Abstract:
BACKGROUND:Cardiac rehabilitation (CR) programs provide significant benefit for people with cardiovascular disease. Despite these benefits, such services are not universally available. We designed and evaluated a national home-based CR (HBCR) program in the Veterans Health Administration (VHA). The primary aim of the study was to examine barriers and facilitators associated with site-level implementation of HBCR. METHODS:This study used a convergent parallel mixed-methods design with qualitative data to analyze the process of implementation, quantitative data to determine low and high uptake of the HBCR program, and the integration of the two to determine which facilitators and barriers were associated with adoption. Data were drawn from 16 VHA facilities, and included semi-structured interviews with multiple stakeholders, document analysis, and quantitative analysis of CR program attendance codes. Qualitative data were analyzed using the Consolidated Framework for Implementation Research codes including three years of document analysis and 22 interviews. RESULTS:Comparing high and low uptake programs, readiness for implementation (leadership engagement, available resources, and access to knowledge and information), planning, and engaging champions and opinion leaders were key to success. High uptake sites were more likely to seek information from the external facilitator, compared to low uptake sites. There were few adaptations to the design of the program at individual sites. CONCLUSION:Consistent and supportive leadership, both clinical and administrative, are critical elements to getting HBCR programs up and running and sustaining programs over time. All sites in this study had external funding to develop their program, but high adopters both made better use of those resources and were able to leverage existing resources in the setting. These data will inform broader policy regarding use of HBCR services.
journal_name
BMC Cardiovasc Disordjournal_title
BMC cardiovascular disordersauthors
Wakefield BJ,Drwal K,Paez M,Grover S,Franciscus C,Reisinger HS,Kaboli PJ,El Accaoui Rdoi
10.1186/s12872-019-1224-ysubject
Has Abstractpub_date
2019-11-06 00:00:00pages
242issue
1issn
1471-2261pii
10.1186/s12872-019-1224-yjournal_volume
19pub_type
杂志文章abstract:BACKGROUND:We assessed the degree to which differences in guideline-based medical therapy for acute myocardial infarction (AMI) contribute to the higher mortality associated with kidney disease. METHODS:In the PREMIER registry, we evaluated patients from 19 US centers surviving AMI. Cox regression evaluated the associ...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2261-9-29
更新日期:2009-07-08 00:00:00
abstract:BACKGROUND:Early detection of heart failure is essential to effectively reduce related mortality. The quantification of the mechanical properties of the myocardium, a primordial indicator of the viability of the cardiac tissue, is a key element in patient's care. Despite an incremental utilization of multi-parametric m...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/1471-2261-13-24
更新日期:2013-03-27 00:00:00
abstract:BACKGROUND:Optimal treatment of acute ST-elevation myocardial infarction (STEMI) involves rapid diagnosis, and transfer to a cardiac centre capable of percutaneous coronary intervention (PCI) for immediate mechanical revascularisation. Successful treatment requires rapid return of perfusion to the myocardium achieved b...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/1471-2261-14-44
更新日期:2014-04-04 00:00:00
abstract:BACKGROUND:Oxidation and inflammation play significant roles in the pathogenesis of coronary artery diseases. Monocyte count to high-density lipoprotein (HDL) cholesterol ratio (MHR) is a new marker and has revealed as an indicator of inflammation in the literature. The present study aimed to search the effect of MHR o...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-016-0367-3
更新日期:2016-10-03 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-018-0805-5
更新日期:2018-04-10 00:00:00
abstract:BACKGROUND:Serum paraoxonase 1 (PON1), an enzyme associated with high - density lipoproteins (HDL) particles, inhibits the oxidation of serum lipoproteins and cell membranes. PON1 activity is lower in patients with atherosclerosis and in inflammatory diseases. The systemic inflammatory response provoked during cardiopu...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-017-0528-z
更新日期:2017-04-04 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12872-016-0244-0
更新日期:2016-04-19 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-020-01798-2
更新日期:2020-12-04 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章,多中心研究
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-017-0521-6
更新日期:2017-03-23 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-017-0702-3
更新日期:2017-10-18 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12872-017-0654-7
更新日期:2017-08-15 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/1471-2261-9-27
更新日期:2009-06-23 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-018-0816-2
更新日期:2018-04-27 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-020-01491-4
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journal_title:BMC cardiovascular disorders
pub_type: 临床试验,杂志文章
doi:10.1186/1471-2261-12-19
更新日期:2012-03-22 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-017-0483-8
更新日期:2017-01-31 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章,meta分析
doi:10.1186/s12872-019-1236-7
更新日期:2019-11-07 00:00:00
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章
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更新日期:2013-07-28 00:00:00
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pub_type: 杂志文章
doi:10.1186/1471-2261-10-15
更新日期:2010-03-18 00:00:00
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pub_type: 杂志文章
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更新日期:2020-04-21 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-019-01287-1
更新日期:2019-12-30 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/1471-2261-11-67
更新日期:2011-11-09 00:00:00
abstract:BACKGROUND:The usefulness of the CHA2DS2-VASC risk score (CVRS) in predicting the occurrence of contrast-induced nephropathy (CIN) among patients with chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI) remains unclear. METHOD:A total of 239 patients with CTO who underwent PCI were includ...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-019-1060-0
更新日期:2019-03-29 00:00:00
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pub_type: 杂志文章
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更新日期:2010-11-10 00:00:00
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-01-29 00:00:00
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pub_type: 杂志文章,meta分析
doi:10.1186/s12872-019-1160-x
更新日期:2019-08-22 00:00:00