Effectiveness of a web- and mobile phone-based intervention to promote physical activity and healthy eating in middle-Aged males: Randomized controlled trial of the manup study

Background: The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviours, necessitate broad-reaching intervention strategies. IT-based (web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. Objective: This study examines the effectiveness of a 9-month IT-based intervention to improve the physical activity, dietary behaviours and health literacy in middle-aged males compared to a print-based intervention. Methods: Participants, recruited offline (e.g. newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favour of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in two regional cities in Queensland Australia who could access the internet, owned a mobile phone and were able to increase their activity level. The intervention, ManUp, was informed by social cognitive and self regulation theories and was specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviours was promoted. Intervention content was the same in both intervention arms, only the delivery mode differed, and content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviours, and health literacy were measured using online surveys at baseline, 3 months and 9 months. Results: A total of 301 participants completed baseline assessments, 205 in the ITbased arm and 96 in the print-based arm. A total of 124 participants completed all three assessments. There were no significant between group differences in physical 5 activity and dietary behaviours (p ≥0.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (b(exp)=1.45, 95% CI=1.09-1.95; b(exp)=1.61, 95% CI=1.17-2.22) and 9 months (b(exp)=1.55, 95% CI=1.14-2.10; b(exp)=1.51, 95% CI=1.15-2.00). Overall dietary behaviours improved at 3 months (b(exp)=1.07, 95% CI=1.03-1.11) and 9 months (b(exp)=1.10, 95% CI=1.05-1.13). The proportion of participants in both groups eating higher-fibre bread and low-fat milk increased at 3 months (b(exp) = 2.25, 95% CI = 1.29-3.92; b(exp)=1.65, 95% CI = 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (b(exp)=0.48, 95% CI=0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (b(exp)=1.70, 95% CI=1.02-2.82). The average number of logins to the IT-platform at 3 and 9 months was 6.99 (SE=0.86) and 9.22 (SE=1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE=2.38) and 22.51 (SE=3.79), respectively. Conclusions: The ManUp intervention was effective in improving physical activity and dietary behaviours in middle aged males with no significant differences between IT- and print-based delivery modes

A mobile phone-based care model for outpatient cardiac rehabilitation: the care assessment platform (CAP)

<p>Abstract</p> <p>Background</p> <p>Cardiac rehabilitation programs offer effective means to prevent recurrence of a cardiac event, but poor uptake of current programs have been reported globally. Home based models are considered as a feasible alternative to avoid various barriers related to care centre based programs. This paper sets out the study design for a clinical trial seeking to test the hypothesis that these programs can be better and more efficiently supported with novel Information and Communication Technologies (ICT).</p> <p>Methods/Design</p> <p>We have integrated mobile phones and web services into a comprehensive home- based care model for outpatient cardiac rehabilitation. Mobile phones with a built-in accelerometer sensor are used to measure physical exercise and WellnessDiary software is used to collect information on patients' physiological risk factors and other health information. Video and teleconferencing are used for mentoring sessions aiming at behavioural modifications through goal setting. The mentors use web-portal to facilitate personal goal setting and to assess the progress of each patient in the program. Educational multimedia content are stored or transferred via messaging systems to the patients phone to be viewed on demand. We have designed a randomised controlled trial to compare the health outcomes and cost efficiency of the proposed model with a traditional community based rehabilitation program. The main outcome measure is adherence to physical exercise guidelines.</p> <p>Discussion</p> <p>The study will provide evidence on using mobile phones and web services for mentoring and self management in a home-based care model targeting sustainable behavioural modifications in cardiac rehabilitation patients.</p> <p>Trial registration</p> <p>The trial has been registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with number ACTRN12609000251224.</p

Mobile applications towards prevention and management of chronic diseases

Chronic disease is the leading cause of death and disability, and poses a major burden to heathcare systems in Australia and other western countries. To alleviate this burden, we developed three mobile phone based solutions to address primary and secondary prevention of the leading chronic diseases such as cardiovascular diseases and chronic obstructive pulmonary diseases. This paper focuses on how the mobile solutions could address the clinical problems, and briefly discusses some of the preliminary findings

Developing a user centred smartphone application for patients with acute coronary syndrome: The MoTER-ACS intervention

Background:Post-discharge interventions are limited for patients with Acute Coronary Syndromes (ACS) due to few scheduled visits to outpatient clinics and traveling from remote areas. Smartphones have become viable lifestyle technology to deliver home-based educational and health interventions.Objective:The aim of this study was to develop a smartphone-based intervention to provide post-discharge support for patients with ACS.Methods:In 2017, a series of small studies (pre-study survey) were conducted in the Prince Charles hospital, Queensland, Australia which consisted of questionnaires with a convenience sample of ACS patients (N=30), a focus group discussion with healthcare professionals (N=10) and an online survey with cardiologists (N=15). The results of the patients’ survey identified the educational topics of the MoTER-ACS intervention. The focus group with healthcare professionals assisted with identifying educational materials, health monitoring and self-management interventions. Monitoring symptoms related to heart failure exacerbation considered as weekly diary based on the results of the online survey with cardiologists.Results:The smartphone application covers multimedia educational materials to adopt a healthy lifestyle and, user-friendly tools to monitor physiological and health parameters such as blood pressure, weight, and pain assisting patients to self-manage their condition. Using the web-portal, clinicians can regularly access to patients’ data and provide support.Conclusions:The feasibility of the MoTER-ACS intervention as a home-based program is tested in a pilot study. If proven valid, this research, would enable clinicians to overcome accessibility barriers of home-based rehabilitation with the clinical expertise, supervision, and coaching that has traditionally been limited to hospital-based services

A Software Architecture and Data Model for Community-Based Healthcare Environments

Abstract — Major changes in healthcare delivery are needed to ease the pressures caused by global increase in ageing population and prevalence of chronic diseases. Recent care initiatives address these problems by delivering care in community-based settings, away from hospitals. The community care model requires that a patient’s health condition is also monitored in the home environment to allow assessment and follow-up of the health status. Our work presented in this paper aims to design a system architecture and data model that would provide efficient means to perform essential information management for ambulatory monitoring in a home health care setting. We describe a general purpose architecture and data model that is designed for collecting ambulatory data from various existing devices and systems, as well as for analyzing, storing and presenting clinically significant information to the care personnel. I

Can a mobile phone be used as a pedometer in an outpatient cardiac rehabilitation program?

Our aim is to evaluate the use of a mobile phone as a step counter in cardiovascular disease patients, to measure daily walking activity through the course of an outpatient cardiac rehabilitation program. A conventional Omron pedometer (HJ-7201TE) and a mobile phone inbuilt step counter (Nokia StepCounter Beta V0.26) were used in the study. Firstly, we conducted a laboratory trial with 11 normal healthy subjects to investigate the performance of the two devices over different step rates during walking. Secondly, we collected and analysed 141 daily step count records from 18 patients wearing the two devices during a clinical trial. The laboratory study revealed that both devices maintain an accuracy of less than 2% error rate within step rates of between 85 and 125 steps/min but tend to degrade outside this step rate range. During the clinical trial, patients carried the mobile phone as well as the Omron pedometer in a free living environment. The results of this study showed that despite the underperformance of these devices during the slow walk, the reliability of the mobile phone ((error 10%+/-30%) was better than the Omron pedometer (20.5%+/30% error) and accounted reliable assessment of 84% of the patients. This demonstrates the feasibility of using the inbuilt step counter as an integral solution of the mobile phone for delivery an ICT-based home care CR program