Table 1.

REHAB‐HF Adherence Plan

Strategy	Implementation examples
Identify and address medical and social barriers	Identify barriers: ◦Comorbidities ◦Conflicting medical appointments ◦Conflicting personal commitments (work, childcare, travel) ◦Lack of social support ◦Lack of transportation Implement mitigation solutions: ◦Adapt intervention to accommodate comorbid conditions, guided by SPEC ◦Allow for flexible session scheduling ◦Engage formal or informal caregivers (family, friends, neighbors) ◦Devise transportation plan with local services or family members
Engage social support	With participant approval, engage caregivers in: ◦Discussions with study doctor and interventionists for setting goals and mitigating barriers ◦Encouragement and support for the participant to comply with study requirements
Communicate study expectations	Provide: ◦Behavioral agreement detailing intervention requirements (3x/wk for 12 wks) ◦Written schedule of all intervention visits ◦Written communications about clinic visits ◦Same‐day phone calls for reminders and missed visits when necessary
Manage interruptions to the intervention	Implement management actions: ◦Document missed sessions and reasons (personal vs medical) ◦Provide timely contact with participants following missed visits ◦Recommence intervention as soon as feasible after resolution of intervening issue ◦Upon recommencement, reevaluate functional level and re‐introduce exercises for safe progress ◦Allow make‐up sessions when missing ≥3 consecutive visits for medical issues
Monitor and report participant progress	Biweekly meetings of the SPEC to discuss participant engagement, retention, and adherence: ◦Review health status, adherence, and exercise progression of each participant ◦Collaboratively discuss solutions to mitigate barriers ◦Develop progress reports for visual display of progression ▪Use progress reports as basis of collaborative decision‐making between participant and interventionist for goal setting and progression
Develop participant self‐efficacy	Promote self‐management of exercise: ◦Train participants on safe exercise performance throughout intervention sessions ◦Prescribe home exercise ▪Perform on nonfacility days to support mastery of skills taught in outpatient session ▪Align with recommendations from home and built environment assessment and participant goals and activity preferences ▪Track compliance

SPEC indicates Sustaining Participant Engagement Committee.