JMIR Publications

ABSTRACT

Background:

Heart failure (HF) is a leading cause of mortality, morbidity and hospitalization in people over 65 years of age. Patient self-care is crucial in reducing hospitalizations, unfortunately, many patients lack self-care skills. The popularity of smart phones makes them a potentially useful mechanism for delivering HF management interventions. Mobile health (mHealth) can potentially empower older adults in self-care. For this to work in older adult populations, however, mHealth technology may need adjustment. The current mHealth landscape lacks knowledge on creating interfaces for this target group.

Objective:

To examine the perceptions of older adult Veterans with HF about which behavior change features they would find important to include in an mHealth HF self-care intervention.

Methods:

Between January and July 2021, we conducted semi-structured interviews with patients with HF aged 65 and older at a single facility in an integrated health care system (the Veterans Health Administration). We performed content analysis and derived themes based on the Middle Range Theory of Chronic Illness, generating findings both deductively and inductively. The qualitative questions captured data on the 3 key themes of the theory: self-care maintenance, self-care monitoring and self-care management. Qualitative responses were analyzed using a qualitative data management platform and descriptive statistics were used to analyze demographic data.

Results:

Among patients interviewed (n=9), most agreed a smartphone app for supporting HF self-care was desirable. In addition to three a priori themes, we identified seven subthemes: education on daily HF care, how often to get education on HF, support of medication adherence, dietary restriction support, goal setting for exercises, stress reduction strategies and prompts of when to call a provider. In addition, we identified three inductive themes related to Veteran preferences for app components: simplicity, ability to share data with caregivers, and positively framing of HF language.

Conclusions:

There is considerable interest and promise of mHealth to support HF self-care of older adults. Our study findings indicate that older adult Veterans with HF are interested in mHealth if desirable features are included in its design. Further research needs to be done to validate these findings. Although developing the ideal mHealth technology will inevitably be challenging these findings can be used to inform a larger study to design and test a gero-focused mHealth intervention in this target population.