A Web-Based Intervention for Health Professionals and Patients to Decrease Cardiovascular Risk Attributable to Physical Inactivity: Development Process

Sassen, Barbara; Kok, Gerjo; Mesters, Ilse; Crutzen, Rik; Cremers, Anita; Vanhees, Luc

doi:10.2196/resprot.1804

Cited by 23 publications

(24 citation statements)

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“…Also, the complexity of the intervention with (too) many modules may have influenced performance and attrition. The Web-based intervention was carefully developed following the Intervention Mapping protocol [ 7 ]. Health care professionals from the target group were involved in the development of the intervention, and they also pre-tested the application, but it may be that (too) much attention was directed at “does the website work as intended”.…”

Section: Discussionmentioning

confidence: 99%

“…Participants had access to the website [ 32 ], which offered several modules. The development and content of the intervention is described in detail elsewhere [ 7 , 30 ]. Modules and a forum were directed at the health care professional to increase professionals’ awareness of their thoughts, and learn skills and strategies to support patients in their own self-management, this to improve their intention and behavior toward patient-centered health education.…”

Section: Methodsmentioning

confidence: 99%

“…The outcome measures of the intervention should include behavior as well as determinants that influence the behavior [ 3 ]. Intervention Mapping has been found to be effective for developing interventions with the objective of changing the behavior of health care professionals and patients, and has led to interventions with effects on patients’ behavior [ 3 , 7 - 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Supporting Health Care Professionals to Improve the Processes of Shared Decision Making and Self-Management in a Web-Based Intervention: Randomized Controlled Trial

Sassen¹,

Kok²,

Schepers³

et al. 2014

J Med Internet Res

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BackgroundResearch to assess the effect of interventions to improve the processes of shared decision making and self-management directed at health care professionals is limited. Using the protocol of Intervention Mapping, a Web-based intervention directed at health care professionals was developed to complement and optimize health services in patient-centered care.ObjectiveThe objective of the Web-based intervention was to increase health care professionals’ intention and encouraging behavior toward patient self-management, following cardiovascular risk management guidelines.MethodsA randomized controlled trial was used to assess the effect of a theory-based intervention, using a pre-test and post-test design. The intervention website consisted of a module to help improve professionals’ behavior, a module to increase patients’ intention and risk-reduction behavior toward cardiovascular risk, and a parallel module with a support system for the health care professionals. Health care professionals (n=69) were recruited online and randomly allocated to the intervention group (n=26) or (waiting list) control group (n=43), and invited their patients to participate. The outcome was improved professional behavior toward health education, and was self-assessed through questionnaires based on the Theory of Planned Behavior. Social-cognitive determinants, intention and behavior were measured pre-intervention and at 1-year follow-up.ResultsThe module to improve professionals’ behavior was used by 45% (19/42) of the health care professionals in the intervention group. The module to support the health professional in encouraging behavior toward patients was used by 48% (20/42). The module to improve patients’ risk-reduction behavior was provided to 44% (24/54) of patients. In 1 of every 5 patients, the guideline for cardiovascular risk management was used. The Web-based intervention was poorly used. In the intervention group, no differences in social-cognitive determinants, intention and behavior were found for health care professionals, compared with the control group. We narrowed the intervention group and no significant differences were found in intention and behavior, except for barriers. Results showed a significant overall difference in barriers between the intervention and the control group (F 1=4.128, P=.02).ConclusionsThe intervention was used by less than half of the participants and did not improve health care professionals’ and patients’ cardiovascular risk-reduction behavior. The website was not used intensively because of time and organizational constraints. Professionals in the intervention group experienced higher levels of barriers to encouraging patients, than professionals in the control group. No improvements were detected in the processes of shared decision making and patient self-management. Although participant education level was relatively high and the intervention was pre-tested, it is possible that the way the information was presented could be the reason for low participation and high dropout. Furth...

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Supporting Health Care Professionals to Improve the Processes of Shared Decision Making and Self-Management in a Web-Based Intervention: Randomized Controlled Trial

Sassen¹,

Kok²,

Schepers³

et al. 2014

J Med Internet Res

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“…In order for any Web-based program to be successful, it must suit the working practices of the health care professional (HCP) [ 44 ]. This was acknowledged when developing the AYH program, ensuring that it can be easily incorporated into the CR service and does not increase the workload of the HCP.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Interactive Web-Based Program, Activate Your Heart, for Cardiac Rehabilitation Patients: A Pilot Study

