scholarly journals Efficacy and Effectiveness of Mobile Health Technologies for Facilitating Physical Activity in Adolescents: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Alexandra M Lee ◽  
Sarah Chavez ◽  
Jiang Bian ◽  
Lindsay A Thompson ◽  
Matthew J Gurka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mobile Health ◽  
Scoping Review ◽  
Text Messaging ◽  
Comparison Group ◽  
Intervention Group ◽  
Analysis Data ◽  
Cardiovascular Fitness ◽  
Health Technologies ◽  
Mhealth Intervention

BACKGROUND Increasing physical activity (PA) levels in adolescents aged 12 to 18 years is associated with prevention of unhealthy weight gain and improvement in cardiovascular fitness. The widespread availability of mobile health (mHealth) and wearable devices offers self-monitoring and motivational features for increasing PA levels and improving adherence to exercise programs. OBJECTIVE The aim of this scoping review was to identify the efficacy or effectiveness of mHealth intervention strategies for facilitating PA among adolescents aged 12 to 18 years. METHODS We conducted a systematic search for peer-reviewed studies published between 2008 and 2018 in the following electronic databases: PubMed, Google Scholar, PsychINFO, or SportDiscus. The search terms used included mHealth or “mobile health” or apps, “physical activity” or exercise, children or adolescents or teens or “young adults” or kids, and efficacy or effectiveness. Articles published outside of the date range (July 2008 to October 2018) and non-English articles were removed before abstract review. Three reviewers assessed all abstracts against the inclusion and exclusion criteria. Any uncertainties or differences in opinion were discussed as a group. The inclusion criteria were that the studies should (1) have an mHealth component, (2) target participants aged between 12 and 18 years, (3) have results on efficacy or effectiveness, and (4) assess PA-related outcomes. Reviews, abstracts only, protocols without results, and short message service text messaging–only interventions were excluded. We also extracted potentially relevant papers from reviews. At least 2 reviewers examined all full articles for fit with the criteria and extracted data for analysis. Data extracted from selected studies included study population, study type, components of PA intervention, and PA outcome results. RESULTS Overall, 126 articles were initially identified. Reviewers pulled 18 additional articles from excluded review papers. Only 18 articles were passed onto full review, and 16 were kept for analysis. The included studies differed in the sizes of the study populations (11-607 participants), locations of the study sites (7 countries), study setting, and study design. Overall, 5 mHealth intervention categories were identified: website, website+wearable, app, wearable+app, and website+wearable+app. The most common measures reported were subjective weekly PA (4/13) and objective daily moderate-to-vigorous PA (5/13) of the 19 different PA outcomes assessed. Furthermore, 5 of 13 studies with a control or comparison group showed a significant improvement in PA outcomes between the intervention group and the control or comparison group. Of those 5 studies, 3 permitted isolation of mHealth intervention components in the analysis. CONCLUSIONS PA outcomes for adolescents improved over time through mHealth intervention use; however, the lack of consistency in chosen PA outcome measures, paucity of significant outcomes via between-group analyses, and the various study designs that prevent separating the effects of intervention components calls into question their true effect.

scholarly journals Efficacy and Effectiveness of Mobile Health Technologies for Facilitating Physical Activity in Adolescents: Scoping Review

10.2196/11847 ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. e11847 ◽  
Author(s):  
Alexandra M Lee ◽  
Sarah Chavez ◽  
Jiang Bian ◽  
Lindsay A Thompson ◽  
Matthew J Gurka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mobile Health ◽  
Scoping Review ◽  
Health Technologies

scholarly journals Perioperative digital behaviour change interventions for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation: a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Katarina Åsberg ◽  
Marcus Bendtsen
Keyword(s):  
Physical Activity ◽  
Smoking Cessation ◽  
Behaviour Change ◽  
Scoping Review ◽  
Text Messaging ◽  
Text Message ◽  
Feasibility Studies ◽  
Small Sample ◽  
Small Sample Sizes ◽  
Randomised Controlled

