics, work schedule constraints and transportation.
Objective
The goal of our trial is to assess the impact of a virtual world-based (Second Life) CR program as an extension of a conventional CR program in achieving healthy behavioral change and self-efficacy among post-acute coronary syndrome patients in comparison to a conventional CR program. We hypothesize that virtual world CR users will improve behaviors (physical activity, diet, smoking) to a greater degree than conventional CR participants.
Methods
Our study is a 2-arm, parallel group, single-center randomized controlled trial at Mayo Clinic Rochester in Minnesota. We will recruit patients hospitalized at Mayo Clinic Hospital, Rochester Campus for an acute coronary syndrome (unstable angina, ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction) with at least one modifiable, lifestyle risk factor target (sedentary lifestyle, unhealthy diet and current smoking). All patients must have home high-speed Internet access. Patients will be randomized at a 1:1 ratio to adjunct virtual world-based CR with conventional CR or conventional CR only. The primary outcome is a composite including at least one of the following: at least 150 minutes per week of physical activity, consumption of five or more fruits and vegetables daily and smoking cessation. Patients will be assessed at three, six and twelve months.
Conclusion
Research on the use of virtual world technology in health programs is in its infancy. It offers unique advantages over current web-based health interventions including social interactivity and active learning. It also increases accessibility to vulnerable populations who have higher burdens of CVD. This study will yield results on the effectiveness of a virtual world-based CR program as an innovative platform to influence healthy lifestyle behavior and self-efficacy.
Key words
Cardiac rehabilitation, cardiovascular diseases, eHealth, telemedicine, Internet, health behavior
Despite proven benefits through the secondary prevention of cardiovascular disease (CVD) and reduction of mortality, cardiac rehabilitation (CR) remains underutilized in cardiac patients. Underserved populations most affected by CVD including rural residents, low socioeconomic status patients and racial/ethnic minorities have the lowest participation rates due to access barriers. Internet-and mobile-based lifestyle interventions have emerged as potential modalities to complement and increase accessibility to CR. A web-based outpatient CR program using virtual world technology may provide an effective alternative to conventional CR by overcoming patient access limitations such as geographics, work schedule constraints and transportation.
Objective
The goal of our trial is to assess the impact of a virtual world-based (Second Life) CR program as an extension of a conventional CR program in achieving healthy behavioral change and self-efficacy among post-acute coronary syndrome patients in comparison to a conventional CR program. We hypothesize that virtual world CR users will improve behaviors (physical activity, diet, smoking) to a greater degree than conventional CR participants.
Methods
Our study is a 2-arm, parallel group, single-center randomized controlled trial at Mayo Clinic Rochester in Minnesota. We will recruit patients hospitalized at Mayo Clinic Hospital, Rochester Campus for an acute coronary syndrome (unstable angina, ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction) with at least one modifiable, lifestyle risk factor target (sedentary lifestyle, unhealthy diet and current smoking). All patients must have home high-speed Internet access. Patients will be randomized at a 1:1 ratio to adjunct virtual world-based CR with conventional CR or conventional CR only. The primary outcome is a composite including at least one of the following: at least 150 minutes per week of physical activity, consumption of five or more fruits and vegetables daily and smoking cessation. Patients will be assessed at three, six and twelve months.
Conclusion
Research on the use of virtual world technology in health programs is in its infancy. It offers unique advantages over current web-based health interventions including social interactivity and active learning. It also increases accessibility to vulnerable populations who have higher burdens of CVD. This study will yield results on the effectiveness of a virtual world-based CR program as an innovative platform to influence healthy lifestyle behavior and self-efficacy.
Key words
Cardiac rehabilitation, cardiovascular diseases, eHealth, telemedicine, Internet, health behavior
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