JMIR Cardio最新文献

{"title":"Physical Activity in Patients With Heart Failure During and After COVID-19 Lockdown: Single-Center Observational Retrospective Study.","authors":"Francesco Maria Angelo Brasca,&nbsp;Maria Carla Casale,&nbsp;Fabio Lorenzo Canevese,&nbsp;Giovanni Tortora,&nbsp;Giulia Pagano,&nbsp;Giovanni Luca Botto","doi":"10.2196/30661","DOIUrl":"https://doi.org/10.2196/30661","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic forced several European governments to impose severe lockdown measures. The reduction of physical activity during the lockdown could have been deleterious.</p><p><strong>Objective: </strong>The aim of this observational, retrospective study was to investigate the effect of the lockdown strategy on the physical activity burden and subsequent reassessment in a group of patients with heart failure who were followed by means of remote monitoring.</p><p><strong>Methods: </strong>We analyzed remote monitoring transmissions during the 3-month period immediately preceding the lockdown, 69 days of lockdown, and 3-month period after the first lockdown in a cohort of patients with heart failure from a general hospital in Lombardy, Italy. We compared variation of daily physical activity measured by cardiac implantable electrical devices with clinical variables collected in a hospital database.</p><p><strong>Results: </strong>We enrolled 41 patients with heart failure that sent 176 transmissions. Physical activity decreased during the lockdown period (mean 3.4, SD 1.9 vs mean 2.9, SD 1.8 hours/day; P<.001) but no significant difference was found when comparing the period preceding and following the lockdown (-0.0007 hours/day; P=.99). We found a significant correlation between physical activity reduction during and after the lockdown (R²=0.45, P<.001). The only significant predictor of exercise variation in the postlockdown period was the lockdown to prelockdown physical activity ratio.</p><p><strong>Conclusions: </strong>An excessive reduction of exercise in patients with heart failure decreased the tolerance to exercise, especially in patients with more comorbidities. Remote monitoring demonstrated exercise reduction, suggesting its potential utility to encourage patients to maintain their usual physical activity levels.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e30661"},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9020797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39740156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Caution When Interpreting Gender-Based Relative Risk. Comment on \"The Effect of Cardiovascular Comorbidities on Women Compared to Men: Longitudinal Retrospective Analysis\".","authors":"Imre Janszky","doi":"10.2196/34647","DOIUrl":"https://doi.org/10.2196/34647","url":null,"abstract":"Abstract","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e34647"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40326367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Reply to: Using Caution When Interpreting Gender-Based Relative Risk. Comment on \"The Effect of Cardiovascular Comorbidities on Women Compared to Men: Longitudinal Retrospective Analysis\".","authors":"Elma Dervic,&nbsp;Carola Deischinger,&nbsp;Nina Haug,&nbsp;Michael Leutner,&nbsp;Alexandra Kautzky-Willer,&nbsp;Peter Klimek","doi":"10.2196/36801","DOIUrl":"https://doi.org/10.2196/36801","url":null,"abstract":"Elma Dervic, MSCE; Carola Deischinger, PhD; Nina Haug, PhD; Michael Leutner, PhD; Alexandra Kautzky-Willer, PhD; Peter Klimek, PhD 1Section for Science of Complex Systems, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria 2Complexity Science Hub Vienna, Vienna, Austria 3Department of Medicine III, Clinical Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria 4Gender Institute, Gars am Kamp, Austria","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e36801"},"PeriodicalIF":0.0,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40324850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Blood Lipid Levels After a Digitally Enabled Cardiometabolic Preventive Health Program: Pre-Post Study in an Adult Dutch General Population Cohort.","authors":"José Castela Forte,&nbsp;Rahul Gannamani,&nbsp;Pytrik Folkertsma,&nbsp;Sridhar Kumaraswamy,&nbsp;Sarah Mount,&nbsp;Sipko van Dam,&nbsp;Jan Hoogsteen","doi":"10.2196/34946","DOIUrl":"https://doi.org/10.2196/34946","url":null,"abstract":"<p><strong>Background: </strong>Despite widespread education, many individuals fail to follow basic health behaviors such as consuming a healthy diet and exercising. Positive changes in lifestyle habits are associated with improvements in multiple cardiometabolic health risk factors, including lipid levels. Digital lifestyle interventions have been suggested as a viable complement or potential alternative to conventional health behavior change strategies. However, the benefit of digital preventive interventions for lipid levels in a preventive health context remains unclear.