Abstract
BackgroundCoronary heart disease (CHD) is the leading cause of death and disability among American women. The prevalence of CHD is expected to increase by more than 40% by 2035. In 2015, the estimated cost of caring for patients with CHD was US $182 billion in the United States; hospitalizations accounted for more than half of the costs. Compared with men, women with CHD or those who have undergone coronary revascularization have up to 30% more rehospitalizations within 30 days and up to 1 year. Center-based cardiac rehabilitation is the gold standard of care after an acute coronary event, but few women attend these valuable programs. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care.ObjectiveThe ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. First, this study aimed to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD (herein referred to as HerBeat). Second, we examined the influence of HerBeat on selected health behaviors (self-efficacy for diet, exercise, and managing chronic illness) and psychological (perceived stress and depressive symptoms) characteristics of the participants.MethodsUsing a single-group, pretest, posttest design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat app was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment.ResultsAll 10 women (age: mean 64.4 years, SD 6.3 years) completed the study. The usability and acceptability of HerBeat were good, with a mean system usability score of 83.60 (SD 16.3). The participants demonstrated statistically significant improvements in waist circumference (P=.048), weight (P=.02), and BMI (P=.01). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (P=.04).ConclusionsThe mHealth prototype was feasible and usable for women with CHD. Participants provided data that were useful for further development of HerBeat. The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings.
Highlights
Center-based cardiac rehabilitation (CBCR) is a multidisciplinary, comprehensive, evidence-based intervention with proven morbidity and mortality benefits [1,2,3,4]
We explore the feasibility of delivering technology supported behavior change interventions to women with coronary heart disease (CHD)
All participants had Coronary heart disease (CHD), with 2 participants diagnosed with a myocardial infarction and one with heart failure
Summary
Center-based cardiac rehabilitation (CBCR) is a multidisciplinary, comprehensive, evidence-based intervention with proven morbidity and mortality benefits [1,2,3,4]. Deprived women who face transportation challenges, family or work obligations, depression, anxiety, or low social support are especially unable to use CBCR [22,23,24,25,26,27]. These limitations have prompted a call to redesign CBCR for women [7,28,29]. Effective home-based interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care. This study aimed to examine the usability of a prototypic mHealth intervention designed for women with CHD ( referred to as HerBeat). The mHealth intervention is expected to help women with CHD self-manage their health behaviors. A randomized controlled trial is needed to further verify the findings
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