scholarly journals Comparison of On-Site Versus Remote Mobile Device Support in the Framingham Heart Study Using the Health eHeart Study for Digital Follow-up: Randomized Pilot Study Set Within an Observational Study Design (Preprint)

2019 ◽  
Author(s):  
Nicole L Spartano ◽  
Honghuang Lin ◽  
Fangui Sun ◽  
Kathryn L Lunetta ◽  
Ludovic Trinquart ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Pilot Study ◽  
Framingham Heart Study ◽  
Clinic Visit ◽  
Highly Educated ◽  
Heart Study ◽  
Observational Study Design ◽  
N 93 ◽  
Device Use

BACKGROUND New electronic cohort (e-Cohort) study designs provide resource-effective methods for collecting participant data. It is unclear if implementing an e-Cohort study without direct, in-person participant contact can achieve successful participation rates. OBJECTIVE The objective of this study was to compare 2 distinct enrollment methods for setting up mobile health (mHealth) devices and to assess the ongoing adherence to device use in an e-Cohort pilot study. METHODS We coenrolled participants from the Framingham Heart Study (FHS) into the FHS–Health eHeart (HeH) pilot study, a digital cohort with infrastructure for collecting mHealth data. FHS participants who had an email address and smartphone were randomized to our FHS-HeH pilot study into 1 of 2 study arms: remote versus on-site support. We oversampled older adults (age ≥65 years), with a target of enrolling 20% of our sample as older adults. In the remote arm, participants received an email containing a link to enrollment website and, upon enrollment, were sent 4 smartphone-connectable sensor devices. Participants in the on-site arm were invited to visit an in-person FHS facility and were provided in-person support for enrollment and connecting the devices. Device data were tracked for at least 5 months. RESULTS Compared with the individuals who declined, individuals who consented to our pilot study (on-site, n=101; remote, n=93) were more likely to be women, highly educated, and younger. In the on-site arm, the connection and initial use of devices was ≥20% higher than the remote arm (mean percent difference was 25% [95% CI 17-35] for activity monitor, 22% [95% CI 12-32] for blood pressure cuff, 20% [95% CI 10-30] for scale, and 43% [95% CI 30-55] for electrocardiogram), with device connection rates in the on-site arm of 99%, 95%, 95%, and 84%. Once connected, continued device use over the 5-month study period was similar between the study arms. CONCLUSIONS Our pilot study demonstrated that the deployment of mobile devices among middle-aged and older adults in the context of an on-site clinic visit was associated with higher initial rates of device use as compared with offering only remote support. Once connected, the device use was similar in both groups.

scholarly journals Comparison of On-Site Versus Remote Mobile Device Support in the Framingham Heart Study Using the Health eHeart Study for Digital Follow-up: Randomized Pilot Study Set Within an Observational Study Design

10.2196/13238 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e13238
Author(s):  
Nicole L Spartano ◽  
Honghuang Lin ◽  
Fangui Sun ◽  
Kathryn L Lunetta ◽  
Ludovic Trinquart ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Pilot Study ◽  
Framingham Heart Study ◽  
Clinic Visit ◽  
Highly Educated ◽  
Heart Study ◽  
Observational Study Design ◽  
N 93 ◽  
Device Use

Background New electronic cohort (e-Cohort) study designs provide resource-effective methods for collecting participant data. It is unclear if implementing an e-Cohort study without direct, in-person participant contact can achieve successful participation rates. Objective The objective of this study was to compare 2 distinct enrollment methods for setting up mobile health (mHealth) devices and to assess the ongoing adherence to device use in an e-Cohort pilot study. Methods We coenrolled participants from the Framingham Heart Study (FHS) into the FHS–Health eHeart (HeH) pilot study, a digital cohort with infrastructure for collecting mHealth data. FHS participants who had an email address and smartphone were randomized to our FHS-HeH pilot study into 1 of 2 study arms: remote versus on-site support. We oversampled older adults (age ≥65 years), with a target of enrolling 20% of our sample as older adults. In the remote arm, participants received an email containing a link to enrollment website and, upon enrollment, were sent 4 smartphone-connectable sensor devices. Participants in the on-site arm were invited to visit an in-person FHS facility and were provided in-person support for enrollment and connecting the devices. Device data were tracked for at least 5 months. Results Compared with the individuals who declined, individuals who consented to our pilot study (on-site, n=101; remote, n=93) were more likely to be women, highly educated, and younger. In the on-site arm, the connection and initial use of devices was ≥20% higher than the remote arm (mean percent difference was 25% [95% CI 17-35] for activity monitor, 22% [95% CI 12-32] for blood pressure cuff, 20% [95% CI 10-30] for scale, and 43% [95% CI 30-55] for electrocardiogram), with device connection rates in the on-site arm of 99%, 95%, 95%, and 84%. Once connected, continued device use over the 5-month study period was similar between the study arms. Conclusions Our pilot study demonstrated that the deployment of mobile devices among middle-aged and older adults in the context of an on-site clinic visit was associated with higher initial rates of device use as compared with offering only remote support. Once connected, the device use was similar in both groups.