</p><p><strong>Objective: </strong>This observational study aimed to determine how the levels of lipids, namely total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, non-HDL cholesterol, and triglycerides, changed over time in a Dutch general population cohort undergoing a digital preventive health program. Moreover, we looked to establish associations between lifestyle factors at baseline and lipid levels.</p><p><strong>Methods: </strong>We included 348 adults from the Dutch general population who underwent a digitally enabled preventive health program at Ancora Health between January 2020 and October 2021. Upon enrollment, participants underwent a baseline assessment involving a comprehensive lifestyle questionnaire, a blood biochemistry panel, physical measurements, and cardiopulmonary fitness measurements. Thereafter, users underwent a lifestyle coaching program and could access the digital application to register and track health behaviors, weight, and anthropometric data at any time. Lipid levels were categorized as normal, elevated, high, and clinical dyslipidemia according to accepted international standards. If at least one lipid marker was high or HDL was low, participants received specific coaching and advice for cardiometabolic health. We retrospectively analyzed the mean and percentage changes in lipid markers in users who were remeasured after a cardiometabolic health-focused intervention, and studied the association between baseline user lifestyle characteristics and having normal lipid levels.</p><p><strong>Results: </strong>In our cohort, 199 (57.2%) participants had dyslipidemia at baseline, of which 104 participants were advised to follow a cardiometabolic health-focused intervention. Eating more amounts of favorable food groups and being more active were associated with normal lipid profiles. Among the participants who underwent remeasurement 9 months after intervention completion, 57% (17/30), 61% (19/31), 56% (15/27), 82% (9/11), and 100% (8/8) showed improvements at remeasurement for total, LDL, HDL, and non-HDL cholesterol, and triglycerides, respectively. Moreover, between 35.3% and 77.8% showed a return to normal levels. In those with high lipid levels at baseline, total cholesterol decreased by 0.5 mmol/L (7.5%), LDL cholesterol decreased by 0.39 mmol/L (10.0%), non-HDL cholesterol decreased by 0.44","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e34946"},"PeriodicalIF":0.0,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8987960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40316385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing and Implementing an mHealth Heart Failure Self-care Program to Reduce Readmissions: Randomized Controlled Trial.","authors":"Amber E Johnson,&nbsp;Shuvodra Routh,&nbsp;Christy N Taylor,&nbsp;Meagan Leopold,&nbsp;Kathryn Beatty,&nbsp;Dennis M McNamara,&nbsp;Esa M Davis","doi":"10.2196/33286","DOIUrl":"https://doi.org/10.2196/33286","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted with decompensated heart failure (HF) are at risk for hospital readmission and poor quality of life during the discharge period. Lifestyle behavior modifications that promote the self-management of chronic cardiac diseases have been associated with an improved quality of life. However, whether a mobile health (mHealth) program can assist patients in the self-management of HF during the acute posthospital discharge period is unknown.</p><p><strong>Objective: </strong>We aimed to develop an mHealth program designed to enhance patients' self-management of HF by increasing knowledge, self-efficacy, and symptom detection. We hypothesized that patients hospitalized with HF would be willing to use a feasibly deployed mHealth program after their hospital discharge.</p><p><strong>Methods: </strong>We employed a patient-centered outcomes research methodology to design a stakeholder-informed mHealth program. Adult patients with HF admitted to a large academic hospital were enrolled and randomized to receive the mHealth intervention versus usual care. Our feasibility outcomes included ease of program deployment, use of the clinical escalation process, duration of participant recruitment, and participant attrition. Surveys assessing the demographics and clinical characteristics of HF were measured at baseline and at 30 and 90 days after discharge.</p><p><strong>Results: </strong>The study period was between July 1, 2019, and April 7, 2020. The mean cohort (N=31) age was 60.4 (range 22-85) years. Over half of the participants were men (n=18, 58%) and 77% (n=24) were White. There were no significant differences in baseline measures. We determined that an educational mHealth program tailored for patients with HF is feasibly deployed and acceptable by patients. Though not significant, we found notable trends including a higher mean quality of life at 30 days posthospitalization among program users and a longer duration before rehospitalization, which are suggestive of better HF prognosis.