Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 13, 2023
Date Accepted: Jul 24, 2023
Warning: This is an author submission that is not peer-reviewed or edited.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.
Testing the effects of app-based motivational messages on physical activity and resting heart rate via smartphone app compliance in patients with vulnerable coronary artery plaques: Protocol for a micro-randomized trial.
ABSTRACT
Background Achieving the physical activity recommendations of at least 150 to 300 minutes a week of moderate-intensity, or 75 to 150 minutes a week of vigorous-intensity aerobic exercise, is important for reducing cardiometabolic risk, but evidence shows that most people struggle to meet these goals, particularly in the mid to long-term. Objectives The Messages Improving Resting hearT Health (MIRTH) study aims to determine whether or not: (1) sending daily motivational messages via a research app is effective in improving motivation and in promoting adherence to physical activity recommendations in men and women with coronary heart diseases randomized to a 12-month intensive lifestyle intervention, and (2) the time of the day when the message is delivered impacts compliance with exercise training. Design A single center, micro-randomized trial (MRT). Participants will be randomized daily to either receive or not receive motivational messages over two 90-day periods at the beginning (months 4-6) and at the end (10-12) of the LIVEPLUS trial (ACTRN12620001151921). Wrist-worn devices (Fitbit Inspire 2) Bluetooth paired with smartphones will be used to passively collect data for proximal (i.e., physical activity duration, steps walked, heart rate within 180 minutes of receiving messages) and distal (i.e., change values for resting heart rate and total steps walked within and across both Phases 1 and 2 of the trial) outcomes. Setting Participants will be recruited from a large academic Cardiology office practice (Central Sydney Cardiology) and Royal Prince Alfred Hospital (RPAH) Departments of Cardiology and Radiology. All clinical investigations will be undertaken at the Charles Perkins Centre-RPAH clinic. Participants Individuals (n = 58) with stable coronary heart disease who have low attenuation plaque based on a CCTA within the past 3 months and have been randomized to an intensive lifestyle intervention program. Discussion This MIRTH micro-randomization trial will represent the single most detailed and integrated analysis of the effects of a comprehensive lifestyle intervention targeting multiple metabolic pathways, delivered via a customized mHealth App on smart devices, on time-based motivational messaging for patients with coronary heart disease. This study will also help inform future studies optimizing for just-in-time adaptive interventions. Trial Registration ACTRN12622000731796; pre-results Universal Trial Number (UTN) U1111-1269-8610
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