Abstract Background Evidence suggests that unhealthy lifestyle behaviours are modifiable risk factors for postoperative complications. Digital behaviour change interventions (DBCIs), for instance text messaging programs and smartphone apps, have shown promise in achieving lifestyle behaviour change in a wide range of clinical populations, and it may therefore be possible to reduce postoperative complications by supporting behaviour change perioperatively using digital interventions. This scoping review was conducted in order to identify existing research done in the area of perioperative DBCIs for reducing alcohol consumption, improving dietary intake, increasing physical activity and smoking cessation. Main text This scoping review included eleven studies covering a range of surgeries: bariatric, orthopaedic, cancer, transplantation and elective surgery. The studies were both randomised controlled trials and feasibility studies and investigated a diverse set of interventions: one game, three smartphone apps, one web-based program and five text message interventions. Feasibility studies reported user acceptability and satisfaction with the behaviour change support. Engagement data showed participation rates ranged from 40 to 90%, with more participants being actively engaged early in the intervention period. In conclusion, the only full-scale randomised controlled trial (RCT), text messaging ahead of bariatric surgery did not reveal any benefits with respect to adherence to preoperative exercise advice when compared to a control group. Two of the pilot studies, one text message intervention, one game, indicated change in a positive direction with respect to alcohol and tobacco outcomes, but between group comparisons were not done due to small sample sizes. The third pilot-study, a smartphone app, found between group changes for physical activity and alcohol, but not with respect to smoking cessation outcomes. Conclusion This review found high participant satisfaction, but shows recruitment and timing-delivery issues, as well as low retention to interventions post-surgery. Small sample sizes and the use of a variety of feasibility outcome measures prevent the synthesis of results and makes generalisation difficult. Future research should focus on defining standardised outcome measures, enhancing patient engagement and improving adherence to behaviour change prior to scheduled surgery.

Effect of an mHealth-Based Intervention on Excessive Gestational Weight Gain Prevention among Overweight and Obese Women: A Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Hung Hui Chen ◽  
Ching-Fang Lee ◽  
Jian-Pei Huang ◽  
Li-Kang Chi ◽  
Yvonne Hsiung
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Obese Women ◽  
Third Trimester ◽  
Overweight Women ◽  
Mhealth Intervention ◽  
Excessive Gestational Weight Gain

BACKGROUND Excessive gestational weight gain (GWG) is a public health concern since it can lead to adverse consequences and health problems for expecting mothers and their unborn infants. There is a need to evaluate the effects of a GWG management intervention to reduce the burden and risk among overweight and obese women during pregnancy. OBJECTIVE To explore the efficacy of a mobile health (mHealth) intervention to prevent excessive GWG, overweight and obese pregnant women were invited to use an app and wearable activity tracker (WAT). METHODS A randomized controlled trial with an experimental study design. Ninety-two pregnant women were recruited, and all overweight and obese participants from the two prenatal outpatient clinics in northern Taiwan had, at less than 17 weeks gestation, a prepregnancy body mass index (BMI) ≥ 25 kg/m2. These participants were randomly assigned (1:1) by a random number table; the experimental group received an mHealth-based program using the MyHealthyWeight (MHW) app and a WAT to wear during pregnancy. The control group received standard antenatal treatments without any mHealth-based elements. Two hospital follow-up visits were scheduled at 24-26 weeks in the second trimester and 34-36 weeks in the third trimester. Sociodemographic characteristics, pregnancy physical activity questionnaire (PPAQ), a self-efficacy questionnaire and body weight were measures of interest. A generalized estimating equation (GEE) was used to examine the trajectories and the intervention effect on GWG. RESULTS No difference in GWG was found between the intervention and control groups at baseline. The weight gain trajectory in the entire cohort of women with obesity exhibited a quadratic pattern; compared with the control group, a slight increase in the intervention group was found in the second trimester. Throughout the whole pregnancy, the mHealth intervention group had a significantly lower proportion of excessive GWG in total and weekly weight gain. In particular, obese women in the intervention group, compared with obese women in the control group, gained less weight (average difference of 8.76 kg) in the third trimester. The GEE model indicated that obese women who were aged 35 years, had prepregnancy exercise habits, had perceived self-efficacy of diet, and had more physical activity had lower GWG (p<.05). CONCLUSIONS The mHealth program has shown positive results in significantly managing GWG among obese and overweight women. Among obese women, the second semester trajectory of weight gain and the lower proportion of excessive GWG were more notable than those of overweight women. Although the intervention seems to be more effective among women with obesity, our results show the potential to prevent excessive GWG during pregnancy in both overweight and obese women. Guidance may be provided to health-care professionals who wish to promote healthy diet and physical activity behaviors. CLINICALTRIAL The protocol of the study was registered in ClinicalTrials. gov (NCT04553731).

