{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T22:04:24Z","timestamp":1768255464866,"version":"3.49.0"},"reference-count":86,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,12,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Innovative restructuring of cardiac rehabilitation (CR) delivery remains critical to reduce barriers and improve access to diverse populations.\n              <jats:italic>Destination Cardiac Rehab<\/jats:italic>\n              is a novel virtual world technology\u2010based CR program delivered through the virtual world platform, Second Life, which previously demonstrated high acceptability as an extension of traditional center\u2010based CR. This study aims to evaluate efficacy and adherence of the virtual world\u2013based CR program compared with center\u2010based CR within a community\u2010informed, implementation science framework.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using a noninferiority, hybrid type 1 effectiveness\u2010implementation, randomized controlled trial, 150 patients with an eligible cardiovascular event will be recruited from 6 geographically diverse CR centers across the United States. Participants will be randomized 1:1 to either the 12\u2010week\n              <jats:italic>Destination Cardiac Rehab<\/jats:italic>\n              or the center\u2010based CR control groups. The primary efficacy outcome is a composite cardiovascular health score based on the American Heart Association Life's Essential 8 at 3 and 6\u2009months. Adherence outcomes include CR session attendance and participation in exercise sessions. A diverse patient\/caregiver\/stakeholder advisory board was assembled to guide recruitment, implementation, and dissemination plans and to contextualize study findings. The institutional review board\u2013approved randomized controlled trial will enroll and randomize patients to the intervention (or control group) in 3 consecutive waves\/year over 3\u2009years. The results will be published at data collection and analyses completion.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The\n              <jats:italic>Destination Cardiac Rehab<\/jats:italic>\n              randomized controlled trial tests an innovative and potentially scalable model to enhance\n              <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n              participation and advance health equity. Our findings will inform the use of effective virtual\n              <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>\n              programs to expand equitable access to diverse patient populations.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT05897710.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030883","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T11:23:01Z","timestamp":1701170581000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Efficacy 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