Abstract
Introduction: Exercise & nutritional intervention programs are effective in lowering cardiovascular events in randomized control trials but success in real world settings may be limited by resource constraints. We describe the implementation & preliminary effectiveness of a comprehensive telehealth lifestyle approach that provides culturally relevant lifestyle interventions, recognizing the role of acculturative stressors & behavior patterns unique to South Asians. Methods: CardioClick was introduced in the Stanford South Asian Translational Heart Initiative on 11/1/2017 to deliver care via video visits. Patients ages 20-60 were offered enrollment. Those who did not consent were followed in the traditional in-person program. Both programs included a comprehensive risk assessment & personalized treatment plan focused on aggressive risk reduction, with a set of 3 cardiologist & 3 dietitian visits over 6 months. CardioClick patients received a lifestyle questionnaire & satisfaction survey at each visit. Based on responses & online dialog, culturally tailored nutrition, exercise recommendations & resources to address sleep deficiencies & perceived stress, were provided. Results: Out of 110 currently enrolled 23 have completed CardioClick. These patients were similar in age (44 vs 43 years) BMI (27.1 vs 26.7) & cardiovascular risk (ASCVD 4.8 vs 4.5) but had more dietitian visits (3 vs 1), more likely to lose weight 83% (19/23) vs 54% (44/82) & lost more weight (9lbs vs 0.7lbs) compared to traditional program patients. In the CardioClick group QDiabetes score (9.2 to 7.2) & TG/HDL ratio (2.3 to 1.8) dropped. Questionnaire 100% (23/23) & survey 57%(13/23) responses showed improved lifestyle behaviors & patient satisfaction. Conclusion: Early results from a novel telemedicine preventive cardiology program showed improved patient engagement, lifestyle behaviors & cardiometabolic benefits in high risk South Asians.
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