</p><p><strong>Conclusions: </strong>Our mHealth tool should be further assessed in a larger comparative effectiveness trial. Our pilot intervention offers promise as an innovative means to help HF patients lead healthy, independent lives. These preliminary data suggest that patient-centered mHealth tools can enable high-risk patients to play a role in the management of their HF after discharge.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03982017; https://clinicaltrials.gov/ct2/show/NCT03982017.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e33286"},"PeriodicalIF":0.0,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8981015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40309155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Wearable Tracking Devices on Cardiorespiratory Fitness Among Inactive Adults: Crossover Study","authors":"L. H. Larsen, M. H. Lauritzen, Mikkel Sinkjaer, T. Kjaer","doi":"10.2196/31501","DOIUrl":"https://doi.org/10.2196/31501","url":null,"abstract":"Background Modern lifestyle is associated with a high prevalence of physical inactivity. Objective This study aims to investigate the effect of a wearable tracking device on cardiorespiratory fitness among inactive adults and to explore if personal characteristics and health outcomes can predict adoption of the device. Methods In total, 62 inactive adults were recruited for this study. A control period (4 weeks) was followed by an intervention period (8 weeks) where participants were instructed to register and follow their physical activity (PA) behavior on a wrist-worn tracking device. Data collected included estimated cardiorespiratory fitness, body composition, blood pressure, perceived stress levels, and self-reported adoption of using the tracking device. Results In total, 50 participants completed the study (mean age 48, SD 13 years, 84% women). Relative to the control period, participants increased cardiorespiratory fitness by 1.52 mL/kg/minute (95% CI 0.82-2.22; P<.001), self-reported PA by 140 minutes per week (95% CI 93.3-187.1; P<.001), daily step count by 982 (95% CI 492-1471; P<.001), and participants’ fat percentage decreased by 0.48% (95% CI –0.84 to –0.13; P=.009). No difference was observed in blood pressure (systolic: 95% CI –2.16 to 3.57, P=.63; diastolic: 95% CI –0.70 to 2.55; P=.27) or perceived stress (95% CI –0.86 to 1.78; P=.49). No associations were found between adoption of the wearable tracking device and age, gender, personality, or education. However, participants with a low perceived stress at baseline were more likely to rate the use of a wearable tracking device highly motivating. Conclusions Tracking health behavior using a wearable tracking device increases PA resulting in an improved cardiorespiratory fitness among inactive adults.","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42726895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Preoperative Virtual Reality App for Patients Scheduled for Cardiac Catheterization: Pre-Post Questionnaire Study Examining Feasibility, Usability, and Acceptability.","authors":"Jiska J Aardoom,&nbsp;Alexander D Hilt,&nbsp;Tamar Woudenberg,&nbsp;Niels H Chavannes,&nbsp;Douwe E Atsma","doi":"10.2196/29473","DOIUrl":"https://doi.org/10.2196/29473","url":null,"abstract":"<p><strong>Background: </strong>Pre- and postoperative anxiety is a common phenomenon associated with negative postoperative outcomes. Symptoms of posttraumatic stress disorder, such as fear, nightmares, and sleep deprivation, are prevalent in approximately 30% to 50% of patients following discharge from intensive care units after cardiac surgery. Preliminary evidence suggests a promising role of virtual reality (VR) in preventing stress-related reactions using stress inoculation training. Such training enables cognitive preparation of individuals for stressful situations, thereby becoming more tolerant and resistant to stress, subsequently reducing the risk of potential negative psychological consequences. This study investigated a preoperative VR app-Pre-View-aimed at better informing and preparing patients for cardiac catheterization.</p><p><strong>Objective: </strong>This study aims to assess the feasibility, usability, and acceptability of Pre-View in patients undergoing cardiac catheterization.</p><p><strong>Methods: </strong>Eligible participants were adults scheduled for elective cardiac catheterization. Pre-View comprised an interactive virtual representation of the whole care process related to cardiac catheterization, from entering the hospital for admission to postprocedural stay and discharge. These processes were represented through 360° videos and interactive photos. Self-report questionnaires were completed at baseline (ie, before catheterization and after undergoing the VR experience) and after cardiac catheterization. Outcome measures included user experience and satisfaction, VR presence and immersive tendencies, and user friendliness. The perceived effectiveness was assessed exploratively.