Cardiac rehabilitation (CR) is strongly recommended for patients with coronary heart disease. However, patient enrollment and completion of cardiac rehabilitation is low. This study will examine if a mobile phone intervention that uses a text messaging program can successfully promote participation in cardiac rehabilitation.
Mobile phone interventions, such as text messaging programs, have been shown to promote healthy behaviors in patients with coronary heart disease, but it is unknown whether text messaging can successfully promote participation in cardiac rehabilitation. This study will have the following aims: Aim 1: Adapt a theory- and evidence-based text messaging intervention to promote participation in cardiac rehabilitation. Aim 2: Determine whether text messaging improves participation in cardiac rehabilitation among eligible patients. This study will have two parts. In part 1, the investigators will enroll patients with heart disease to rate the acceptability of text messages. In part 2, the investigators will enroll patients to participate in a randomized controlled trial. Participants will be randomized to receive text messages or no text messages for 6 months. Those who have been assigned to receive the text messaging intervention will be sent several text messages per week throughout the study period. The content of these text messages is designed promote healthy behaviors and participation in cardiac rehabilitation. Those who have not been assigned to receive the text messaging intervention will receive usual care. Outcome measures will be assessed at a baseline visit and at a 6-month follow-up visit at the end of the intervention. Additionally, some participants in the text messaging intervention group will be interviewed about their overall satisfaction and engagement with the text messages upon completion of the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
38
After completing baseline procedures, study staff will activate the intervention in the participant's profile on the text messaging platform if the participant was randomized to the intervention. The text messaging platform will deliver messages by an automated algorithm. Participants will receive 4 messages per week for 6 months.
University of Washington Medical Center
Seattle, Washington, United States
Attendance at cardiac rehab
Documented attendance at one or more cardiac rehab sessions. Primary analysis will compare the proportion attending cardiac rehab in the text message intervention and no text message intervention arms.
Time frame: 6 months
Number of cardiac rehab sessions attended
Documented attendance at cardiac rehab sessions
Time frame: 6 months
Physical activity
Self-reported via International Physical Activity Questionnaire (IPAQ) - Total physical activity in continuous MET-min/week. Total physical activity is the sum of walking, moderate, and vigorous physical activity. Walking MET-minutes/week = 3.3 \* walking minutes \* walking days. Moderate MET-minutes/week = 4.0 \* moderate-intensity activity minutes \* moderate days. Vigorous MET-minutes/week = 8.0 \* vigorous-intensity activity minutes \* vigorous-intensity days.
Time frame: 6 months
Exercise capacity
6-minute walk test (6MWT)
Time frame: 6 months
Tobacco use
Participant self-report of tobacco use in past 30 days
Time frame: 6 months
Diet
Self-reported diet via Rate Your Plate questionnaire. Score 23-69, with 69 representing best diet.
Time frame: 6 months
Blood pressure
Blood pressure measured by study staff
Time frame: 6 months
Body Mass Index (BMI)
Weight measured by study staff. BMI = weight (kg) / height in meters squared (m2)
Time frame: 6 months
Cholesterol (LDL)
Obtained from medical records
Time frame: 6 months
Disease-specific health status
Self-reported health status via validated Seattle Angina Questionnaire (SAQ) - Short Form for participants with ischemic heart disease. The questionnaire is scored from 0-100 with 100 being the highest reportable health status. SAQ domains will include: Physical Limitation, Angina Frequency, and Quality of Life.
Time frame: 6 months
Disease-specific health status
Self-reported health status via validated Kansas City Cardiomyopathy Questionnaire (KCCQ) - Short Form for participants with heart failure or valvular heart disease. The questionnaire is scored from 0-100 with 100 being the highest reportable health status. KCCQ domains will include: Physical Limitation, Symptom Frequency, Quality of Life, and Social Limitation.
Time frame: 6 months
Depressive symptoms
Self-reported depressive symptoms via Patient Health Questionnaire-9 (PHQ-9). Scored 0-27 with 0 representing no depressive symptoms and 27 representing severe depressive symptoms.
Time frame: 6 months
Patient activation
Self-reported activation via the Patient Activation Measure 13 (PAM-13)
Time frame: 6 months
Patient satisfaction
Self-reported satisfaction with the intervention
Time frame: 6 months
Patient experience
Self-reported experience with the intervention
Time frame: 6 months
Hospitalizations
Confirm participant-reported events from medical records. We will report a composite of number of participants with Hospitalizations, ER visits, or Death, as well as number of participants with each individual outcome.
Time frame: 6 months
ER visits
Confirm participant-reported events from medical records. We will report a composite of number of participants with Hospitalizations, ER visits, or Death, as well as number of participants with each individual outcome.
Time frame: 6 months
Death
Confirm participant-reported events from medical records. We will report a composite of number of participants with Hospitalizations, ER visits, or Death, as well as number of participants with each individual outcome.
Time frame: 6 months
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