Leila Pfaeffli Dale|Robyn Whittaker|Yannan Jiang|Ralph Stewart|Anna Rolleston|Ralph Maddison
Text Message and Internet Support for Coronary Heart Disease Self-Management: Results From the Text4Heart Randomized Controlled Trial
University of Auckland|University of Auckland|University of Auckland|Auckland City Hospital|University of Auckland|University of Auckland
mobile technology potential deliver behavior change interventions mhealth reduce coronary heart disease chd modest cost previous studies focused single behaviors however cardiac rehabilitation cr component chd selfmanagement needs address multiple risk factorsthe aim investigate effectiveness mhealthdelivered comprehensive cr program text4heart improve adherence recommended lifestyle behaviors smoking cessation physical activity healthy diet nonharmful alcohol use addition usual care traditional cra 2arm parallel randomized controlled trial conducted new zealand adults diagnosed chd participants recruited inhospital encouraged attend centerbased cr usual care control addition intervention group received personalized 24week mhealth program framed social cognitive theory sent fully automated daily short message service sms text messages supporting website primary outcome adherence healthy lifestyle behaviors measured using selfreported composite health behavior score 3 3 6 months secondary outcomes included clinical outcomes medication adherence score selfefficacy illness perceptions anxiety andor depression 6 months baseline 6month followup assessments unblinded conducted personeligible patients n123 recruited 2 large metropolitan hospitals randomized intervention n61 control n62 group participants predominantly male 100123 813 new zealand european 73123 593 mean age 595 sd 111 years significant treatment effect favor intervention observed primary outcome 3 months aor 255 95 ci 112584 p03 6 months aor 193 95 ci 083453 p13 intervention group reported significantly greater medication adherence score mean difference 058 95 ci 019097 p004 majority intervention participants reported reading text messages 5261 85 number visits website per person ranged zero 100 median 3 6month intervention perioda mhealth cr intervention plus usual care showed positive effect adherence multiple lifestyle behavior changes 3 months new zealand adults chd compared usual care alone effect sustained end 6month intervention larger study needed determine size effect longer term whether change behavior reduces adverse cardiovascular eventsactrn 12613000901707 httpswwwanzctrorgautrialregistrationtrialreviewaspxid364758isreviewtrue archived webcite httpwwwwebcitationorg6c4qhchkt