Introduction
depression, COPD
COPD, RECRUITMENT, CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic Obstructive Pulmonary Disease (COPD) is the leading cause of hospitalization for older adults in the United States, and accounts for 1.5 million emergency department visits per year [We hypothesized that referral to a telehealth-delivered PR program (TelePR) would overcome access barriers to PR, which in turn would increase adherence, with subsequent improvement in health outcomes. As with access to other forms of health care, people with health disparities also have barriers to accessing PR which include socioeconomic factors such as insurance coverage and transportation costs, disruption to established routines, travel and location of PR, lack of perceived benefit, depression and poor state of health, and inconvenient PR schedule times [Despite iterative and user-centered design, and despite the iterative feedback of a stakeholder-based community advisory board, the study was limited by difficulties in recruitment and retention of the target population. To evaluate our TelePR program to inform future study designs and the implementation of TelePR, we applied The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. This systematic framework has been successfully used to evaluate the implementation of healthcare interventions [