scholarly journals Use of mobile health technologies for postoperative care in paediatric surgery: A systematic review

2020 ◽  
pp. 1357633X2093468
Author(s):  
Nam Nguyen ◽  
Etienne Leveille ◽  
Elena Guadagno ◽  
Luc Malemo Kalisya ◽  
Dan Poenaru
Keyword(s):  
Systematic Review ◽  
Mobile Health ◽  
Postoperative Care ◽  
Data Extraction ◽  
Intervention Group ◽  
Paediatric Surgery ◽  
High Quality Research ◽  
Health Technologies ◽  
Surgery Patient ◽  
Wide Range

Introduction Mobile health (mHealth) is the use of mobile communication devices such as smartphones, wireless patient monitoring devices and tablet computers to deliver health services. Paediatric surgery patient care could potentially benefit from these technologies. This systematic review summarises the current literature on the use of mHealth for postoperative care after children’s surgery. Methods Seven databases were searched by a senior medical librarian. Studies were included if they reported the use of mHealth systems for postoperative care for children  <18 years old. Data extraction and risk of bias assessment were performed in duplicate. Results A total of 18 studies were included after screening. mHealth use was varied and included appointment or medication reminders, postoperative monitoring and postoperative instruction delivery. mHealth systems included texting systems and mobile applications, and were implemented for a wide range of surgical conditions and countries. Discussion Studies showed that mHealth systems can increase the postoperative follow-up appointment attendance rate ( p < 0.001), decrease the rate of postoperative complications and returns to the emergency department and reliably monitor postoperative pain. mHealth systems were generally appreciated by patients. Most non-randomised and randomised studies had many methodological problems, including lack of appropriate control groups, lack of blinding and a tendency to devote more time to the care of the intervention group. mHealth systems have the potential to improve postoperative care, but the lack of high-quality research evaluating their impact calls for further studies exploring evidence-based mHealth implementation.

scholarly journals A Mobile Health Intervention for Adolescents Exposed to Secondhand Smoke: Pilot Feasibility and Efficacy Study

10.2196/18583 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18583
Author(s):  
Natalie Nardone ◽  
Jeremy Giberson ◽  
Judith J Prochaska ◽  
Shonul Jain ◽  
Neal L Benowitz
Keyword(s):  
Pilot Study ◽  
Mobile Health ◽  
Secondhand Smoke ◽  
Text Messaging ◽  
Text Message ◽  
Preliminary Evidence ◽  
Text Messages ◽  
Urinary Cotinine ◽  
Mhealth Intervention ◽  
Shs Exposure

