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An identified barrier was the financial resources available to support the provision of nutrition care.

To ensure that patients receive the benefits of evidence-based nutrition care, program staff may require additional support, particularly regarding the use of evidence-based behavior change techniques. NS105 Key facilitators that may be leveraged to achieve this include the high value and priority that CR program coordinators place on nutrition care.

To ensure that patients receive the benefits of evidence-based nutrition care, program staff may require additional support, particularly regarding the use of evidence-based behavior change techniques. Key facilitators that may be leveraged to achieve this include the high value and priority that CR program coordinators place on nutrition care.

To investigate the changes in activities and participation, and mental and physical functions for 9 mo after cardiac rehabilitation (CR) among adults with chronic cardiac conditions.

Twenty-five adults with chronic cardiac conditions scheduled for discharge from CR were assessed at four different times within 2-wk window of CR discharge date, 1 mo, 3 mo, and 9 mo after CR discharge. Nine assessments according to the International Classification of Functioning, Disability and Health were used to track the changes post-CR.

Participants showed significant changes in the Cognitive Instrumental Activities of Daily Living adequacy of Performance Assessment of Self-Care Skills-Clinic (F = 8.10, P = .017) and improvements in the applied cognitive domain of the Activity Measure for Post-Acute Care Outpatient Short Form (F = 4.493, P = .016). Participants also showed significant decline in the CogState Detection test (F = 3.307, P = .045), the Physical Activity and Leisure Motivation Scale (PALMS) (F = 4.749, P = .005), and the affiliation subscale of the PALMS (F = 5.316, P = .002), and improvements in the 6-min walk test (F = 9.000, P = .011). Lastly, participants showed depressive symptoms for 3 mo post-CR. No other significant changes were detected among other outcome measures.

Adults with chronic cardiac conditions discharged from site-based CR maintained their activity and participation level following discharge with little improvement. They also showed depressive symptoms and decreased motivation for physical activity post-CR.

Adults with chronic cardiac conditions discharged from site-based CR maintained their activity and participation level following discharge with little improvement. They also showed depressive symptoms and decreased motivation for physical activity post-CR.

To review the principles, advantages, and disadvantages of asynchronous and synchronous delivery models of home-based cardiac rehabilitation (HBCR).

We reviewed recently published systematic reviews and other publications of randomized studies of asynchronous and synchronous HBCR to assess principles, outcomes, and limitations of those delivery methods compared with center-based cardiac rehabilitation (CBCR).

While most studies prior to 2016 involved asynchronous HBCR approaches to care, studies since 2016 have included asynchronous or synchronous delivery models. Both delivery models have been shown to help provide core components of cardiac rehabilitation (CR). Studies using either method have been shown to have similar short-term patient outcomes as CBCR, at least in low- to moderate-risk patients who have been studied. Asynchronous HBCR offers greater flexibility for patients and CR staff, while synchronous HBCR provides greater real-time oversight and feedback to patients.Asynchronous and synchronodback to patients.Asynchronous and synchronous HBCR is an option to consider for patients eligible for CR. Additional research is needed for both delivery models, applied separately or in combination, to compare their impact on shorter- and longer-term patient outcomes and to assess their impact in patient subgroups (referral diagnosis, women, elderly, underrepresented racial and ethnic minority groups, patients at a higher cardiovascular disease risk, patients with multiple comorbid conditions, etc).Although cardiac rehabilitation (CR) is safe and highly effective for individuals with various cardiovascular health conditions, to date there are only seven diagnoses or procedures identified by the Centers for Medicare & Medicaid Services that qualify for referral. When considering the growing number of individuals with cardiovascular disease (CVD), or other health conditions that increase the risk for CVD, it is important to determine the extent for which CR could benefit these populations. Furthermore, there are some patients who may currently be eligible for CR (spontaneous coronary artery dissection, left ventricular assistant device) but make up a relatively small proportion of the populations that are regularly attending and participating. Thus, these patient populations and special considerations for exercise might be less familiar to professionals who are supervising their programs. The purpose of this review is to summarize the current literature surrounding exercise testing and programming among four specific patient populations that either do not currently qualify for (chronic and end-stage renal disease, breast cancer survivor) or who are eligible but less commonly seen in CR (sudden coronary artery dissection, left ventricular assist device). While current evidence suggests that individuals with these health conditions can safely participate in and may benefit from supervised exercise programming, there is an immediate need for high-quality, multisite clinical trials to develop more specific exercise recommendations and support the inclusion of these populations in future CR programs.

