Development and uptake of the National Heart Foundation of Australia Smart Heart Guideline App (Preprint)

BACKGROUND Implementation of clinical guidelines into routine practice remains highly variable. Strategies to increase guideline uptake include developing digital tools and mobile applications (apps) for real-time use in clinical practice. The National Heart Foundation of Australia publish three key cardiac clinical guidelines in collaboration with the Cardiac Society of Australia and New Zealand including: 1) the Australian clinical guidelines for the prevention and detection of atrial fibrillation; 2) the Australian clinical guidelines for the detection and management of heart failure ; and 3) the Australian clinical guidelines for the management of acute coronary syndromes. To improve access and uptake for healthcare providers we developed the Smart Heart Guideline App OBJECTIVE To understand the need for, develop and evaluate the uptake of an Australian-specific mobile app to improve access and uptake of three national cardiac clinical guidelines. METHODS We used an iterative mixed methods approach, an established method in mobile app development and evaluation. First, we conducted an online survey of end-users in 2017 to determine the need and acceptability of an Australian-specific mobile app to access cardiac clinical guidelines. Second, we engaged a software developer to create the Smart Heart Guidelines App using a process of design, testing and revision, which included user testing. The app was registered with the regulatory body in Australia, the Therapeutic Goods Administration, and made freely available from October 2019 on iOS and Android operating systems and promoted using multiple methods. Third, data from the app stores was analyzed between 1 October 2019 – 1 October 2020 to evaluate the app’s uptake and performance. Fourth, data from two annual national General Practitioner (GP) surveys in 2019 and 2020 were analyzed to assess awareness and use of the clinical guidelines and the app. RESULTS Most health professionals surveyed (89%; n=447/504) reported accessing resources electronically and most (70%) reported they would use an Australian-specific cardiac guidelines app. The app was downloaded 11 313 times (66%; n=7483 from Apple App Store; 34%; n=3,830 from Google Play) during the first 20-month period. Most downloads (84%; n=6300) were a result of searching for the app in the stores. Apple App Store data indicated over 59900 impressions (the number of times the app appeared in a search) and 9000 product page views (number of times a user viewed the apps product page). Monthly downloads rates varied. Many (85%) Android users deleted the app. CONCLUSIONS Health professionals supported the development of the Smart Heart Guidelines App. The number of app store searches and total downloads indicate initial promotion of the app was effective. Further evaluation of users’ experience is needed.

Intravenous diuretic administration in the home environment

Chronic heart failure is a condition associated with ageing, affecting 1–2% of the adult population, raising to 70% of the adult population over 70 years of age. Diuretics are often the first-line treatment for patients with symptomatic heart failure, not just oedema. Traditionally, intravenous (IV) diuretic therapy has been administered only in hospitals. In 2012, the British Heart Foundation ran a pilot study investigating the effectiveness of IV diuretic administration within the home. Since then, there has been an increase in these services. This article examines the advantages and disadvantages of this service, whether community nurses are best placed to deliver this, and what the benefits to the patient might be.

Understanding donor preferences to optimise charity marketing and communications

This case study explores how a leading charity, the British Heart Foundation (BHF), used research to ensure that the focus of its marketing and communications contributed to a story that people found engaging and were compelled to support. Amongst some staff, there was a view that the methodology of some of the BHF’s previous market research was not robust enough and that studies often lacked the quantitative data needed to develop marketing and communication strategies with confidence. Behavioural economics shows that there is usually a disconnect between what people say they will do and what they do in real life, the BHF wanted to develop a methodology that would interrogate this paradox. In doing so, it hoped to identify the areas of its work the public found most engaging and which would encourage people to support them. This insight would then be used to inform their new marketing communications plans. This note explains what the BHF learnt from involving explicit and implicit testing via a mix of qualitative and quantitative techniques.

Metaphor, Religion, and Gender: A Case Study of Metaphor Analysis in Islamic Motivational Speech Corpus

Metaphor plays a vital role in human communication and its presence is evident in various discourses across genres. Nevertheless, there is a scarcity in the study of metaphors used among different genders especially in religious discourse. Thus, the current study aims to examine metaphor use in religious motivational speeches between two (male and female) speakers. A corpus-based approach, that involved analysis of keywords, collocation, and concordance, was selected in identifying linguistic metaphors while conceptual mapping (Lakoff & Johnson, 1980) was chosen to identify conceptual metaphors in both corpora. The main data consist of four speeches of Yasmin Mogahed (YM Corpus) and four speeches of Nouman Ali Khan’s speeches (NAK Corpus) retrieved from their YouTube Channels. #LancsBox 5.0 was chosen as the tool in analysing the language patterns. From the findings, it can be concluded Yasmin used a higher frequency of metaphors compared to Nouman. This is evident from the results in the collocation analysis in YM corpus that showed seven collocates (‘SWT’, ‘heart’, ‘foundation’, ‘healthy’, ‘fear’, ‘solid’, and ‘fill’) were predetermined to have signals of metaphorical expressions as compared to NAK corpus that only has four collocates (‘evil’, ‘syirik’, ‘religion’, and ‘faith’) with signals of metaphorical expressions. It is also apparent that the variety of metaphors used by Yasmin is more diverse (BUILDING, HUMAN/LIVING ORGANISM, TREE, and CONTAINER metaphors) as compared to Nouman that only uses COMPUTER FILE and CONTAINER metaphors. Yasmin’s choice of metaphors seems to be heavily influenced with the common metaphors used in the Qur’an, while Nouman’s lack choice of metaphors indicate his preference in explaining religious concepts through literal explanation instead of metaphorical one. Future studies are recommended to have a bigger sample to better differentiate the metaphor usage between genders. It is also imperative for future research to further examine the implications of different choice of metaphors on the construction of meaning in the Islamic motivational religious corpus between different genders.