scholarly journals Feasibility of a Digital Health Intervention to Improve Diet Quality Among Women With High Blood Pressure: Randomized Controlled Feasibility Trial (Preprint)

2019 ◽  
Author(s):  
Dori M Steinberg ◽  
Melissa C Kay ◽  
Laura P Svetkey ◽  
Sandy Askew ◽  
Jacob Christy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Digital Health ◽  
Population Level ◽  
Health Intervention ◽  
Text Messages ◽  
Feasibility Trial ◽  
Dash Score ◽  
Active Comparator ◽  
Randomized Controlled

BACKGROUND Over 100 million individuals have high blood pressure, and more than half of them are women. The Dietary Approaches to Stop Hypertension (DASH) dietary pattern is a proven lifestyle approach to lower blood pressure, yet population-level adherence is poor. Innovative strategies that promote DASH are needed. OBJECTIVE This paper aims to improve adherence to the DASH diet among women with hypertension or prehypertension. METHODS We conducted a 3-month randomized controlled feasibility trial comparing app-based diet tracking (active comparator) to app-based diet tracking plus feedback on DASH adherence via text message (intervention). The intervention platform extracted nutrient data from the app, compared it to DASH recommendations, and sent tailored feedback text messages. Outcomes included the number of days participants tracked their diet, changes in their DASH adherence score, and blood pressure. RESULTS The women (N=59) had a mean age of 49.9 (SD 11.9) years and were primarily non-Hispanic White (41/59, 69%) and college educated (49/59, 83%). The mean baseline DASH score was 2.3 (SD 1.3). At 3 months, the intervention and active comparator participants had similar mean days tracked per week (4.2, SD 2.1 days vs 4.6, SD 2.7 days; <i>P</i>=.54) and mean changes in their DASH score (0.8, 95% CI 0.2-1.5 vs 0.8, 95% CI 0.4-1.2; <i>P</i>=.75). Intervention participants had lower systolic (mean difference: –2.8 mmHg, 95% CI –1.8 to 7.4; <i>P</i>=.23) and diastolic (mean difference: –3.6 mmHg, 95% CI –0.2 to 7.3; <i>P</i>=.07) blood pressure compared with active comparator participants. Most intervention participants (23/29, 79%) said they would recommend the DASH Cloud intervention to a friend or family member. However, only 34% (10/59) indicated that the feedback text messages helped them reach their diet goals. CONCLUSIONS A digital health intervention to improve DASH adherence is feasible and produces moderately high engagement among women with elevated blood pressure. The intervention did not enhance DASH adherence over diet tracking alone but resulted in greater reductions in blood pressure. Larger studies are needed to determine how digital health interventions can improve population-level adherence to DASH. CLINICALTRIAL ClinicalTrials.gov NCT03215472; https://clinicaltrials.gov/ct2/show/study/NCT03215472

scholarly journals Feasibility of a Digital Health Intervention to Improve Diet Quality Among Women With High Blood Pressure: Randomized Controlled Feasibility Trial

10.2196/17536 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e17536
Author(s):  
Dori M Steinberg ◽  
Melissa C Kay ◽  
Laura P Svetkey ◽  
Sandy Askew ◽  
Jacob Christy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Digital Health ◽  
Population Level ◽  
Health Intervention ◽  
Text Messages ◽  
Feasibility Trial ◽  
Dash Score ◽  
Active Comparator ◽  
Randomized Controlled

