JMIR Publications

ABSTRACT

Background:

Cardiovascular disease, including atherosclerotic cardiovascular disease (ASCVD), is a growing public health threat globally and many individuals remain undiagnosed, untreated and uncontrolled. Simultaneously, mobile health (mHealth) interventions using short messaging service (SMS) have gained popularity globally. There is an opportunity for innovative approaches such as mHealth to encourage and enable adherence to medications for ASCVD and its risk factors.

Objective:

This study seeks to understand mobile technology acceptance, use and facilitating conditions amongst the study population ahead of the design of an mHealth intervention.

Methods:

Using data from a mixed methods study conducted in Singapore we conducted a cross-sectional survey with 100 participants and in-depth semi-structured interviews with 20 patients. All participants were over the age of 40 with ASCVD and/or its risk factors. Interviews were conducted in English and Mandarin and if needed translated to English. QSR Nvivo 11 was used for analyses.

Results:

Participants reported their perspectives on technology use and preferences, including low or sporadic mobile phone use and usability concerns including small screen and text size, amongst others; the benefit of previous mHealth use in creating a favourable opinion of SMS for health information; trust in both the source of mHealth SMS, as well as trust in treatment, the formation of habits and fear of sequelae or death for facilitating intention to use an mHealth intervention and adhere to medication. We also highlight a case which underscored the importance of the period after diagnosis in habit forming as an opportunity for an mHealth intervention.

Conclusions:

We identify factors relating to technology use, as well as factors impacting adherence to medications, that influence a patient’s intention to use an mHealth intervention, as well as enable or inhibit their intention to adopt such an intervention. As mHealth becomes increasingly used for the management of chronic conditions, it is important that mHealth interventions are contextually appropriate and consider the breadth of factors influencing patient uptake and use.