JMIR Publications

ABSTRACT

Background:

Over six million Americans have heart failure, and one in eight deaths included heart failure as a contributing cause in 2016. Lifestyle changes and adherence to diet and exercise regimens are important in limiting disease progression. Health coaching and public commitment are two interactive communication strategies that may improve self-management of heart failure.

Objective:

To conduct patient focus groups to gain insight into how best to implement health coaching and public commitment strategies within the heart failure population.

Methods:

Focus groups (n=7) occurred in two locations. We studied two patients in Oakland, CA and five patients in Los Angeles, CA. Patients were referred by local cardiologists and had to have a diagnosis of chronic heart failure. We used a semi-structured interview tool to explore five patient-centered themes including medication adherence, exercise habits, dietary habits, goals, accountability, and rewards. We coded focus group data using a priori coding criteria for these domains.

Results:

Medication adherence barriers included regimen complexity, forgetfulness, and difficulty coping with side effects. Participants reported that they receive little instruction from care providers on appropriate exercise and dietary habits. They also reported personal and social obstacles to achieving these objectives. Participants were favorable to structured goal setting, use of online social networks, and financial rewards as a means of promoting health lifestyles. Peers were viewed as better motivating agents than family members.

Conclusions:

An active communication framework involving dissemination of diet- and exercise-related health information, structured goal setting, peer accountability, and financial rewards appear promising in the management of heart failure.