JMIR Publications

ABSTRACT

Background:

Coronary heart disease (CHD) afflicts 7 million American women annually and is their leading cause of disability worldwide [1, 2]. The overall prevalence of CHD is expected to increase by more than 40% by 2035[2]. In 2015, the estimated cost of caring for CHD patients was $182 billion in the U.S.; hospitalizations accounted for more than half of the costs [2]. Compared to men, women with CHD or who have undergone coronary revascularization have up to 30% more re-hospitalizations within 30 days, up to 1 year. Women are undertreated and underrepresented in research and rectifying sex-specific disparities in CHD outcomes is a national priority [2]. Effective interventions for improving cardiovascular health among women with CHD are vital for addressing this gap in care.

Objective:

The ubiquity of mobile phones has made mobile health (mHealth) behavioral interventions a viable option to improve healthy behaviors of both women and men with CHD. The aim of the study was to examine the usability of a prototypic mHealth intervention designed specifically for women with CHD, herein referred to as HerBeat™. We also examined the influence of HerBeat™ on selected behavioral concepts (self-efficacy for diet, exercise and managing chronic illness) and psychological (perceived stress and depressive symptoms) health of participants.

Methods:

Using a single group pre-test, post-test design, 10 women participated in the 12-week usability study. Participants were provided a smartphone and a smartwatch on which the HerBeat™ application was installed. Using a web portal dashboard, a health coach monitored participants’ ecological momentary assessment data, their behavioral data, and their heart rate and step count. Participants then completed a 12-week follow-up assessment.

Results:

Ten women (mean age 64.4± 6.3) completed the study. Usability of and acceptability of HerBeat™ was good with a mean System Usability Score of 83.60± 16.3. The participants had clinically modest but statistically significant improvements in waist circumference (p=.048), weight (p=.016) and body mass index (p=.012). Furthermore, depressive symptoms, measured with the Patient Health Questionnaire-9, significantly improved from baseline (p=.038).

Conclusions:

The mHealth prototype was feasible and usable for women with CHD. Participants provided data is useful for further development of HerBeat™. The mHealth intervention is expected to facilitate women with CHD self-management of their health behaviors. A randomized controlled trial is needed to verify the findings.