In addition to primary cardiovascular disease prevention through health promotion, Dr. Brewer also focuses research on secondary prevention. This includes looking for ways to improve recovery and resulting lifestyle changes after a cardiac event to prevent an additional future event. After a cardiac event, such as a heart attack, patients are generally referred to a cardiac rehabilitation program. Though cardiac rehab is extremely beneficial, it is poorly attended, especially among those who face barriers such as transportation, insurance coverage, or other access issues. Patients in racial/ethnic minority groups, women, and individuals with lower socioeconomic status are among those who are far less likely to attend or complete a cardiac rehab program.
In an effort to improve accessibility, Dr. Brewer and her team developed Destination Rehab, a virtual world-based cardiac rehab program. Using the virtual world platform Second Life®, patients who attend Destination Rehab log into the internet on their personal computer and have an avatar, or online persona, who they can direct throughout the program. Patients can act out scenarios related to traditional cardiac rehab using their avatar, such working out with an exercise physiologist, attending a lecture on risk factors for heart disease, grocery shopping with a dietician and even connecting with other patients in a support group discussion. Research has shown that people who simulate activities like this online are more likely to translate those actions to real life.
Pilot studies using the virtual world-based cardiac rehab (VWCR) program have been successful. Participants met weekly with an exercise physiologist and a cardiac rehab nurse who provided education and instruction just as they would in a traditional center-based program. They were able to connect in an anonymous way with other cardiovascular disease survivors, which they may have otherwise not felt comfortable doing. The participants were able to access the benefits of cardiac rehab from the comfort of their own home and for no cost, and the results showed improvements in their cardiovascular health by the end of the study. Dr. Brewer and her team are currently working on securing funding for a larger-scale VWCR study that will include a diverse group of patients to assess how useful this technology can be for those facing a variety of barriers to access traditional cardiac rehab programs.
Publications related to VWCR:
- Novel Virtual World-Based Cardiac Rehabilitation Program to Broaden Access to Underserved Populations: A Patient Perspective
- A Community-Informed Virtual World-Based Cardiac Rehabilitation Program as an Extension of Center-Based Cardiac Rehabilitation: MIXED-METHODS ANALYSIS OF A MULTICENTER PILOT STUDY
- Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology
- Patient-perceived acceptability of a virtual-world based cardiac rehabilitation program
- The use of virtual world-based cardiac rehabilitation to encourage healthy lifestyle choices among cardiac patients: intervention development and pilot study protocol