Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 14, 2019
Open Peer Review Period: May 17, 2019 - Jul 12, 2019
Date Accepted: Feb 22, 2020
(closed for review but you can still tweet)
Sustainability of mHealth effects on cardiometabolic risk factors: 5-year results of a randomized clinical trial
ABSTRACT
Background:
Long-term effect of mHealth interventions has not been documented, especially in resource-constrained settings.
Objective:
This study aimed at assessing the 5-year effect of a mHealth intervention on blood pressure levels and bodyweight in low-resource urban settings in Peru.
Methods:
After 5 years from randomisation, we attempted to contact the 212 individuals originally enrolled in the GISMAL Study in Peru. Primary outcomes were changes in systolic and diastolic blood pressure; and, in addition, hypertension incidence was also evaluated. Secondary outcome measures were changes in bodyweight and body mass index, and self-reported target behaviours. Study personnel collecting data were masked to group assignment. Linear mixed models were used to evaluate the effect of the intervention in primary and secondary outcomes in an intent-to-treat analysis.
Results:
Data from 164 (77.4%) out of 212 participants originally enrolled were available and analysed (80 in the intervention and 84 in the control group). The intervention did not result in changes in systolic (-2.54 mm Hg; 95% CI: -8.23; 3.15) or diastolic blood pressure (3.41 mm Hg; 95% CI: -0.75; 7.57) compared with the control group. The intervention reduced the risk of developing hypertension, but result was not significant (RR = 0.76; 95% CI: 0.45; 1.28). However, among secondary outcomes, those who received the intervention had a lower bodyweight (-5.42 kg; 95% CI: -10.4; -0.48) and BMI (-2.56 kg/m2; 95% CI: -4.46; -0.66). In addition, compared to controls, those who received ≥50% of the scheduled calls during the intervention had greater reductions of bodyweight (-6.23 kg; 95% CI: -11.47; -0.99) and BMI (-2.81 kg/m2; 95% CI: -4.77; -0.85).
Conclusions:
An mHealth intervention comprising motivational interview calls and SMS appears to have long-term effects on health. Although there were no effects on blood pressure levels, important reductions in bodyweight and BMI were seen five years after randomisation. Thus, mHealth appears to be a promising preventive strategy for non-communicable diseases in resource-constrained settings. Clinical Trial: N/A
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