Cardiovascular disease is the leading cause of death and disability in the US, regardless of gender or race. Exercise training reduces morbidity and mortality and improves quality of life among patients with a broad range of heart disease, including those who have recently undergone coronary artery bypass surgery (CABG). Widely recommended as a standard of care, exercise training remains substantially underutilized, particularly among Native Hawaiians and Pacific Peoples (NHPP) with only 10-20% of eligible patients being referred to cardiac rehabilitation programs. Interventions that can improve accessibility and adherence, particularly among ethnic minorities, are needed. In this proposed project, we plan to evaluate the impact of hula, the traditional dance form of Native Hawaiians, on patients who have recently undergone CABG. Originally performed by Native Hawaiians to convey their history and spiritual beliefs, hula is now commonly practiced as a form of exercise and expression that may be particularly suitable for debilitated individuals with limited mobility, and fits within the recommended paradigm for exercise training and the secondary prevention of coronary artery disease. We plan to develop a culturally relevant intervention using hula that is consistent with the goals and philosophy of cardiac rehabilitation exercise training - low-intensity, prolonged (30-60' duration) exercise designed to achieve 70-80% of the maximal predicted heart rate prescribed at 3-4 times per week. We will then evaluate the safety and efficacy of this culturally relevant intervention among NHPP subjects who have recently undergone CABG. We hypothesize that hula will improve functional capacity and health-related quality of life compared to a control group who meet at a similar frequency and duration. Our secondary goal is to explore the possible mechanisms underlying any beneficial effect of hula. Cardiac rehabilitation exercise training remains substantilly underutilized among patients with heart disease, particularly among NHPP, despite being shown to improve survival and quality of life. It is widely recognized that innovative ways to improve access and adherence is needed, particularly among racial minorities. This study will test the impact of a culturally relevant exercise training intervention based on hula among NHPP who have recently undergone CABG.
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