Abstract MP24: Comparison of on-site versus Remote Support for a Mobile-Device Pilot Study: A Collaboration Between the Framingham Heart Study and Health eHeart Study (FHS-HeH)

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Nicole L Spartano ◽  
Fangui Sun ◽  
Kathryn L Lunetta ◽  
Ludovic Trinquart ◽  
Maureen Valentino ◽  
...  
Keyword(s):  
Pilot Study ◽  
Framingham Heart Study ◽  
Implementation Strategies ◽  
Clinic Visit ◽  
Highly Educated ◽  
Email Address ◽  
Heart Study ◽  
Pressure Cuff ◽  
Device Use ◽  
Study Designs

Background: New “e-Cohort” study designs provide resource-effective methods for collecting participant data. It is unclear if implementing an e-cohort without direct, in-person participant contact can achieve successful participation rates. The FHS-HeH randomized pilot study compared two distinct implementation strategies for co-enrolling participants from the Framingham Heart Study (FHS) into the Health eHeart Study, a digital cohort with infrastructure for collecting mHealth data. Methods: FHS participants who had an email address and smartphone were randomized to one of two approaches: remote vs. on-site support. In the remote arm, participants received an email containing an enrollment URL, and, upon enrollment, were sent four Bluetooth sensor devices. Participants in the on-site arm were invited to visit FHS and were provided in-person support for enrollment and connecting the devices. Results: Compared to participants that declined, individuals that accepted an invitation to participate in our pilot study (n=101 remote , n=101 on-site ) were more often women, highly educated, and younger (Figure 1). All on-site participants completed the consent, compared to 93% of the remote arm. Of participants who consented to participate, connection and initial use of devices was also higher in the on-site arm (100% connected the activity monitor, 94% the blood pressure cuff and scale, and 84% the electrocardiogram) compared to the remote arm (74%, 75%, 80%, and 42%). Roughly 75-78% of those that initially connected in both arms were still using the devices by the 3 rd month and 58-60% were still participating by the 6 th month. Conclusions: Our pilot study demonstrated that deployment of mobile devices among middle-aged and older adults in the context of an on-site clinic visit was associated with higher initial rates of device use as compared to offering only remote support. Once connected, drop-off rates were similar in both groups.

scholarly journals 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study

The Lancet ◽  
2015 ◽  
Vol 386 (9989) ◽  
pp. 154-162 ◽  
Author(s):  
Renate B Schnabel ◽  
Xiaoyan Yin ◽  
Philimon Gona ◽  
Martin G Larson ◽  
Alexa S Beiser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Framingham Heart Study ◽  
Heart Study ◽  
Incidence Risk

scholarly journals Residential proximity to major roads, exposure to fine particulate matter and aortic calcium: the Framingham Heart Study, a cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (3) ◽  
pp. e013455 ◽  
Author(s):  
Kirsten S Dorans ◽  
Elissa H Wilker ◽  
Wenyuan Li ◽  
Mary B Rice ◽  
Petter L Ljungman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Particulate Matter ◽  
Framingham Heart Study ◽  
Fine Particulate Matter ◽  
Residential Proximity ◽  
Fine Particulate ◽  
Heart Study

scholarly journals Increasing mixed-berry flavonoid intake may reduce depressive symptoms in older adults: Framingham Heart Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 864-864
Author(s):  
Courtney Millar ◽  
Alyssa Dufour ◽  
Marian Hannan ◽  
Shivani Sahni
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Framingham Heart Study ◽  
Randomized Clinical Trials ◽  
Epidemiological Studies ◽  
Prospective Longitudinal Study ◽  
Heart Study ◽  
Flavonoid Intake ◽  
Prospective Longitudinal ◽  
Dietary Flavonoids

Abstract Depression affects more than 250 million people worldwide. Although epidemiological studies have linked higher dietary flavonoids with depression prevention in older women, it is unknown if increasing dietary flavonoids could effectively reduce depression. Mixed berries (blueberry, blackberry, and raspberry) are a rich source of flavonoids, particularly anthocyanin, flavanol, and flavan-3-ol subclasses. Our aim was to determine the association of mixed-berry flavonoid intake with change in depressive symptoms over ~8 years in older adults from the Framingham Heart Study. This community-based prospective longitudinal study included 1,278 adults with assessments on diet (food frequency questionnaire) and depressive symptoms (Center for Epidemiologic Studies Depression, CES-D) at baseline (1998-2001) and follow-up (2005-2008). Absolute change in mixed-berry flavonoid intake (defined as sum of anthocyanin, flavanol, and flavon-3-ols, mg/day) and change in CES-D scores were calculated. Linear regression estimated beta and standard error (SE) for change in CES-D scores per 250 mg/day increase in mixed-berry flavonoids (obtained from ~3/4 cup of mixed berries), adjusting for baseline age, sex, energy-intake, current smoking, body mass index, physical activity, cardiovascular disease, and non-melanoma cancer. Mean age was 59±9 years (range: 33-81), 57% female and mean change in mixed-berry flavonoid intake was 15.0±72.8 mg/day over ~8 years. In adjusted models, each 250 mg/day increase in mixed-berry flavonoid intake was associated with a 1-point reduction in depressive symptoms (beta: -1.06, SE: 0.61, p=0.08) over ~8 years, although this was not statistically significant. These data highlight the need for randomized clinical trials of flavonoid-rich berries to target depressive symptoms in older adults.