Background Over 100 million individuals have high blood pressure, and more than half of them are women. The Dietary Approaches to Stop Hypertension (DASH) dietary pattern is a proven lifestyle approach to lower blood pressure, yet population-level adherence is poor. Innovative strategies that promote DASH are needed. Objective This paper aims to improve adherence to the DASH diet among women with hypertension or prehypertension. Methods We conducted a 3-month randomized controlled feasibility trial comparing app-based diet tracking (active comparator) to app-based diet tracking plus feedback on DASH adherence via text message (intervention). The intervention platform extracted nutrient data from the app, compared it to DASH recommendations, and sent tailored feedback text messages. Outcomes included the number of days participants tracked their diet, changes in their DASH adherence score, and blood pressure. Results The women (N=59) had a mean age of 49.9 (SD 11.9) years and were primarily non-Hispanic White (41/59, 69%) and college educated (49/59, 83%). The mean baseline DASH score was 2.3 (SD 1.3). At 3 months, the intervention and active comparator participants had similar mean days tracked per week (4.2, SD 2.1 days vs 4.6, SD 2.7 days; P=.54) and mean changes in their DASH score (0.8, 95% CI 0.2-1.5 vs 0.8, 95% CI 0.4-1.2; P=.75). Intervention participants had lower systolic (mean difference: –2.8 mmHg, 95% CI –1.8 to 7.4; P=.23) and diastolic (mean difference: –3.6 mmHg, 95% CI –0.2 to 7.3; P=.07) blood pressure compared with active comparator participants. Most intervention participants (23/29, 79%) said they would recommend the DASH Cloud intervention to a friend or family member. However, only 34% (10/59) indicated that the feedback text messages helped them reach their diet goals. Conclusions A digital health intervention to improve DASH adherence is feasible and produces moderately high engagement among women with elevated blood pressure. The intervention did not enhance DASH adherence over diet tracking alone but resulted in greater reductions in blood pressure. Larger studies are needed to determine how digital health interventions can improve population-level adherence to DASH. Trial Registration ClinicalTrials.gov NCT03215472; https://clinicaltrials.gov/ct2/show/study/NCT03215472

scholarly journals mCARE, a digital health intervention package on pregnancy surveillance and care-seeking reminders from 2018 to 2027 in Bangladesh: a model-based cost-effectiveness analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042553
Author(s):  
Youngji Jo ◽  
Amnesty Elizabeth LeFevre ◽  
Hasmot Ali ◽  
Sucheta Mehra ◽  
Kelsey Alland ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Home Visit ◽  
Digital Health ◽  
Status Quo ◽  
Health Intervention ◽  
Text Messages ◽  
Care Seeking ◽  
Intervention Package ◽  
The Status ◽  
The Cost

ObjectiveWe estimated the cost-effectiveness of a digital health intervention package (mCARE) for community health workers, on pregnancy surveillance and care-seeking reminders compared with the existing paper-based status quo, from 2018 to 2027, in Bangladesh.InterventionsThe mCARE programme involved digitally enhanced pregnancy surveillance, individually targeted text messages and in-person home-visit to pregnant women for care-seeking reminders for antenatal care, child delivery and postnatal care.Study designWe developed a model to project population and service coverage increases with annual geographical expansion (from 1 million to 10 million population over 10 years) of the mCARE programme and the status quo.Major outcomesFor this modelling study, we used Lives Saved Tool to estimate the number of deaths and disability-adjusted life years (DALYs) that would be averted by 2027, if the coverage of health interventions was increased in mCARE programme and the status quo, respectively. Economic costs were captured from a societal perspective using an ingredients approach and expressed in 2018 US dollars. Probabilistic sensitivity analysis was undertaken to account for parameter uncertainties.ResultsWe estimated the mCARE programme to avert 3076 deaths by 2027 at an incremental cost of $43 million relative to the status quo, which is translated to $462 per DALY averted. The societal costs were estimated to be $115 million for mCARE programme (48% of which are programme costs, 35% user costs and 17% provider costs). With the continued implementation and geographical scaling-up, the mCARE programme improved its cost-effectiveness from $1152 to $462 per DALY averted from 5 to 10 years.ConclusionMobile phone-based pregnancy surveillance systems with individually scheduled text messages and home-visit reminder strategies can be highly cost-effective in Bangladesh. The cost-effectiveness may improve as it promotes facility-based child delivery and achieves greater programme cost efficiency with programme scale and sustainability.

Comparison of alprazolam versus captopril in high blood pressure: A randomized controlled trial

2011 ◽  
Vol 20 (4) ◽  
pp. 239-243 ◽  
Author(s):  
Serkan Yilmaz ◽  
Murat Pekdemir ◽  
Ümit Tural ◽  
Mecit Uygun
Keyword(s):  
Blood Pressure ◽  
Randomized Controlled Trial ◽  
High Blood Pressure ◽  
Controlled Trial ◽  
Randomized Controlled

scholarly journals Development and Evaluation of a Digital Health Intervention for Substance Use Reduction in Young Refugees With Problematic Use of Alcohol and/or Cannabis—Study Protocol for a Single-Armed Feasibility Trial