Despite guideline consensus that quality of nutrition affects most modifiable cardiovascular disease risk factors, the implementation of dietary interventions varies considerably in cardiac rehabilitation (CR) programs. The purpose of this review is to highlight the current existing literature and provide recommendations on best practices for nutrition interventions and future research that support secondary prevention outcomes.

The review examines original investigations, systematic reviews, and guidelines regarding nutrition intervention in CR.

Nutrition intervention in CR plays an integral role in the success of patients; however, the literature is limited and standardization of practice is in its infancy. The role of a qualified registered dietician nutritionist, standardization of dietary assessments, individualized and intensive nutrition interventions, and application of specific behavior change techniques are central components in improving diet in CR. This review provides an overview of the evidence-based cardioprotective diets, nutritional interventions and behavioral strategies in CR, and explores areas for best practices and opportunities for innovation in the delivery of nutrition intervention in CR.

Nutrition intervention in CR plays an integral role in the success of patients; however, the literature is limited and standardization of practice is in its infancy. The role of a qualified registered dietician nutritionist, standardization of dietary assessments, individualized and intensive nutrition interventions, and application of specific behavior change techniques are central components in improving diet in CR. This review provides an overview of the evidence-based cardioprotective diets, nutritional interventions and behavioral strategies in CR, and explores areas for best practices and opportunities for innovation in the delivery of nutrition intervention in CR.

Cardiac rehabilitation (CR) has been shown to improve functional status, quality of life, and recurrent cardiovascular disease (CVD) events. Despite its demonstrated compelling benefits and guideline recommendation, CR is underutilized, and there are significant disparities in CR utilization particularly by race, ethnicity, sex, and socioeconomic status. The purpose of this review is to summarize the evidence and drivers of these disparities and recommend potential solutions.

In this review, key studies documenting disparities in CR referrals, enrollment, and completion are discussed. Additionally, potential mechanisms for these disparities are summarized and strategies are reviewed for addressing them.

There is a wealth of literature demonstrating disparities among racial and ethnic minorities, women, those with lower income and education attainment, and those living in rural and dense urban areas. However, there was minimal focus on how the social determinants of health contribute to the observed disparities in CR utilization in many of the studies reviewed. Interventions such as automatic referrals, inpatient liaisons, mitigation of economic barriers, novel delivery mechanisms, community partnerships, and health equity metrics to incentivize health care organizations to reduce care disparities are potential solutions.

There is a wealth of literature demonstrating disparities among racial and ethnic minorities, women, those with lower income and education attainment, and those living in rural and dense urban areas. However, there was minimal focus on how the social determinants of health contribute to the observed disparities in CR utilization in many of the studies reviewed. Interventions such as automatic referrals, inpatient liaisons, mitigation of economic barriers, novel delivery mechanisms, community partnerships, and health equity metrics to incentivize health care organizations to reduce care disparities are potential solutions.Early outpatient (ECR) and maintenance cardiac rehabilitation (MCR) programs are essential, evidence-based services that have received unequivocal endorsement by national and international professional organizations. However, the latest data characterizing ECR enrollment and adherence fell well short of what would be expected for a therapy that has accumulated decades of empirical evidence touting the associated physiologic, physical, psychosocial, and financial benefits. Although national participation levels have remained stagnant, a series of recent publications showcase effective strategies that could bolster both ECR enrollment and adherence levels at the institutional level. Unlike ECR, fewer reports on enrollment and adherence rates exist for MCR, partly due to the lack of standardization of this service. In this review, we aim to highlight current data on enrollment and adherence to ECR and MCR and discuss evidence-based programmatic strategies to support utilization of both services.Three coronavirus disease 2019 (COVID-19) vaccines have been authorized for use in the United States; specifically, the Pfizer-BioNTech, Moderna, and Johnson & Johnson-Janssen COVID-19 vaccines were granted emergency use authorization by the U.S. Food and Drug Administration in late 2020 and early 2021. Vaccination coverage and intent among adults are lowest among those aged 18-39 years and among females in particular. In females of reproductive age, enthusiasm for receiving a COVID-19 vaccine may be negatively affected by claims currently circulating widely on diverse social media platforms regarding the vaccines adversely affecting fertility and pregnancy. Yet it is important to note that these claims are anecdotal in nature and not supported by the available scientific evidence. It is also imperative that the effects of COVID-19 vaccine on reproductive health are clarified. Herein, we discuss the existing scientific data supporting COVID-19 vaccine safety and efficacy in people who are planning to conceive or who are pregnant or lactating and highlight the importance of COVID-19 vaccination in females of reproductive age.

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