Cardiovascular Behavioral Medicine: Research Reflections During the COVID-19 Pandemic

Alyssa Vela, PhD^✉ and Allison Gaffey, PhD^✉; Cardiovascular Disease SIG

Since early 2020, the COVID-19 pandemic changed work, lifestyle, and quality of life in numerous ways. The impact of the virus on work-flow changes in medical and academic settings has been extensive. Cardiovascular behavioral health research may be more important than ever, as early signs indicate that the virus can majorly impact cardiac health, with unknown long-term physical and psychological consequences (Madjid, Safavi-Naeini, P., & Solomon, S.D., 2020). Given the rapid shift in research practice, implementation, and scope, the Cardiovascular Disease Special Interest Group-in-Formation (CVD SIG) reached out to members concerning how the pandemic has affected their CVD-oriented research.

Feedback from SIG members indicated that both benefits and challenges have resulted from COVID-19-related changes. Dr. Brie Turner-McGrievy, Associate Professor and Deputy Director of the TecHealth Center at the University of South Carolina, shared her experience conducting a study examining the impact diet has on CVD risk factors. The study originally included group-based classes with in-kitchen cooking demonstrations. Since switching to virtual meetings, group attendance has increased compared to in-person classes, but the research team has had difficulty completing the planned physiological assessments (i.e. weight, blood pressure, blood draws, and DXA scans). Other members described similar challenges that slowed, stopped, or prevented their research from starting all together.

Dr. Kimberly Garza, Associate Professor and Graduate Program Officer at the Auburn University Harrison School of Pharmacy, planned to submit a proposal to collaborate with a local community-based cardiac rehabilitation facility. Her plans were tabled due to a surge of COVID-19 cases that temporarily closed the facility. Given the particularly severe impact on cardiac rehabilitation programs, Dr. Garza expects that this research will remain on hold. Dr. Garza’s experience speaks to the uncertainty many researchers are experiencing related to the nature and timing of projects, particularly studies including individuals with cardiovascular conditions that make them especially vulnerable to COVID-19.

As universities, hospitals, and research laboratories have re-opened and resumed their work, it has not been business as usual. Members of the CVD SIG reflected on the procedural, personnel, and spatial adjustments that are necessary to accommodate COVID-related restrictions, while also accounting for individual and public-health. Changes include increasing safety precautions for participants (and researchers) and adjusting timelines to accommodate a range of data collection details. Such changes are likely to mean research timelines will be longer and programs will be slower to re-activate. Further, for those who conduct human subjects research, they must also respond to changes in participant lifestyle, health behaviors, and mood that may impact participation and research outcomes. For example, Dr. Turner-McGrievy reported her participants have noted weight gain over the past several months that was attributed to COVID-19-related stress and changes in diet and physical activity levels while sheltering-in-place.

Heightened stress over the past several months has also impacted research participants’ comfort in attending research study visits. Dr. Kenneth Freeland, Professor of Psychiatry and Psychology at Washington University School of Medicine, shared his team’s experience conducting a randomized controlled trial among patients with comorbid heart failure and depression. After transitioning to phone-based study visits for the past several months, Dr. Freeland and his team surveyed participants to assess how they were coping with the pandemic and gauge their interest in returning to in-person visits. He reported that the study’s participants have demonstrated good insight into their risk and unique vulnerabilities, and thus, few are comfortable with resuming in-clinic visits. Overall, CVD SIG members indicated study participants are being appropriately cautious, and to quote Dr. Freeland “resilient.”

Cardiovascular behavioral medicine research has been impacted by the COVID-19 pandemic in numerous ways. While it appears that not only the participants, but the researchers have been resilient over the past several months, it may be years before we can truly reflect on the impact of COVID-19 on CVD research implementation and outcomes.

Thank you to the members of the CVD SIG who contributed their insight and experiences to allow for the development of this article.

 

References

Madjid, M., Safavi-Naeini, P., & Solomon, S.D. (2020). Potential effects of coronaviruses on the cardiovascular system: A review. JAMA Cardiology, 5(7),831-40. doi:10.1001/jamacardio.2020.1286