2021 ◽  
Vol 9 ◽  
Author(s):  
Laura Charlotte Fischer ◽  
Vera Kölligan ◽  
Nuri Wieland ◽  
Michael Klein
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Digital Health ◽  
Health Intervention ◽  
Target Group ◽  
Feasibility Trial ◽  
Secondary Outcome ◽  
Post Intervention ◽  
Problematic Use ◽  
Digital Interventions

Background: Refugee populations are at substantial risk of developing substance use disorder (SUD) and other mental health disorders. At the same time, refugee populations face numerous barriers to accessing mental health services. Digital interventions can address some of these issues, as emerging evidence indicates that digital interventions offer an effective, low-cost alternative with high accessibility and similar efficacy as standard SUD prevention programs. As an add-on to traditional services, they further present a viable approach to the lack of personnel available for foreign language communication in preventive and therapeutic settings. In the present study, we thus aim to develop and evaluate a digital health intervention (DHI) for the reduction of substance use for young refugees with problematic use of alcohol and/or cannabis. The intervention will be implemented in a smartphone app, translated into Arabic, English, Farsi, German, and Pashto, and is to be used stand-alone. It is based on methods from cognitive behavioral therapy, contains culturally adapted elements, provides practical information on how to deal safely with alcohol and cannabis, and motivates behavior change through increased self-reflection and behavioral, cognitive, and emotional skills-training in interactive exercises.Methods: We conduct a single-armed feasibility trial among 150 young refugees with problematic use of alcohol and/or cannabis. Participants will receive a digital screening and digital health intervention (DHI) for the reduction of problematic substance use, carried out over a 4-week time frame. The primary outcomes are the intervention's feasibility and the target population's acceptance of the intervention. The secondary outcome is a change in substance use post-intervention from baseline. Measurements are taken pre-intervention (baseline), post-intervention (after 4 weeks), and at 3- and 6-month follow-ups. We expect the intervention to be feasible and accepted by the target group.Discussion: The present study will establish to what degree the digital intervention (the “BePrepared App”) is feasible and accepted by the target group. The evaluation of an easily accessible, feasible, and accepted intervention may impact refugees' mental health and health-related consequences. It aims at overcoming barriers to preventive health care in the substance use field for underserved refugee populations as a tool within a larger set of urgently needed interventions.Trial Registration: DRKS00021095 at the “German Clinical Trials Register” (30.03.2020).

scholarly journals An Interactive Parent-Targeted Text Messaging Intervention to Improve Oral Health in Children Attending Urban Pediatric Clinics: Feasibility Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Belinda Borrelli ◽  
Michelle Henshaw ◽  
Romano Endrighi ◽  
William G Adams ◽  
Timothy Heeren ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Behaviors ◽  
Self Efficacy ◽  
Text Messaging ◽  
Text Messages ◽  
Feasibility Trial ◽  
Randomized Controlled ◽  
Oral Health Behaviors ◽  
Scale Range