</p><p><strong>Results: </strong>A total of 8 individuals, with a mean age of 67 (SD 7.5) years, participated in this study. Half of them underwent the VR experience at the hospital and the other half at home. Participants reported high levels of presence in the virtual environment (Presence Questionnaire score: mean 129.1, SD 13.4). The usability of Pre-View was well evaluated (System Usability Scale score: mean 89.1, SD 12.0), and patient satisfaction was high (Client Satisfaction Questionnaire score: mean 27.1, SD 3.2). Usability and satisfaction scores were higher for participants who underwent Pre-View at home versus those who underwent Pre-View at the hospital, although the latter group was significantly older; 72.8 versus 61.3, respectively. All participants reported Pre-View to be effective in terms of feeling better informed about the care process of cardiac catheterization. Most participants (7/8, 88%) reported Pre-View to be effective in terms of feeling better prepared for cardiac catheterization, acknowledging the potential of Pre-View in reducing negative psychological consequences after catheterization.</p><p><strong>Conclusions: </strong>The results provide initial support for the feasibility and acceptability of a preoperativ","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e29473"},"PeriodicalIF":0.0,"publicationDate":"2022-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39653527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frameworks for implementation, uptake and use of digital health interventions in ethnic minority populations: a scoping review using cardiometabolic disease as a case study. (Preprint)","authors":"M. Ramasawmy, L. Poole, Zareen Thorlu-Bangura, Aneesha Chauhan, Mayur Murali, Parbir Jagpal, Mehar Bijral, J. Prashar, Abigail G-Medhin, E. Murray, F. Stevenson, A. Blandford, H. Potts, K. Khunti, W. Hanif, Paramjit Gill, Madiha Sajid, K. Patel, H. Sood, N. Bhala, Ayath Ullah, Shivali Modha, M. Mistry, Vinod Patel, Sarah N Ali, A. Ala, A. Banerjee","doi":"10.2196/preprints.37360","DOIUrl":"https://doi.org/10.2196/preprints.37360","url":null,"abstract":"\u0000 BACKGROUND\u0000 Digital health interventions (DHIs) have become increasingly common across healthcare, both before and during the COVID-19 pandemic. Health inequalities, particularly by ethnicity, are recognised across diseases, but may be excluded in frameworks addressing implementation of DHIs.\u0000 \u0000 \u0000 OBJECTIVE\u0000 Using cardiometabolic disease as an exemplar, this scoping review aims to assess how health inequalities are addressed in frameworks relevant to the implementation, uptake and use of DHIs, health and ethnic inequalities, and interventions for cardiometabolic disease.\u0000 \u0000 \u0000 METHODS\u0000 SCOPUS, PubMed, EMBASE and grey literature was searched to identify frameworks relevant to: implementation, uptake and use of DHIs; ethnically or culturally diverse populations and health inequalities; and interventions for cardiometabolic disease. We assessed the extent to which these include health inequalities, specifically regarding ethnicity; and explored how these were addressed, drawing out recommendations for good practice.\u0000 \u0000 \u0000 RESULTS\u0000 Of 58 relevant frameworks, 22 (38%) included reference to health inequalities. Inequalities were conceptualised to operate across four levels: society, system, intervention and individual. Only five frameworks considered all levels. Three frameworks considered how DHIs might interact with or exacerbate existing health inequalities; and three considered the process of implementation, uptake and use of health technologies and suggested opportunities to improve equity in digital health. Where ethnicity was considered, this was often within the broader social determinants of health. Only three frameworks explicitly addressed ethnicity: one focused on culturally tailoring DHIs; and two were applied to management of cardiometabolic disease.\u0000 \u0000 \u0000 CONCLUSIONS\u0000 Existing frameworks evaluate implementation, uptake and use of DHIs, but to consider factors related to ethnicity necessitates looking across frameworks. We have developed a guide to support future research to assess real world usability and applicability of these frameworks, to mitigate against digital health inequalities and to inform digital health policies.\u0000","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41492653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of smart health ecosystems that support self-care among people with heart failure: A scoping review (Preprint)","authors":"R. Nourse, Elton H Lobo, Jenna McVicar, F. Kensing, S. Islam, L. Kayser, R. Maddison","doi":"10.2196/preprints.36773","DOIUrl":"https://doi.org/10.2196/preprints.36773","url":null,"abstract":"\u0000 BACKGROUND\u0000 People with heart failure are supported by healthcare providers who follow clinical guidelines, and they are also encouraged to participate in self-care behaviors. However, the management of heart failure is complex. Innovative solutions are required to support healthcare providers with decision-making and to support people with heart failure to sustain appropriate self-care behaviors. In recent years, more sophisticated technologies have emerged within healthcare practice. These technologies use data collection, intelligent data processing, and communication to enable new models of healthcare, such as smart health ecosystems, to assist diagnosis and treatment of conditions, support patients in managing a condition, and monitor patients to support disease prevention. Currently, there is little information about the behavioral and technical characteristics of smart health ecosystems for people with heart failure.