JMIR Publications

ABSTRACT

Background:

Cardiovascular diseases (CVDs) are a leading cause of death and disability worldwide. For people living with CVD, clinical guidelines recommend ongoing self-care such as symptom monitoring, medication adherence, and lifestyle modifications. However, many people struggle to engage in all self-care activities due to the complexity of disease management, limited understanding of their condition, and a lack of culturally tailored support. Conversational agents (CAs) offer a promising solution to these challenges by providing AI-driven, voice-based support that enables human-like communication. While many CAs and digital interventions have shown positive outcomes for people with CVDs, they have typically been designed for mainstream populations and often overlook the unique needs of culturally and linguistically diverse (CALD) communities.

Objective:

This study outlines the protocol for pilot testing for the feasibility and usability of DESI-Heart program, to support self-care management among Indian diaspora populations with CVDs in Australia over an 8-week intervention period. It also describes the formative development of DESI-Heart to ensure it meet the needs of this population.

Methods:

We integrated the Double diamond model and ecological validity model to guide the development of our DESI-Heart program. First, we co-designed the program with end-users, who identified four key goals to support effective engagement with self-care through culturally and linguistically appropriate approaches. Based on these user-informed priorities and unique ideas, we developed specific goals including: (1) medication reminders, (2) daily exercise guidance, (3) diet buddy, and (4) guided meditation. Participants will access the DESI-Heart program through a web-based conversational agent, available via smartphone, laptop, or PC. Based on their preferred timing, individuals will receive links to access specific components of the program corresponding to each goal. These links will be sent to participants via SMS or email, depending on their preference. A single-arm pre-post pilot trial (N = 28) will be conducted to evaluate the feasibility and usability of the DESI-Heart program among Indian adults living in Australia with CVDs. The primary outcome will assess feasibility indicators, including recruitment, engagement, and usability, while secondary outcomes will examine changes in self-care behaviours and quality of life.

Results:

The DESI-Heart program received ethics approval in July 2024. Recruitment for the pilot trial is scheduled to begin in June 2025 and conclude by September 2025, with participant follow-up expected to be completed by the end of November 2025.

Conclusions:

We have co-designed and developed the DESI-Heart program, a culturally and linguistically appropriate self-care intervention aimed at supporting Indian adults with CVD living in Australia. The next step is to conduct a pilot study to assess the feasibility and usability of DESI-Heart, which will inform the design of a larger evaluation trial. DESI-Heart has the potential to complement existing health services by helping individuals with CVD to manage their condition within the community, while acknowledging their cultural backgrounds and language preferences.