Vivo Heart: Home-Based Virtual Exercise Program for Older Adults With Cardiovascular Disease

Inclusion Criteria: * 60 - 80 years * Lives in a rural area based on established urban-rural definitions (e.g., RUCA codes, RUCC, UIC) * A qualifying Cardio Vascular Disease (CVD) event or procedure * Cognitively unimpaired Telephone Interview for Cognitive Status (TICS-m ≥32) * No major depressive symptoms Patient Health Questionnaire (PHQ-8 \<10) * Ambulatory and community-dwelling * Less than 150 min per week of moderate-to-intensive aerobic or resistance exercise in the past month * Medically cleared for exercise if event was within the last 6 months * Access to a tablet or computer and internet/Wi-Fi in defined exercise space * Able to provide own transportation to study visits * Not participating in a clinical trial * Willing to provide informed consent Exclusion Criteria: * \<60 years or \>80 years * Lives in non-rural area * No CVD or a qualifying event or procedure * Dementia or severe cognitive impairment (TICS-m \<32) * Clinical depression (PHQ-8 ≥10) * Non-ambulatory, institutionalized, or requires walker * Regular aerobic or resistance exercise (including current participation in a cardiac rehab program) * Not medically cleared for exercise * Advanced kidney disease requiring dialysis or dialysis anticipated within 6 months * Insulin-dependent diabetes * Use of any supplemental oxygen for COPD * Significant impairment from a prior stroke * Progressive neurologic disease (Parkinson's, ALS, multiple sclerosis, Alzheimer's disease, dementia) * Severe arthritis, fracture, chronic injury, or other musculoskeletal disorder that prevents walking independently * Cancer (not including non-melanoma skin cancers) requiring treatment with the past year * Excessive alcohol consumption (\>7/week alcoholic beverages for women and \>14/week for men) in the past month * Joint replacement or other orthopedic surgery in past 12 months or planned in next 6 months * No computer, tablet or internet access * No access to transportation for travel to study visits * Current participation in a clinical trial * Inability or unwillingness to comply with the study requirements