Holly Yahyawi

Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Aleshire, Mollie

Committee Member

Anderson, Debra

Author's Keywords

phase II cardiac rehabilitation; video intervention; adherence; quality improvement


Background: In the U.S., heart disease affects over 30 million adults and is the leading cause of death. Cardiac rehabilitation (CR) decreases cardiac hospital readmissions, decreases the risk of additional cardiac events, and increases life expectancy. Environment: This project was implemented at a CR program which serves rural Indiana and Kentucky counties. Purpose: This QI project uses a Plan-Study-Do-Act framework to evaluate patient adherence to a rural CR program, implement a video intervention for patients, and measure patient’s perceptions. Procedures: CR patients watched four videos describing what CR is, what to expect at CR, CR benefits, and a patient CR success story. Patients watched videos while exercising. After watching the videos, patients shared their perspectives about the intervention via survey. Retrospective chart audits collected pre- and post-intervention patient characteristics and number of CR sessions attended. Descriptive statistics and independent t-tests were employed for data analysis. Results: Although not statistically significant, post-intervention CR patients (n=8) attended an average of 29 sessions compared to an average of 22.8 sessions attended by the pre-intervention patients (n=34). In the pre-intervention group, patients who smoked attended significantly fewer CR sessions than patients who did not smoke (p= 0.026). Discussion: The video intervention was well-received by patients and should be modified and integrated into the CR education model at this site and piloted at other rural CR programs. Benefits of CR and the dose-response relationship must be included in CR patient education. Patients with characteristics predictive of non-adherence should be identified and provided support.

Included in

Nursing Commons