Abstract
BackgroundCardiac rehabilitation (CR) is a secondary prevention program that offers education and support to assist patients with coronary heart disease (CHD) make lifestyle changes. Despite the benefits of CR, attendance at centre-based sessions remains low. Mobile technology (mHealth) has potential to reach more patients by delivering CR directly to mobile phones, thus providing an alternative to centre-based CR. The aim of this trial is to evaluate if a mHealth comprehensive CR program can improve adherence to healthy lifestyle behaviours (for example, physically active, fruit and vegetable intake, not smoking, low alcohol consumption) over and above usual CR services in New Zealand adults diagnosed with CHD.Methods/designA two-arm, parallel, randomised controlled trial will be conducted at two Auckland hospitals in New Zealand. One hundred twenty participants will be randomised to receive a 24-week evidence- and theory-based personalised text message program and access to a supporting website in addition to usual CR care or usual CR care alone (control). The primary outcome is the proportion of participants adhering to healthy behaviours at 6 months, measured using a composite health behaviour score. Secondary outcomes include overall cardiovascular disease risk, body composition, illness perceptions, self-efficacy, hospital anxiety/depression and medication adherence.DiscussionThis study is one of the first to examine an mHealth-delivered comprehensive CR program. Strengths of the trial include quality research design and in-depth description of the intervention to aid replication. If effective, the trial has potential to augment standard CR practices and to be used as a model for other disease prevention or self-management programs.Trial registryAustralian New Zealand Clinical Trials Registry: ACTRN12613000901707
Highlights
Cardiac rehabilitation (CR) is a secondary prevention program that offers education and support to assist patients with coronary heart disease (CHD) make lifestyle changes
The trial has potential to augment standard CR practices and to be used as a model for other disease prevention or self-management programs
Unhealthy lifestyle behaviours, including smoking, physical inactivity, hazardous alcohol consumption and low intake of fruit and vegetables have been shown to contribute to the development of coronary heart disease (CHD) [1,2], which remains a leading cause of death worldwide [3]
Summary
The Text4Heart trial will evaluate a comprehensive mHealth CR intervention to improve adherence to lifestyle behaviours. Many mHealth studies fail to fully describe their interventions, in particular the behaviour change theory or BCTs used, if any, and the evidence behind the content of the intervention [25,53]. Additional file 2: Example of text message content and related social cognitive theory (SCT) construct and behaviour change techniques (BCTs). We provide examples of intervention content and the related theoretical constructs.
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