1. Brewer, LaPrincess C. MD, MPH
  2. Abraham, Helayna MD
  3. Kaihoi, Brian MBA
  4. Leth, Shawn MEd
  5. Egginton, Jason MPH
  6. Slusser, Joshua BS
  7. Scott, Christopher MS
  8. Penheiter, Sumedha PhD
  9. Albertie, Monica MA
  10. Squires, Ray PhD
  11. Thomas, Randal MD
  12. Scales, Robert PhD, MS
  13. Trejo-Gutierrez, Jorge MD
  14. Kopecky, Stephen MD


Purpose: Innovative methods for delivering cardiac rehabilitation (CR) that provide strategies to circumvent the mounting barriers to traditional CR have the potential to widen access to a well-established secondary prevention strategy. Our study assesses the feasibility and acceptability of a novel virtual world-based CR (VWCR) program, Destination Rehab, as an extension of a conventional center-based CR program.


Methods: Adult cardiac patients hospitalized at Mayo Clinic hospitals with a diagnosis for CR and >=1 modifiable, lifestyle risk factor target-sedentary lifestyle (<3 hr physical activity/wk), unhealthy diet (<5 servings fruits and vegetables/d), or current smoking (>1 yr)-were recruited. Patients participated in an 8-wk health education program using a virtual world (VW) platform from a prior proof-of-concept study and a post-intervention focus group. Primary outcome measures included feasibility and acceptability. Secondary outcome measures included changes from baseline to post-intervention in cardiovascular (CV) health behaviors and biometrics, CV health knowledge, and psychosocial factors.


Results: Of the 30 enrolled patients (age 59.1 +/- 9.7 yr; 50% women), 93% attended >=1 session and 71% attended >=75% of sessions. The overall VWCR experience received an 8 rating (scale 0-10) and had high acceptability. Clinically relevant trends were noted in CV health behaviors and biometrics, although not statistically significant.


Conclusions: The VWCR program is a feasible, highly acceptable, and innovative platform to potentially influence health behaviors and CV risk and may increase accessibility to disadvantaged populations with higher CV disease burdens.