Background Secondhand smoke (SHS) exposure in children and adolescents has adverse health effects. For adolescents of lower socioeconomic status (SES), exposure is widespread, evidenced in the measurement of urinary cotinine, a major metabolite of nicotine. Direct intervention with exposed children has been proposed as a novel method, yet there is minimal evidence of its efficacy. Combining this approach with a mobile health (mHealth) intervention may be more time and cost-effective and feasible for adolescent populations. Objective In this pilot study, we assessed the feasibility and preliminary evidence of efficacy of a 30-day text message–based mHealth intervention targeted at reducing SHS exposure in adolescent populations of low SES. Methods For the study, 14 nonsmoking and nonvaping participants between the ages of 12-21 years exposed to SHS were enrolled. The intervention consisted of a daily text message sent to the participants over the course of a month. Text message types included facts and information about SHS, behavioral methods for SHS avoidance, or true-or-false questions. Participants were asked to respond to each message within 24 hours as confirmation of receipt. Feasibility outcomes included completion of the 30-day intervention, receiving and responding to text messages, and feedback on the messages. Efficacy outcomes included a reduction in urinary cotinine, accuracy of true-or-false responses, and participants’ perceptions of effectiveness. Results Of the 14 participants that were enrolled, 13 completed the intervention. Though not required, all participants had their own cell phones with unlimited text messaging plans. Of the total number of text messages sent to the 13 completers, 91% (372/407) of them received on-time responses. Participant feedback was generally positive, with most requesting more informational and true-or-false questions. In terms of efficacy, 54% (6/11) of participants reduced their cotinine levels (however, change for the group overall was not statistically significant (P=.33) and 45% (5/11) of participants increased their cotinine levels. Of the total number of true-or-false questions sent across all completers, 77% (56/73) were answered correctly. Participants’ ratings of message effectiveness averaged 85 on a scale of 100. Conclusions In this pilot study, the intervention was feasible as the majority of participants had access to a cell phone, completed the study, and engaged by responding to the messages. The efficacy of the study requires further replication, as only half of the participants reduced their cotinine levels. However, participants answered the majority of true-or-false questions accurately and reported that the messages were helpful.

scholarly journals Sustainability of mHealth Effects on Cardiometabolic Risk Factors: Five-Year Results of a Randomized Clinical Trial

10.2196/14595 ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. e14595
Author(s):  
Antonio Bernabe-Ortiz ◽  
Julia Pauschardt ◽  
Francisco Diez-Canseco ◽  
J Jaime Miranda
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Text Messaging ◽  
Intervention Group ◽  
Significant Risk ◽  
Secondary Outcome ◽  
Control Group ◽  
Preventive Strategy ◽  
Resource Constrained ◽  
Mhealth Intervention

Background The long-term effects of mobile health (mHealth) interventions have not been documented, especially in resource-constrained settings. Objective This study aimed to assess the effects of a 1-year mHealth intervention on blood pressure levels and body weight in low-resource urban settings in Peru, 4 years after the completion of the original study. Methods Four years after the original Grupo de Investigación en Salud Móvil en America Latina (GISMAL) study, we attempted to contact the 212 individuals originally enrolled in the study in Peru. The primary outcomes were systolic and diastolic blood pressure levels and hypertension incidence. Secondary outcome measures were body weight, BMI, and self-reported target behaviors. The study personnel collecting the data were masked to the group assignment. Linear mixed models were used to evaluate the effects of the intervention on primary and secondary outcomes in an intention-to-treat analysis. Results Data from 164 (77.4%) of the 212 originally enrolled participants were available and analyzed (80 in the intervention group and 84 in the control group). The intervention did not result in changes in systolic (–2.54 mm Hg, 95% CI –8.23 to 3.15) or diastolic (3.41 mm Hg, 95% CI –0.75 to 7.57) blood pressure compared with the control group. The intervention reduced the risk of developing hypertension, but the result was not significant (risk ratio (RR) 0.76, 95% CI 0.45-1.28). However, those who received the intervention had lower body weight (–5.42 kg, 95% CI –10.4 to –0.48) and BMI (–2.56 kg/m2, 95% CI –4.46 to –0.66). In addition, compared to the control participants, those who received ≥50% of the scheduled calls during the intervention had greater reductions in body weight (–6.23 kg, 95% CI –11.47 to –0.99) and BMI (–2.81 kg/m2, 95% CI –4.77 to –0.85). Conclusions An mHealth intervention comprising motivational interview calls and SMS text messaging appears to have effects on health 4 years after intervention completion. Although there were no effects on blood pressure levels, important reductions in body weight and BMI were seen 5 years after randomization. Thus, mHealth appears to be a promising preventive strategy for noncommunicable diseases in resource-constrained settings. Trial Registration Clinicaltrials.gov NCT01295216; https://clinicaltrials.gov/ct2/show/NCT01295216