\u0000 \u0000 \u0000 OBJECTIVE\u0000 We aimed to identify and describe the characteristics of smart health ecosystems that support self-care for people with heart failure.\u0000 \u0000 \u0000 METHODS\u0000 We conducted a scoping review using the Joanna Briggs Institute (JBI) methodology. Searches of MEDLINE, Embase, CINAHL, PsycINFO, IEEE Xplore, and ACM Digital Library databases were searched from January 2008 to September 2021. The search strategy focused on studies that described smart health ecosystems to support self-care among people with heart failure. Two reviewers screened studies at the title and abstract level, and full text then extracted relevant data from the included full texts.\u0000 \u0000 \u0000 RESULTS\u0000 After removing duplicates, 1543 articles were screened, and 34 articles were identified, representing 13 interventions. Articles represented study designs from different stages of the e-health development cycle; conceptual and planning (n=6), development and usability (n=14), pilot/feasibility (n=2), effectiveness testing (n=9), implementation (n=1), all phases (n=2). They collected data from the end user with sensors and questionnaires and used tailoring to provide personalized support. Interventions supported heart failure self-care behaviors using 34 different behavior change techniques (BCTs), which were facilitated by a combination of 8 intervention features; automated feedback, monitoring (integrated and manual input), presentation of data, education, reminders, communication with a healthcare provider and psychological support. Furthermore, features to support healthcare providers included the presentation of data, alarms, and alerts, communication with the end user, remote care plan modification, health record integration, and communication with other members of the care team.\u0000 \u0000 \u0000 CONCLUSIONS\u0000 This scoping review identified that there are few reports of smart health ecosystems to support self-care among people with heart failure, and those that have been reported do not provide comprehensive support across all domains of self-care. Further research on i","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68489174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of a Mobile App on Participation in Cardiac Rehabilitation and Understanding Barriers to Success: Comparative Cohort Study.","authors":"John T Rivers,&nbsp;Carla Smith,&nbsp;Ian Smith,&nbsp;James Cameron","doi":"10.2196/24174","DOIUrl":"https://doi.org/10.2196/24174","url":null,"abstract":"<p><strong>Background: </strong>Poor patient uptake of cardiac rehabilitation (CR) remains a challenge for multiple reasons including geographic, time, cultural, cost, and psychological constraints.</p><p><strong>Objective: </strong>We evaluated the impact on CR participation rates associated with the addition of the option of mobile app-based CR (Cardihab) for patients declining conventional CR.</p><p><strong>Methods: </strong>A total of 204 consecutive patients were offered CR following angioplasty; of these, 99 were in cohort 1 (offered conventional CR only) and 105 were in cohort 2 (app-based CR offered to those declining conventional CR). Patients in each cohort were followed throughout a 6-week CR program and participation rates were compared for both groups. Patients in cohort 2 declining both forms of CR were interviewed to assess reasons for nonparticipation.</p><p><strong>Results: </strong>CR participation improved from 21% (95% CI 14%-30%) to 63% (95% CI 53%-71%) with the addition of the app (P<.001). Approximately 25% (9/39) of the group declining the app-based program identified technology issues as the reason for nonparticipation. The remainder declined both CR programs or were ineligible due to frailty or comorbidities.</p><p><strong>Conclusions: </strong>Providing patients with the additional option of an app-based CR program substantially improved CR participation. Technology and psychological barriers can limit CR participation. Further innovation in CR delivery systems is required to improve uptake.</p>","PeriodicalId":14706,"journal":{"name":"JMIR Cardio","volume":" ","pages":"e24174"},"PeriodicalIF":0.0,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8804955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39828399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}