BACKGROUND Effective preventive treatments for dental decay exist, but caries experience among preschoolers has not changed, with marked disparities in untreated decay. Despite near-universal use of SMS text messaging, there are no studies using text messages to improve the oral health of vulnerable children. OBJECTIVE This randomized controlled feasibility trial aimed to test the effects of oral health text messages (OHT) versus a control (child wellness text messages or CWT). OHT was hypothesized to outperform CWT on improving pediatric oral health behaviors and parent attitudes. METHODS Parents with a child aged &lt;7 years were recruited at urban clinics during pediatric appointments (79% [41/52] below poverty line; 66% [36/55] black) and randomized to OHT (text messages on brushing, dental visits, bottle and sippy cups, healthy eating and sugary beverages, and fluoride) or CWT (text messages on reading, safety, physical activity and development, secondhand smoke, and stress) groups. Automated text messages based on Social Cognitive Theory were sent twice each day for 8-weeks. Groups were equivalent on the basis of the number of text messages sent, personalization, interactivity, and opportunity to earn electronic badges and unlock animated characters. Assessments were conducted at baseline and 8 weeks later. Data were analyzed with linear mixed–effects models. RESULTS A total of 55 participants were randomized (28 OHT and 27 CWT). Only one participant dropped out during the text message program and 47 (24 OHT and 23 CWT) completed follow up surveys. Response rates exceeded 68.78% (1040/1512) and overall program satisfaction was high (OHT mean 6.3; CWT mean 6.2; 1-7 scale range). Of the OHT group participants, 84% (21/25) would recommend the program to others. Overall program likeability scores were high (OHT mean 5.90; CWT mean 6.0; 1-7 scale range). Participants reported high perceived impact of the OHT program on brushing their child’s teeth, motivation to address their child's oral health, and knowledge of their child's oral health needs (mean 4.7, 4.6, and 4.6, respectively; 1-5 scale range). At follow up, compared with CWT, OHT group participants were more likely to brush their children’s teeth twice per day (odds ratio [OR] 1.37, 95% CI 0.28-6.50) and demonstrated improved attitudes regarding the use of fluoride (OR 3.82, 95% CI 0.9-16.8) and toward getting regular dental checkups for their child (OR 4.68, 95% CI 0.24-91.4). There were modest, but not significant, changes in motivation (F1,53=0.60; <italic>P</italic>=.45) and self–efficacy (F1,53=0.24; <italic>P</italic>=.63) to engage in oral health behaviors, favoring OHT (<italic>d</italic>=0.28 and <italic>d</italic>=0.16 for motivation and self–efficacy, respectively). CONCLUSIONS The OHT program demonstrated feasibility was well utilized and appealing to the target population and showed promise for efficacy.

scholarly journals TO EVALUATE THE EFFICACY OF GUDUCHYADI YOGA IN THE MANAGEMENT OF RAKTACHAPADHIKYATA OR ESSENTIAL HYPERTENSION-A RANDOMIZED CONTROLLED CLINICAL TRIAL

2020 ◽  
pp. 13-20
Author(s):  
Nitish Pathania ◽  
Umesh C C ◽  
Gopala Krishna G ◽  
Monika Pathania
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
High Blood Pressure ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Standard Drug ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Group B ◽  
Trial Drug

Hypertension is the most pressing public health challenges. It is estimated that approximately 1 billion people are suffering from high blood pressure and the numbers are to increase to 2.5 billion by 2025. Raktachaapadhikya is the coined term for increased blood pressure given by recent authors where it can be understood as the pathology of Vyanvayu. The usage of Guduchyadi Yoga has been highlighted in the classics of Ayurveda for targeting the Hridaya sthitha vayu, which has not been evaluated yet. Aim: To evaluate and compare the efficacy of Navahridaya Kalpa (standard drug) and Guduchyadi Yoga (trial drug) for management of essential hypertension. Materials and Methods: A simple randomized controlled clinical study where 40 patients were equally divided as group A: Navahridaya kalpa (standard drug) and Group B: Guduchyadi yoga (trial drug) for a period of one month. Observations and results: The study result revealed that both the groups were beneficial in reducing high blood pressure however with no statistically significant difference found between the groups with p value being 0.339 for standard drug and 0.363 for trial drug. The group B was also found to be effective in reducing systolic blood pressure of stage I hypertension with p value .044 on comparing between the groups. Conclusion: The Guduchyadi yoga acts as Rasayana with the property of rejuvenation and antihypertensive which will check the high blood pressure at a very minimum cost without having any major adverse effects in the patients and hence can be advocated for use on a daily a basis.

scholarly journals Feasibility and Acceptability of a Physical Activity Tracker and Text Messages to Promote Physical Activity During Chemotherapy for Colorectal Cancer: Pilot Randomized Controlled Trial (Smart Pace II)

JMIR Cancer ◽  
10.2196/31576 ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. e31576
Author(s):  
Erin L Van Blarigan ◽  
Anand Dhruva ◽  
Chloe E Atreya ◽  
Stacey A Kenfield ◽  
June M Chan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Digital Health ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Walk Test ◽  
Randomized Controlled ◽  
6 Minute Walk Test ◽  
Minute Walk

