Previously submitted to: JMIR Formative Research (no longer under consideration since Jan 15, 2021)
Date Submitted: Mar 22, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Cardiac Rehabilitation Sustainability by Utilization of Accelerometer and Low-Frequency Text Messaging
ABSTRACT
Background:
Participation in outpatient cardiac rehabilitation (CR) Phase II reduces morbidity, mortality, and improves the quality of life. After Phase II, patients enter Phase III where they attempt to maintain the heart-healthy lifestyle learned during CR Phase II. Despite the benefits of CR Phase II, adherence to lifestyle recommendations can be challenging to sustain in Phase III. The use of mobile health (mHealth) technologies (accelerometer, text messaging, self-monitoring, etc.) can impact adherence and cardiovascular health; however, the impact of utilization frequency of text messaging on CR sustainability should be assessed.
Objective:
This trial aimed to determine CR sustainability, at 12 weeks post CR Phase II, by utilization of i) accelerometer, and ii) text messaging either at a) low-frequency with minimal supportive content or b) high-frequency with enhanced supportive content.
Methods:
The trial was a single-blinded randomized controlled trial with a 2-arm parallel group design. 42 participants were randomized to receive text messaging either a) bi-monthly (low-frequency group; N=22), with text messages being reminders of study participation and the date for the 12-week assessment; or b) tri-weekly (high-frequency group; N=20), with text messages being educational (nutrition, exercise, medication compliance) or supportive (encouragement). All participants were instructed to track steps using accelerometers (Fitbit, Smartphone, Smartwatch, etc.). A 6-minute walk test was used to determine physical fitness as measured by metabolic equivalents (METs). Rate Your Plate (RYP) scores, body mass index (BMI), weight, and waist-to-hip ratio (W:H) were used to assess dietary compliance.
Results:
Two-way repeated measure of analysis of variance found that the high-frequency and low-frequency group had similar sustainability (no decline), with no significant difference in METs (P = .62), RYP scores (P = .15), or BMI (P = .73). However, the high-frequency group did average significantly more steps per week vs. the low-frequency group (52,542 2,611 vs. 43,077 1,550; P = .002).
Conclusions:
This trial showed that CR sustainability at 12-weeks can be achieved with a simple utilization of mobile health (mHealth) technology (accelerometer and low-frequency text messaging), thus eliminating the decline in fitness and dietary compliance often seen at 12-weeks post-CR Phase II. Clinical Trial: IRBNet ID: 957218-2
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.