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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
A randomised controlled trial of providing personalised cardiovascular risk information to modify health behaviour
Leah L Zullig1, Linda L Sanders, Ryan J Shaw
1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, USA.
Insights
A web-based cardiovascular disease (CVD) intervention showed modest engagement but no significant clinical improvements compared to usual care. Human interaction remains crucial for CVD risk communication and decision-making support.
Area of Science:
- Digital Health
- Cardiovascular Disease Prevention
- Health Behavior Change
Background:
- Cardiovascular disease (CVD) poses a significant public health challenge.
- Web-based interventions offer a scalable approach to deliver health information and support behavior change.
- Personalized risk information and tailored strategies are key components for effective CVD prevention.
Purpose of the Study:
- To assess the feasibility of a web-based intervention for cardiovascular disease (CVD) risk reduction.
- To evaluate participant engagement and clinical outcomes of a self-guided online program.
- To explore the role of web-administered interventions in managing CVD risk factors.
Main Methods:
- A feasibility study utilizing block randomization comparing a 3-month web-based intervention to usual care.
- Intervention group received personalized CVD risk assessment (Framingham risk score) and access to six self-guided behavioral/lifestyle modules.
- Engagement measured by module completion; clinical outcomes assessed for blood pressure, BMI, CVD risk, smoking cessation, and medication adherence.
Main Results:
- Most intervention participants (77%) completed all modules, indicating good engagement with the self-guided format.
- No significant differences were observed between the intervention and usual care groups in systolic blood pressure, BMI, CVD risk, smoking cessation, or medication adherence after 3 months.
- The study demonstrated that entirely web-administered interventions can achieve modest clinical improvements.
Conclusions:
- Web-based interventions are feasible for delivering CVD risk information and behavioral strategies.
- While engagement can be high, current web-based models may not fully replace the need for human interaction in CVD risk communication and decision support.
- Further research is needed to optimize web-based interventions for greater clinical impact in cardiovascular disease prevention.
Abstract:
We conducted a feasibility study of a web-based intervention, which provided personalized cardiovascular disease (CVD) risk information, behavioural risk reduction strategies and educational resources. Participants were block-randomized to the 3-month intervention (n = 47) or to usual care (n = 49). Participants in the intervention group were presented with their CVD risk based on the Framingham risk score, and in three subsequent online encounters could select two behavioural/lifestyle modules, giving them an opportunity to complete six modules over the course of the study. Because it was self-guided, participants had differing levels of engagement with intervention materials. Most intervention group participants (77%, n = 36) completed all modules. After 3 months there were no significant differences between the intervention and usual care groups for systolic blood pressure, body-mass index, CVD risk, smoking cessation or medication non-adherence. The study suggests that modest clinical improvements can be achieved by interventions that are entirely web-administered. However, web-based interventions do not replace the need for human interaction to communicate CVD risk and assist with decision-making.
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