Community Health Worker-Led Intervention to Increase Cardiac Rehabilitation Participation

Johns Hopkins University50 enrolled

Overview

This study is being done to evaluate whether a program called Heart to Heart, that helps patients make a more informed decision about cardiac rehab (CR), is interesting, acceptable to participants, and whether participants would recommend it to others.

This is a prospective, single-institution pilot study to evaluate the acceptability, feasibility and preliminary efficacy of a tailored Community Health Worker (CHW) led intervention to increase CR participation called H2H. Individuals hospitalized with Cardio Vascular Disease (CVD) events (aged 21 and older) will be identified and screened for eligibility from two Johns Hopkins acute care sites into the pilot study. The duration of participation for each participant is up to 6 months from baseline assessments. All participants will complete a survey at baseline, 3-, and 6-months and will have medical record abstraction conducted performed by the Johns Hopkins (JH) research study team. For the intervention, participants enrolled in the H2H program will complete between 4 to 8 coaching sessions with the CHW (delivered by telephone and/or video chat) who will provide tailored education, improve or engage the participant's existing social support network, and assistance with health system navigation over a 3-month period.

Study Type

INTERVENTIONAL

Allocation

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

Conditions

CVD - Cardiovascular Disease

Interventions

Education, Providing and Engaging Social Support and Assistance with Health System NavigationBEHAVIORAL

1. Introduction to Program and Cardiac Rehab Needs Assessment Education about Cardiac Rehab 2. Education about CVD and how Cardiac Rehab can help in the participants recovery 3. Social Support Module 4. Health System Navigation Module

Eligibility

Sex: ALLMin age: 21 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients hospitalized with cardiac events and eligible for CR at Johns Hopkins Hospital and Bayview Medical Center. CR eligibility is determined by their treating health care team . 2. Low socioeconomic status defined by Medicaid insurance, or top quartile of the area deprivation index in Baltimore city. 3. Age ≥ 21 years 4. Willing to be audio-recorded Exclusion Criteria: 1. Formal diagnosis of dementia or cognitive impairment in the Electronic Health Record (EHR) that would prohibit completion of study activities 2. Formal diagnosis of a severe psychiatric disorders by Diagnostic and Statistical Manual (DSM-5) criteria in the EHR that would prohibit completion of study activities (e.g., schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder). 3. Systemic illness limiting longevity (e.g., advanced cancer) 4. Contraindications to CR as assessed by their health care team 5. Unwilling or unable to follow study procedures. 6. Unable to consent 7. Unable to speak or understand English. Assessments including in-depth interviews will be conducted in English.

Locations (3)

Johns Hopkins Hospital

Baltimore, Maryland, United States

RECRUITING

Johns Hopkins Bayview Medical Center

Baltimore, Maryland, United States

RECRUITING

Johns Hopkins Hospital

Baltimore, Maryland, United States

RECRUITING

Outcomes

Primary Outcomes

Feasibility of H2H intervention as assess by the ability to recruit ≥ 25% of those eligible and the ability to retain ≥ 50% in the study

Proportion enrolled in the H2H among those eligible and approached, and Proportion who complete 4 H2H sessions or enroll in CR

Time frame: 3 months

Acceptability as measured by survey of participant satisfaction with H2H

Questionnaire: Scores on questionnaire to assess satisfaction. Questions are rated on a Likert scale from 1 (not at all) 5 extremely. There are 6 questions in the rating of the overall program with a total score range 6-30. Acceptability cutoff will be proportion of participants with score ≥ 18. There are 4 questions on the H2H coaching sessions and CHW. The maximum and minimum scores are 4 and 20 respectively. Acceptability cutoff will be proportion of participants with scores ≥ 12.

Time frame: 3 months

Acceptability as measured by participant satisfaction (qualitative interview)

A semi-structured interview will be conducted by the research team about the H2H Program overall, and about the coaching sessions with the CHW, to determine the participants' perceptions of the degree to which the intervention was engaging, feasible, acceptable and useful. Recommendations for improving the H2H Program will be solicited. The interviews will take approximately 30-45 minutes. The interviews will be transcribed and analyzed for themes and codes

Time frame: 3 months

Secondary Outcomes

Change in Cardiac rehab barriers scale

Change in Cardiac Rehab Barriers Scale: 21-item questionnaire that assesses participants perceptions of barriers to CR. Each item is rated on a 5-point Likert Scale, with 1 indicating strong disagreement and 5 indicating strong agreement. This is a validated scale. Score range 21- 105. Higher scores indicate greater barriers to patient enrollment or participation in a CR program.

Time frame: 3 months

Central Contacts

Lena Mathews, MD

CONTACT

410-550-5191 lmathew6@jhmi.edu

Data from ClinicalTrials.gov

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