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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

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Nurse-Driven mHealth Implementation Using the Technology Inpatient Program for Smokers (TIPS): Mixed Methods Study.

Amanda C Blok^1,2, Rajani S Sadasivam³, Timothy P Hogan^3,4

¹Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, United States Department of Veterans Affairs, Ann Arbor, MI, United States.

JMIR Mhealth and Uhealth

|October 8, 2019

Summary

This summary is machine-generated.

The Technology Inpatient Program for Smokers (TIPS) effectively engages patients in mobile health interventions for smoking cessation. This low-cost program shows sustained engagement post-discharge, highlighting its feasibility.

Keywords:

care transition implementation strategy mHealth, tobacco use cessation mobile health patient transfer smoking smoking cessation telemedicine tobacco

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Area of Science:

Public Health
Health Services Research
Digital Health

Background:

Smoking cessation interventions in hospitals are inconsistent, despite smoking being a leading cause of preventable disease.
The Technology Inpatient Program for Smokers (TIPS) utilizes mobile health (mHealth) interventions supported by stakeholders to reach hospital inpatients who smoke.

Purpose of the Study:

To evaluate the impact of TIPS implementation strategies on patient engagement with mHealth interventions during care transitions.
To assess the effectiveness of varying intensities of TIPS strategies on intervention adoption and maintenance.

Main Methods:

The study compared passive (posters) versus active (posters + nurse facilitation) TIPS strategies across four hospital units.
RE-AIM framework measures, stakeholder adaptations, and formative data were collected over 30 weeks of implementation and 30 weeks of follow-up.
Smoker-level reach and engagement, strategy adoption, fidelity, and costs were analyzed.

Main Results:

103 smokers enrolled in the mHealth intervention with sustained engagement post-discharge.
Active facilitation (posters + nurse) improved engagement completion rates (85.2%) compared to passive strategies (73.3%), though initial reach was similar.
Program costs were low at $6.63 per smoker, with family member involvement noted as an unintended facilitator.

Conclusions:

The TIPS program is a feasible, low-cost method for engaging smokers in mHealth interventions during and after hospitalization.
Nurse facilitation shows promise for enhancing engagement, and involving patient families may be a valuable strategy.
Further research is needed to optimize nurse facilitation and explore broader reach strategies.