Brough¹,

Boyce²,

Houchen–Wolloff³

et al. 2014

J Med Internet Res

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BackgroundConventional cardiac rehabilitation (CR) programs are traditionally based on time-constrained, structured, group-based programs, usually set in hospitals or leisure centers. Uptake for CR remains poor, despite the ongoing evidence demonstrating its benefits. Additional alternative forms of CR are needed. An Internet-based approach may offer an alternative mode of delivering CR that may improve overall uptake. Activate Your Heart (AYH) is a Web-based CR program that has been designed to support individuals with coronary heart disease (CHD).ObjectiveThe aim of this pilot study was to observe the outcome for participants following the AYH program.MethodsWe conducted a prospective observational trial, recruiting low-risk patients with CHD. Measures of exercise, exercise capacity, using the Incremental Shuttle Walk Test (ISWT), dietary habits, and psychosocial well-being were conducted by a CR specialist at baseline and at 8 weeks following the Web-based intervention.ResultsWe recruited 41 participants; 33 completed the program. We documented significant improvements in the ISWT distance (mean change 49.69 meters, SD 68.8, P<.001), and Quality of Life (QOL) (mean change 0.28, SD 0.4, P<.001). Dietary habits improved with an increased proportion of patients consuming at least 5 portions of fruit and vegetables per day, (22 [71%] to 29 [94%] P=.01) and an increased proportion of patients consuming at least 2 portions of oily fish per week (14 [45%] to 21 [68%], P=.01). We did not detect changes in anxiety and depression scores or exercise behavior.ConclusionsWe observed important improvements in exercise capacity, QOL, and dietary habits in a group of participants following a Web-based CR program. The program may offer an alternative approach to CR. A mobile version has been developed and we need to conduct further trials to establish its value compared to supervised CR.

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“…pacientes, sino como una herramienta para complementar y optimizar los servicios de salud. [38][39][40] Varios estudios han demostrado que en comparación con la medición de presión arterial en la consulta, la auto-medición de la PA en casa permite un mejor control de la presión arterial.37 HBPT: telemonitorización presión arterial en el hogar, es un estudio en Italia que intervino a 252 pacientes asignado al azar (84 grupo control y 168 experimental) durante 48 semanas, mostrando mejores resultados con la HBPT en comparación la atención habitual.37 La vigilancia de PA en casa juega un papel pequeño pero significativo en el mejoramiento de la PA sistólica y diastólica.41 HyperLink es un ensayo clínico aleatorio realizado en el área metropolitana de Minneapolis-St.Paul, EE.UU donde se reclutaron 450 adultos con PA no controlada con una edad media de 61 años, para llevar a cabo 12 meses de intervención y seis meses de post-intervención de seguimiento, a cada paciente se le asignó un telemonitor, recibieron visita telefónicas cada dos meses.…”

Section: Tic E Hipertensión Arterialunclassified

Salud electrónica para el autocuidado de pacientes con factores de riesgo asociados al síndrome metabólico

et al. 2016

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ResumenEl propósito de esta revisión, es identificar la evidencia científica sobre el uso de estrategias de salud electrónica en las intervenciones dirigidas a mejorar el autocuidado de pacientes con factores de riesgo cardiovascular asociado con la presencia de síndrome metabólico. Los artículos analizados fueron identificados en las bases de datos PubMed, Science Direct, Embase, Elsevier, Scielo, Adicional a esto se revisaron publicaciones estadísticas de la Organización Mundial de la Salud, La Federación Internacional de Diabetes, Guía de Síndrome Metabólico 2009 y ICT Facts and Figures World in 2013. Se tuvieron en cuenta 51 publicaciones realizadas entre los años 2009 y 2015, encontrándose mayor información en la intervención basada en el control del sobrepeso y la obesidad, como principal factor de riesgo para el desarrollo del síndrome metabólico. La evidencia encontrada en la literatura científica muestra la utilidad de la salud electrónica en el manejo de los factores de riesgo cardiovasculares asociados al síndrome metabólico, y el impacto de esta en la calidad de vida cuando son aplicadas con un adecuado protocolo. AbstractThe purpose of this review is to identify the scientific evidence on the use of electronic health strategies in interventions aimed at improving self-care of patients with cardiovascular risk factors associated with the presence of metabolic syndrome. The articles analyzed were identified in the databases PubMed, Science Direct, Embase, Elsevier and Scielo. In addition, statistical publications from the World Health Organization, the International Diabetes Federation, Metabolic Syndrome Guide 2009 and ICT Facts and Figures World in 2013 were reviewed. 51 publications between the years 2009 and 2015 were considered, where there were more information about the intervention based on the control of overweight and obesity as a major risk factor for the development of the metabolic syndrome. The evidence found in the scientific literature shows the usefulness of e-health in the management of cardiovascular risk factors associated with metabolic syndrome, and its impact on the quality of life when they are applied with a suitable protocol.

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A Web-Based Intervention for Health Professionals and Patients to Decrease Cardiovascular Risk Attributable to Physical Inactivity: Development Process

Cited by 23 publications

References 46 publications

Supporting Health Care Professionals to Improve the Processes of Shared Decision Making and Self-Management in a Web-Based Intervention: Randomized Controlled Trial

Supporting Health Care Professionals to Improve the Processes of Shared Decision Making and Self-Management in a Web-Based Intervention: Randomized Controlled Trial

Evaluating the Interactive Web-Based Program, Activate Your Heart, for Cardiac Rehabilitation Patients: A Pilot Study

Salud electrónica para el autocuidado de pacientes con factores de riesgo asociados al síndrome metabólico

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