scholarly journals Outcomes From a Hybrid Implementation-effectiveness Study of the Living Well During Pregnancy Tele-coaching Program for Women at High Risk of Excessive Gestational Weight Gain

2022 ◽  
Author(s):  
Susan de Jersey ◽  
Nina Meloncelli ◽  
Taylor Guthrie ◽  
Hilary Powlesland ◽  
Leonie Callaway ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Diet Quality ◽  
Comparison Group ◽  
Intervention Group ◽  
Implementation Effectiveness ◽  
Face To Face ◽  
Historical Comparison ◽  
Gestational Weight ◽  
Living Well

Abstract BackgroundExcess gestational weight gain (GWG) is associated with short-term perinatal complications and longer term cardiometabolic risks for mothers and their babies. Dietitian counselling and weight gain monitoring for women at risk of high pregnancy weight gain is recommended by clinical practice guidelines. However, face-to-face appointments, during a time with high appointment burden, can introduce barriers to engaging with care. Telephone counselling may offer a solution. The Living Well during Pregnancy (LWdP) program is a dietitian-delivered telephone coaching program implemented within routine antenatal care for women at risk of excess GWG. This program evaluation used a hybrid implementation-effectiveness design guided by the RE-AIM framework reports on the primary outcomes (reach, adoption, implementation, maintenance) and secondary outcomes (effectiveness) of the LWdP intervention. MethodsThe LWdP program evaluation compared data from women participating in the LWdP program with a historical comparison group (pregnant women receiving dietetic counselling for GWG in the 12 months prior to the study). The primary outcomes were described for the LWdP program. Between group comparisons were used to determine effectiveness of achieving appropriate GWG and pre and post intervention comparisons of LWdP participants was used to determine changes to dietary intake and physical activity. ResultsThe LWdP intervention group (n=142) were compared with women in the historical comparison group (n=49). Women in the LWdP intervention group attended 3.4 (95% CI 2.9 – 3.8) appointments compared with 1.9 (95% CI, 1.6 – 2.2). GWG was similar between the two groups, including the proportion of women gaining weight above the Institute of Medicine recommendations (70% vs 73%, p=0.69). Within group comparison showed that total diet quality, intake of fruit and vegetables and weekly physical activity were all significantly improved from baseline to follow-up for the women in the LWdP, while consumption of discretionary food and time spent being sedentary decreased (all p<0.05). ConclusionThe LWdP program resulted in more women accessing care and positive improvements in diet quality, intuitive eating behaviours and physical activity. It was as effective as face-to-face appointments for GWG, though more research is required to identify how to engage women earlier in pregnancy and reduce appointment burden.

P573Effects of mobile text messaging on glycemic control in patients with coronary heart disease and diabetes mellitus: a randomized controlled trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
X H Huo ◽  
H M K Krumholz ◽  
X B Bai ◽  
E S S Spatz ◽  
Q D Ding ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Coronary Heart Disease ◽  
Text Messaging ◽  
Hba1c Level ◽  
Primary Outcome ◽  
Intervention Group ◽  
Control Group ◽  
Secondary Outcomes