scholarly journals General practice attendances among patients attending a post-COVID-19 clinic: A pilot study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0016
Author(s):  
John Michael Broughan ◽  
Geoff McCombe ◽  
Gordana Avramovic ◽  
Des Crowley ◽  
Cheyenne Downey ◽  
...  
Keyword(s):  
Older Adults ◽  
General Practice ◽  
Pilot Study ◽  
Hospital Discharge ◽  
Hospital Admissions ◽  
Clinic Visit ◽  
University Hospital ◽  
Care Needs ◽  
Medical Histories

BackgroundAbout 10-35% of people with COVID-19 merit medical care within three weeks of infection. However, the prevalence of ongoing care needs among those experiencing severe COVID-19 illness is unclear.AimThis pilot study aimed to address this knowledge gap by examining GP attendance trends among patients attending a post-COVID-19 hospital follow-up clinic, 3-6 months after an initial clinic visit.Design, and SettingData was collected from adult patients attending a post-COVID-19 follow-up clinic at the Mater Misericordiae University Hospital, Dublin, Ireland.MethodParticipants completed questionnaires outlining their demographics, medical histories, emergency hospital admissions/re-admissions where applicable, and where relevant, GP attendances following hospital discharge. Analyses were conducted using descriptive/inferential statistics.ResultsParticipants’ (n=153) median age =43.5 (IQR =30.9–52.1 years). There were 105 females (68.6%, 95% CI=61.3%–75.9%). Various medical histories were reported among participants. 67 (43.2%, 95% CI=35.9%–51.6%) received emergency COVID-19 hospital care. Older adults, males, ICU admissions, and re-admissions were common among hospital attendees. Of the hospital attendees, 16 (24%, 95% CI=13.7%–34.2%) and 26 (39%, 95% CI=27.3%–50.7%) attended GPs within seven and 30 days of hospital discharge. Older adults, people with pre-existing medical conditions, and individuals admitted to ICU/readmitted to hospital were common among general practice attendees.ConclusionPersistent health issues appear to be common among severe COVID-19 patients, particularly those who are older adults, have pre-existing health problems, and had been in ICU and/or re-admission care. Larger scale studies of ongoing COVID-19 care needs in general practice/primary care are required.

scholarly journals Cross-Sectional Association of Frailty and Arterial Stiffness in Community-Dwelling Older Adults: The Framingham Heart Study

2018 ◽  
Vol 74 (3) ◽  
pp. 373-379 ◽  
Author(s):  
Ariela R Orkaby ◽  
Kathryn L Lunetta ◽  
Fangui J Sun ◽  
Jane A Driver ◽  
Emelia J Benjamin ◽  
...  
Keyword(s):  
Older Adults ◽  
Arterial Stiffness ◽  
Framingham Heart Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Deficit Model ◽  
Phenotype Definition ◽  
Heart Study ◽  
Underlying Mechanisms ◽  
Community Dwelling Older Adults

Abstract Background Frailty is a risk factor for cardiovascular disease (CVD). Underlying mechanisms to explain the connection between frailty and CVD are unclear. We sought to examine the association between frailty and arterial stiffness, a precursor of hypertension and CVD. Methods We conducted a cross-sectional analysis of community-dwelling Framingham Heart Study Offspring and Omni participants ≥60 years of age examined in 2005–2008. Frailty was defined primarily according to the Fried physical phenotype definition, which identifies nonfrail, prefrail, and frail individuals. Arterial stiffness was assessed using carotid–femoral pulse wave velocity (CFPWV). Generalized linear regression was used to examine the association between frailty level and CFPWV (modeled as −1000/CFPWV in msec/m, then transformed back to the original scale, m/s), adjusted for age, sex, cohort, mean arterial pressure, heart rate, height, and smoking. Results Of 2,171 participants (55% women, 91% white), 45% were prefrail and 7% were frail. Mean ages were 67, 70, and 73 years, and adjusted CFPWV least squares means were 10.0 (95% CI, 9.9–10.1), 10.3 (10.2–10.5), and 10.5 m/s (10.1–11.0); p = .0002 for nonfrail, prefrail, and frail groups, respectively. Results were similar using the Rockwood cumulative deficit model of frailty, and in a sensitivity analysis adjusting for prevalent coronary heart disease and diabetes. Conclusions Prefrailty and frailty were associated with higher arterial stiffness in a cohort of community-dwelling older adults. Arterial stiffness may help explain the relationship between frailty and CVD.

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