Evaluating the Impact of the HeartHab App on Motivation, Physical Activity, Quality of Life, and Risk Factors of Coronary Artery Disease Patients: Multidisciplinary Crossover Study

Abstract

Background Telerehabilitation approaches have been successful in supporting coronary artery disease (CAD) patients to rehabilitate at home after hospital-based rehabilitation. However, on completing a telerehabilitation program, the effects are not sustained beyond the intervention period because of the lack of lifestyle adaptations. Furthermore, decline in patients’ motivation lead to recurrence of disease and increased rehospitalization rates. We developed HeartHab, using persuasive design principles and personalization, to enable sustenance of rehabilitation effects beyond the intervention period. HeartHab promotes patients’ understanding, motivates them to reach personalized rehabilitation goals, and helps to maintain positive lifestyle adaptations during telerehabilitation. Objective This study aimed to investigate the impact of the HeartHab app on patients’ overall motivation, increasing physical activities, reaching exercise targets, quality of life, and modifiable risk factors in patients with CAD during telerehabilitation. The study also investigated carryover effects to determine the maintenance of effects after the conclusion of the intervention. Methods A total of 32 CAD patients were randomized on a 1:1 ratio to telerehabilitation or usual care. We conducted a 4-month crossover study with a crossover point at 2 months using a mixed-methods approach for evaluation. We collected qualitative data on users’ motivation, user experience, and quality of life using questionnaires, semistructured interviews and context-based sentiment analysis. Quantitative data on health parameters, exercise capacity, and risk factors were gathered from blood tests and ergo-spirometry tests. Data procured during the app usage phase were compared against baseline values to assess the impact of the app on parameters such as motivation, physical activity, quality of life, and risk factors. Carryover effects were used to gather insights on the maintenance of effects. Results The qualitative data showed that 75% (21/28) of patients found the HeartHab app motivating and felt encouraged to achieve their rehabilitation targets. 84% (21/25) of patients either reached or exceeded their prescribed physical activity targets. We found positive significant effects on glycated hemoglobin ( P =.01; d =1.03; 95% CI 0.24-1.82) with a mean decrease of 1.5 mg/dL and high-density lipoprotein (HDL) cholesterol ( P =.04; d =0.78; 95% CI 0.02-1.55) with a mean increase of 0.61 mg/dL after patients used the HeartHab app. We observed significant carryover effects on weight, HDL cholesterol, and maximal oxygen consumption (VO 2 max), indicating the maintenance of effects. Conclusions Persuasive design techniques integrated in HeartHab and tailoring of exercise targets were effective in mo...

A Personalized eHealth Intervention for Lifestyle Changes in Patients With Cardiovascular Disease: Randomized Controlled Trial

“…The impact of this intervention could potentially have been further improved if a more patient-tailored approach were added. Another study found initial support that an app using persuasive design techniques can improve biological and psychological factors in patients after cardiac rehabilitation [ 9 ]. It is therefore plausible that ambulatory assessments are likely to have better therapeutic effects when combined with prompts that promote health-related behaviors (ie, ecological momentary interventions).…”

Effects of the e-Motivate4Change Program on Metabolic Syndrome in Young Adults Using Health Apps and Wearable Devices: Quasi-Experimental Study

“…Thus, appropriate prevention and intervention is needed in all related fields [ 14 ]. One can significantly lower the risk of and prevent MetS by controlling diet habits, physical activity, smoking, drinking, and stress levels [ 10 , 15 , 16 ]. In particular, men aged 30 to 39 years and women aged 20 to 29 years have worse health activity compared to other age categories, and thus require more active and focused health management to improve their health habits and prevent chronic diseases [ 17 ].…”

Association of changes in cardiorespiratory fitness with health-related quality of life in young adults with mobility disability: secondary analysis of a randomized controlled trial of mobile app versus supervised training

“…A small number of previous studies focused on clinical populations has evaluated the effects of mobile app training on HRQoL [44][45][46][47]. Among those studies, two found that receiving mobile app training had higher effects on HRQoL compared to receiving usual care which included unsupervised self-rehabilitation [44] or one home visit by a physician who provided nutrition and exercise advice [45]. Another study found similar effects between a mobile app program and the provision of an exercise brochure [46].…”