Background We conducted a pilot 2-arm randomized controlled trial to assess the feasibility of a digital health intervention to increase moderate-to-vigorous physical activity in patients with colorectal cancer (CRC) during chemotherapy. Objective This study aimed to determine whether a digital health physical activity intervention is feasible and acceptable during chemotherapy for CRC. Methods Potentially eligible patients with CRC expected to receive at least 12 weeks of chemotherapy were identified in person at the University of California, San Francisco, and on the web through advertising. Eligible patients were randomized 1:1 to a 12-week intervention (Fitbit Flex, automated SMS text messages) versus usual care. At 0 and 12 weeks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size measurements, and an optional 6-minute walk test. Participants could not be masked to their intervention arm, but people assessing the body size and 6-minute walk test outcomes were masked. The primary outcomes were adherence (eg, Fitbit wear and text response rate) and self-assessed acceptability of the intervention. The intervention would be considered feasible if we observed at least 80% complete follow-up and 70% adherence and satisfaction, a priori. Results From 2018 to 2020, we screened 240 patients; 53.3% (128/240) of patients were ineligible and 26.7% (64/240) declined to participate. A total of 44 patients (44/240, 18%) were randomized to the intervention (n=22) or control (n=22) groups. Of these, 57% (25/44) were women; 68% (30/44) identified as White and 25% (11/44) identified as Asian American or Pacific Islander; and 77% (34/44) had a 4-year college degree. The median age at enrollment was 54 years (IQR 45-62 years). Follow-up at 12 weeks was 91% (40/44) complete. In the intervention arm, patients wore Fitbit devices on a median of 67 out of 84 (80%) study days and responded to a median of 17 out of 27 (63%) questions sent via SMS text message. Among 19 out of 22 (86%) intervention patients who completed the feedback survey, 89% (17/19) were satisfied with the Fitbit device; 63% (12/19) were satisfied with the SMS text messages; 68% (13/19) said the SMS text messages motivated them to exercise; 74% (14/19) said the frequency of SMS text messages (1-3 days) was ideal; and 79% (15/19) said that receiving SMS text messages in the morning and evening was ideal. Conclusions This pilot study demonstrated that many people receiving chemotherapy for CRC are interested in participating in digital health physical activity interventions. Fitbit adherence was high; however, participants indicated a desire for more tailored SMS text message content. Studies with more socioeconomically diverse patients with CRC are required. Trial Registration ClinicalTrials.gov NCT03524716; https://clinicaltrials.gov/ct2/show/NCT03524716

scholarly journals Adherence to the DASH-style Diet and the Presence of Cardiovascular Risk Factors in Adults from Tîrgu Mureș

2018 ◽  
Vol 3 (3) ◽  
pp. 134-140
Author(s):  
Victoria Ancuța Rus ◽  
Florina Ruța ◽  
Maria Sălcudean ◽  
Monica Tarcea ◽  
Costela Șerban ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
High Blood Pressure ◽  
Disease Risk ◽  
Healthy Diet ◽  
Abdominal Circumference ◽  
Dash Score ◽  
Dash Diet

Abstract Background: Adopting a healthy lifestyle, including a healthy diet, weight control, regular exercise, smoking cessation, and alcohol limitation, plays an important role in treating high blood pressure and cardiovascular and chronic diseases. Aim: This study aimed to investigate adherence to the DASH diet in relation to the occurrence of high blood pressure and chronic disease risk factors, in a group of people from Tîrgu Mureș. Material and methods: This was a cross-sectional study based on a food frequency and lifestyle questionnaire applied to a group of 2,010 people aged 15–92 years from Tîrgu Mureș. Results: Individuals over the age of 45 had higher DASH scores (Q4, Q5) compared to subjects younger than 40 years (Q1 and Q2, p <0.001). An important percentage (19.3%) of subjects who preferred a meat-based diet (Q3) had significantly larger abdominal circumference (mean 92.2 ± 0.91 cm, p <0.001). An association between pure alcohol intake (mean 5.6 ± 0.43 g) and an unhealthy diet (Q1) was observed, compared to the average 1.7 ± 19 g of alcohol consumed by subjects with a healthy diet (Q5), alcohol consumption decreasing with an increasing DASH score (p <0.001). Conclusion: This study shows that individuals diagnosed with at least one cardiovascular risk factor had a higher adherence to the DASH diet than individuals with no cardiovascular risk factors, most likely due to the fact that diagnosed individuals had changed their eating behavior and lifestyle from the time of diagnosis, with a positive impact on treatment outcomes and quality of life.

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