Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 6, 2025
Date Accepted: Sep 25, 2025
Peer-led digital health lifestyle intervention in a low-income community at risk for cardiovascular disease: Development and process evaluation (MYCardio-PEER)
ABSTRACT
Background:
Low-income populations face significant barriers to cardiovascular disease (CVD) prevention, including limited access to health information, preventive services, and ongoing support for behavior change. Digital health technologies present scalable opportunities to empower patients and foster participatory healthcare, especially when integrated with peer-led, community-based approaches.
Objective:
This study aimed to describe the development and process evaluation of a peer-led digital health lifestyle intervention (MYCardio-PEER) designed to empower low-income adults at risk for CVD through mobile technology and community-based peer support.
Methods:
MYCardio-PEER was developed using the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions, which involves four key stages: (i) review of evidence, (ii) drawing on existing theory, (iii) planning the development process, and (iv) designing and refining the intervention. The developed intervention was then tested for feasibility, and a process evaluation was conducted.
Results:
The 8-week MYCardio-PEER program included bite-sized educational videos, infographics, and interactive activities focusing on knowledge, nutrition, and lifestyle behaviors related to CVD. Thirty participants (59.4% male, mean age 58.2 ± 6.7 years) completed the program. Significant reductions were observed in CVD risk score, systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol. Additionally, increased physical activity levels and improved dietary intake were noted. Program adherence was high, with 82.4% of participants completing all peer-led activities. Participants reported high satisfaction with the content (85.7%) and peer leadership (96.0%).
Conclusions:
The high adherence and satisfaction rates demonstrate the MYCardio-PEER’s potential for CVD prevention among underserved populations. These positive outcomes suggest that peer-led digital health interventions can effectively improve cardiovascular health behaviors and prevent chronic diseases in resource-limited settings. Clinical Trial: Clinicaltrials.gov NCT06408493
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