JMIR Publications

ABSTRACT

Background:

The HeartHealth program is a six-month SMS message-based support program offered to patients with a recent cardiovascular hospitalisation or recent cardiovascular clinic visit in Western Sydney, Australia. Its customised content focuses on cardiovascular risk factors, with a focus on lifestyle, treatments and general heart health information.

Objective:

This study aimed to evaluate the implementation of the HeartHealth program.

Methods:

A mixed-methods study was conducted assessing program reach, effectiveness, implementation and maintenance using program data, participant feed-back surveys and staff focus-group discussions. Consecutive adult patients who had attended cardiology clinics or had been discharged from cardiology hospitalisation at Westmead Hospital, between April 2020 and April 2024 were included in the analysis. Content analysis was utilised to interpret the qualitative data.

Results:

A total of 23095 patients were invited, 8804 (38.1%; 8804/23095) enrolled into the program and 7964 (90.5%; 7964/8804) completed the six-month duration. Participant mean age was 60.5 years, 60.5% were male, and 59.7% were recruited from an out-patient clinic setting. A total of 851058 SMS messages were sent with 99.41% being successfully delivered. 3533 participants completed the post-program survey and four HeartHealth staff members participated in a focus group discussion. 60.5% of participants reported the programming improving their regular vegetable intake and 53.6% reported improved physical activity levels. Content analysis of participant feedback identified that the program was effective in prompting participants to change diet, provided emotional support, reminded them of importance of behaviour change, improved their confidence in managing their health and kept participants focused. HeartHealth staff recommended that future program adjustments should expand program dissemination and improve program personalisation.

Conclusions:

The program had a broad reach, translated to improved health behaviours, provided participants with needed support at low cost and low resource requirements. Key program barriers and future adaptions to long-term maintenance were identified, such as increased program personalisation, increased site staff involvement and wider program dissemination. This analysis highlights the successful implementation and scalability of the HeartHealth program and provides key learnings for health systems who are looking to implement similar programs in the future.