Pulmonary Rehabilitation for Rural Patients With COPD

Inclusion Criteria * 40 years of age or older * Physician-diagnosed COPD * Living in a rural area defined by Rural-Urban Commuting Area Codes 4-10 * mMRC score\>=1 * English Speaking Exclusion Criteria * Inability to walk (orthopedic/neurologic/cardiac limitation causing immobility) * Cognitive impairment or inability to understand and follow instructions. * Patients with no COPD symptom burden, no breathlessness (mMRC score 0), as based on our previous studies they usually perceive no benefit from PR and do not have compliance with PR. * Traditional center-based PR was completed within 3 months of initial study recruitment. * Transition to hospice or end-of-life care at the time of screening. * Acute exacerbation at the time of screening.