JMIR Publications

ABSTRACT

Background:

Few mobile applications have technologies for self-monitoring multiple heart-healthy behaviors simultaneously, as well as automated and personalized feedback on individual behavioral outcomes for cardiovascular health. An app named “My HeartHELP” was developed for the general adult population to promote six heart-healthy lifestyle behaviors—physical activity, non-sedentary behaviors, healthy eating behaviors, non-smoking, no alcohol binge drinking, and self-assessment of body weight. Three essential technologies were used: 1) text messaging the users for information on cardiovascular health; 2) self-monitoring of six heart-healthy behaviors to fill out the blanks of behavioral items; and 3) automated and personalized feedback messaging with diagrams and texts to users for behavioral outcomes obtained from self-monitoring.

Objective:

This study aimed to evaluate the feasibility and acceptability of the “My HeartHELP” app.

Methods:

The participants were 29 community residents who met at least one criterion of metabolic syndrome. To evaluate the feasibility, we assessed three behavioral records, which are as follows: First, the “record for self-monitoring” was determined as feasible if an average percentage for each of the six behaviors over four weeks was 75% or higher based on percentages of participants who completed to record each of six heart-health behaviors. Second, the “record for access to the app” was determined as feasible if users accessed the app once or more per week. Third, “records for behavioral changes” over four weeks were collected via a self-reported questionnaire. To evaluate acceptability, we used an assessment tool comprising 12 items that included subscales for comprehensibility, ease, health benefits, technical completeness, overall satisfaction, and recommendation to others on a five-point Likert scale. Acceptability was determined as acceptable if the average scores for the total scale and each subscale were 3.5 points or greater. Second, qualitative data were collected through focus group interviews.

Results:

During the four weeks, 95.6% of the participants adhered to more than 75% of “completion of daily self-monitoring of each heart-healthy behavior,” having met the criterion. The participants accessed the app on average 1.8 times per day, meeting the criteria. Participants had positive behavioral changes in all six behaviors, of which non-sedentary behavior (p < .001) and non-fast food intake were especially statistically significant (p = .031) over four weeks. Participants reported 3.8 points for a total score of acceptability and more than 3.5 points for all subscales, which met the criterion. Qualitative data obtained from focus group interviews indicated that automated and personalized feedback messages motivated participants to promote healthy lifestyles.

Conclusions:

The study results revealed that “My HeartHELP” may be a feasible and acceptable mobile app to promote self-monitoring and possibly behavioral changes in heart-healthy lifestyle behaviors. Clinical Trial: None