Abstract Background Mobile health interventions hold the prospect to support risk factor and lifestyle modification and are readily scalable in healthcare systems. Purpose We aim to assess whether text messaging program can improve glycemic control in high-risk patients with coronary heart disease (CHD) and diabetes mellitus (DM). Methods The study was a multi-centre randomised clinical trial conducted at 34 clinics in China. 502 individuals with both CHD and DM were recruited and randomly assigned to either the text messaging intervention (n=251) or control group (n=251). The control group received 2 thank-you messages per month in addition to usual care. The intervention group received 6 messages per week for 6 months. Messages provided educational and motivational information related to glucose monitoring, BP control, physical activity and lifestyle recommendations. The primary outcome was change in glycemic hemoglobin (HbA1C) from baseline to 6 months. Results Follow-up rate was 99%. At 6 months, HbA1C was significantly lower in intervention group compared to control group (mean HbA1C 6.7% vs. 7.2%, P<0.001), with a mean change of −0.2% and 0.1% from baseline, respectively (mean absolute change −0.3% [95% CI −0.5 to 0.1]; P=0.003). Significantly more participants in intervention group achieved a HbA1c<7% (69.3% vs. 52.6%; P=0.004), and change in FBG was larger in intervention group (−0.5 vs. 0.1 mmol/L; P=0.011). No differences in SBP, LDL-C, BMI and physical activity were observed. Almost all patients reported messages to be easy to understand (97.1%) and useful (94.1%). Table 1. Primary and Secondary Outcomes Analyses at 6 Month Follow-up Parameter Intervention (N=251) Control (N=251) Mean Difference in Change P value for Baseline 6 Months Mean Change Baseline 6 Months Mean Change (95% CI) Difference in Change Primary Outcome HbA1C level, %, mean (SD) 6.9 (1.4) 6.7 (1.3) −0.2 (1.0) 7.1 (1.4) 7.2 (1.5) 0.1 (1.1) −0.3 (−0.5, −0.1) 0.003 Secondary Outcomes HbA1C level<7%, No. (%) 155 (62.0%) 174 (69.3%) – 139 (56.1%) 132 (52.6%) – 1.2 (1.1, 1.3)a 0.004   FBG, mmol/L, mean (SD) 8.1 (2.7) 7.5 (2.7) −0.5 (2.5) 8.5 (3.0) 8.6 (3.3) 0.1 (3.1) −0.6 (−1.1, −0.2) 0.011   SBP, mmHg, mean (SD) 135.9 (18.4) 134.7 (18.7) −1.4 (17.1) 135.9 (18.1) 132.2 (17.7) −3.5 (17.8) 2.4 (−0.8,5.5) 0.144   LDL-C, mmol/L, mean (SD) 2.6 (0.8) 2.5 (0.7) −0.1 (0.7) 2.6 (0.8) 2.5 (0.8) −0.1 (0.7) 0 (−0.1, 0.1) 0.828   BMI, mean (SD) 26.4 (3.2) 26.3 (3.5) −0.1 (2.1) 26.3 (3.2) 26.0 (3.4) −0.4 (2.5) 0.3 (−0.1, 0.7) 0.213   Physical activity (MET min/wk), 1386 1386 177 1386 1386 322 −70.7 0.784     median (IQR) (693–3066) (918–3612) (2840) (693–3066) (693–3002) (2635) (−574.9, 433.5) Conclusion Use of a simple, culturally sensitive mobile text-messaging program could be an effective and scalable way to improve disease self-management among patients with CHD and DM. Acknowledgement/Funding Research Special Fund for Public Welfare Industry of Health (201502009) from the National Health and Family Planning Commission of China

scholarly journals Effect of text messaging on depression in patients with coronary heart disease: a substudy analysis from the TEXT ME randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022637 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Clara K Chow ◽  
Julie Redfern ◽  
Cindy Kok ◽  
Karin Rådholm ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Heart Disease ◽  
Text Messaging ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Support Programme ◽  
History Of ◽  
Randomised Controlled ◽  
History Of Depression

ObjectiveWe aimed to evaluate the effects on depression scores of a lifestyle-focused cardiac support programme delivered via mobile phone text messaging among patients with coronary heart disease (CHD).DesignSubstudy and secondary analysis of a parallel-group, single-blind randomised controlled trial of patients with CHD.SettingA tertiary hospital in Sydney, Australia.InterventionThe Tobacco, Exercise and dieT MEssages programme comprised four text messages per week for 6 months that provided education, motivation and support on diet, physical activity, general cardiac education and smoking, if relevant. The programme did not have any specific mental health component.OutcomesDepression scores at 6 months measured using the Patient Health Questionnaire-9 (PHQ-9). Treatment effect across subgroups was measured using log-binomial regression model for the binary outcome (depressed/not depressed, where depressed is any score of PHQ-9 ≥5) with treatment, subgroup and treatment by subgroup interaction as fixed effects.ResultsDepression scores at 6 months were lower in the intervention group compared with the control group, mean difference 1.9 (95% CI 1.5 to 2.4, p<0.0001). The frequency of mild or greater depressive symptoms (PHQ-9 scores≥5) at 6 months was 21/333 (6.3%) in the intervention group and 86/350 (24.6%) in the control group (relative risk (RR) 0.26, 95% CI 0.16 to 0.40, p<0.001). This proportional reduction in depressive symptoms was similar across groups defined by age, sex, education, body mass index, physical activity, current smoking, current drinking and history of depression, diabetes and hypertension. In particular, the rates of PHQ-9 ≥5 among people with a history of depression were 4/44 (9.1%) vs 29/62 (46.8%) in intervention vs control (RR 0.19, 95% CI 0.07 to 0.51, p<0.001), and were 17/289 (5.9%) vs 57/288 (19.8%) among others (RR 0.30, 95% CI 0.18 to 0.50, p<0.001).ConclusionsAmong people with CHD, a cardiac support programme delivered via mobile phone text messaging was associated with fewer symptoms of mild-to-moderate depression at 6 months in the treatment group compared with controls.Trial registration numberACTRN12611000161921.

scholarly journals Multilevel mobile health approach to improve cardiovascular health in resource-limited communities with Step It Up: a randomised controlled trial protocol targeting physical activity

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040702
Author(s):  
Kosuke Tamura ◽  
Nithya P Vijayakumar ◽  
James F Troendle ◽  
Kaveri Curlin ◽  
Sam J Neally ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mobile Health ◽  
Advisory Board ◽  
Health Concern ◽  
Community Advisory Board ◽  
Washington Dc ◽  
Community Members ◽  
Cvd Risk ◽  
Mhealth Intervention ◽  
Resource Limited

IntroductionAlthough physical activity (PA) reduces cardiovascular disease (CVD) risk, physical inactivity remains a pressing public health concern, especially among African American (AA) women in the USA. PA interventions focused on AA women living in resource-limited communities with scarce PA infrastructure are needed. Mobile health (mHealth) technology can increase access to PA interventions. We describe the development of a clinical protocol for a multilevel, community-based, mHealth PA intervention for AA women.Methods and analysisAn mHealth intervention targeting AA women living in resource-limited Washington, DC communities was developed based on the socioecological framework for PA. Over 6 months, we will use a Sequential Multi-Assignment, Randomized Trial approach to compare the effects on PA of location-based remote messaging (named ‘tailored-to-place’) to standard remote messaging in an mHealth intervention. Participants will be randomised to a remote messaging intervention for 3 months, at which point the intervention strategy will adapt based on individuals’ PA levels. Those who do not meet the PA goal will be rerandomised to more intensive treatment. Participants will be followed for another 3 months to determine the contribution of each mHealth intervention to PA level. This protocol will use novel statistical approaches to account for the adaptive strategy. Finally, effects of PA changes on CVD risk biomarkers will be characterised.Ethics and disseminationThis protocol has been developed in partnership with a Washington, DC-area community advisory board to ensure feasibility and acceptability to community members. The National Institutes of Health Intramural IRB approved this research and the National Heart, Lung, and Blood Institute provided funding. Once published, results of this work will be disseminated to community members through presentations at community advisory board meetings and our quarterly newsletter.Trial registration numberNCT03288207.

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