Enhancing Lifestyle Change in Cardiac Patients Through the Do CHANGE System ("Do Cardiac Health: Advanced New Generation Ecosystem"): Randomized Controlled Trial Protocol

Mirela Habibović, Eva Broers, Jordi Piera-Jimenez, Mart Wetzels, Idowu Ayoola, Johan Denollet, Jos Widdershoven, Mirela Habibović, Eva Broers, Jordi Piera-Jimenez, Mart Wetzels, Idowu Ayoola, Johan Denollet, Jos Widdershoven

Abstract

Background: Promoting a healthy lifestyle (eg, physical activity, healthy diet) is crucial for the primary and secondary prevention of cardiac disease in order to decrease disease burden and mortality.

Objective: The current trial aims to evaluate the effectiveness of the Do Cardiac Health: Advanced New Generation Ecosystem (Do CHANGE) service, which is developed to assist cardiac patients in adopting a healthy lifestyle and improving their quality of life.

Methods: Cardiac patients (ie, people who have been diagnosed with heart failure, coronary artery disease, and/or hypertension) will be recruited at three pilot sites (Badalona Serveis Assistencials, Badalona, Spain [N=75]; Buddhist Tzu Chi Dalin General Hospital, Dalin, Taiwan [N=100] and Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands [N=75]). Patients will be assisted by the Do Something Different (DSD) program to change their unhealthy habits and/or lifestyle. DSD has been developed to increase behavioral flexibility and subsequently adopt new (healthier) habits. In addition, patients' progress will be monitored with a number of (newly developed) devices (eg, Fitbit, Beddit, COOKiT, FLUiT), which will be integrated in one application.

Results: The Do CHANGE trial will provide us with new insights regarding the effectiveness of the proposed intervention in different cultural settings. In addition, it will give insight into what works for whom and why.

Conclusions: The Do CHANGE service integrates new technologies into a behavior change intervention in order to change the unhealthy lifestyles of cardiac patients. The program is expected to facilitate long-term, sustainable behavioral change.

Trial registration: Clinicaltrials.gov NCT03178305; https://ichgcp.net/clinical-trials-registry/NCT03178305 (Archived by WebCite at http://www.webcitation.org/6wfWHvuyU).

Keywords: behavior change; cardiac health; eHealth; lifestyle; mHealth.

Conflict of interest statement

Conflicts of Interest: MH, EB, JPJ, MW, JD and JW declare no conflict of interest. The Do CHANGE team has received funding for Research and Innovation from the European Union for the current project. Within the consortium, two small and medium-sized enterprises (Docobo, Do Something Different) and one start-up (Onmi – development of COOKiT and FLUiT) are financially supported to develop their products.

©Mirela Habibović, Eva Broers, Jordi Piera-Jimenez, Mart Wetzels, Idowu Ayoola, Johan Denollet, Jos Widdershoven. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.02.2018.

Figures

Figure 1
Figure 1
Study procedure.
Figure 2
Figure 2
Schematic overview of the Do CHANGE intervention components.

References

    1. Cardiosmart. 2018. [2018-01-24]. Heart Disease Statistics .
    1. Newton JN, Briggs ADM, Murray CJL, Dicker D, Foreman KJ, Wang H, Naghavi M, Forouzanfar MH, Ohno SL, Barber RM, Vos T, Stanaway JD, Schmidt JC, Hughes AJ, Fay DFJ, Ecob R, Gresser C, McKee M, Rutter H, Abubakar I, Ali R, Anderson HR, Banerjee A, Bennett DA, Bernabé Eduardo, Bhui KS, Biryukov SM, Bourne RR, Brayne CEG, Bruce NG, Brugha TS, Burch M, Capewell S, Casey D, Chowdhury R, Coates MM, Cooper C, Critchley JA, Dargan PI, Dherani MK, Elliott P, Ezzati M, Fenton KA, Fraser MS, Fürst Thomas, Greaves F, Green MA, Gunnell DJ, Hannigan BM, Hay RJ, Hay SI, Hemingway H, Larson HJ, Looker KJ, Lunevicius R, Lyons RA, Marcenes W, Mason-Jones AJ, Matthews FE, Moller H, Murdoch ME, Newton CR, Pearce N, Piel FB, Pope D, Rahimi K, Rodriguez A, Scarborough P, Schumacher AE, Shiue I, Smeeth L, Tedstone A, Valabhji J, Williams HC, Wolfe CDA, Woolf AD, Davis ACJ. Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Dec 05;386(10010):2257–74. doi: 10.1016/S0140-6736(15)00195-6.
    1. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van HL, Greenlund K, Daniels S, Nichol G, Tomaselli GF, Arnett DK, Fonarow GC, Ho PM, Lauer MS, Masoudi FA, Robertson RM, Roger V, Schwamm LH, Sorlie P, Yancy CW, Rosamond WD, American HASPTFC. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond. Circulation. 2010 Feb 2;121(4):586–613. doi: 10.1161/CIRCULATIONAHA.109.192703.
    1. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Makuc DM, Marcus GM, Marelli A, Matchar DB, Moy CS, Mozaffarian D, Mussolino ME, Nichol G, Paynter NP, Soliman EZ, Sorlie PD, Sotoodehnia N, Turan TN, Virani SS, Wong ND, Woo D, Turner MB, American HASCSS. Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 2012 Jan 3;125(1):e2–e220. doi: 10.1161/CIR.0b013e31823ac046.
    1. Spring B, Ockene JK, Gidding SS, Mozaffarian D, Moore S, Rosal MC, Brown MD, Vafiadis DK, Cohen DL, Burke LE, Lloyd-Jones D, American HABCCOTCOECOLHCFHBPROCN. Better population health through behavior change in adults: a call to action. Circulation. 2013 Nov 5;128(19):2169–76. doi: 10.1161/01.cir.0000435173.25936.e1.
    1. Hivert M, Arena R, Forman DE, Kris-Etherton PM, McBride PE, Pate RR, Spring B, Trilk J, Van HLV, Kraus WE, American Heart Association Physical Activity Committee of the Council on Lifestyle Cardiometabolic Health; the Behavior Change Committee‚ a joint committee of the Council on Lifestyle Cardiometabolic Health and the Council on EpidemiologyPrevention; the Exercise‚ Cardiac Rehabilitation‚ and Secondary Prevention Committee of the Council on Clinical Cardiology; and the Council on Cardiovascular Stroke Nursing Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association. Circulation. 2016 Oct 11;134(15):e308–e327. doi: 10.1161/CIR.0000000000000442.
    1. Lobelo F, Duperly J, Frank E. Physical activity habits of doctors and medical students influence their counselling practices. Br J Sports Med. 2009 Feb;43(2):89–92. doi: 10.1136/bjsm.2008.055426.
    1. Direito A, Carraça E, Rawstorn J, Whittaker R, Maddison R. mHealth Technologies to Influence Physical Activity and Sedentary Behaviors: Behavior Change Techniques, Systematic Review and Meta-Analysis of Randomized Controlled Trials. Ann Behav Med. 2017 Apr;51(2):226–239. doi: 10.1007/s12160-016-9846-0.
    1. Geller K, Lippke S, Nigg CR. Future directions of multiple behavior change research. J Behav Med. 2017 Feb;40(1):194–202. doi: 10.1007/s10865-016-9809-8.
    1. Moller AC, Merchant G, Conroy DE, West R, Hekler E, Kugler KC, Michie S. Applying and advancing behavior change theories and techniques in the context of a digital health revolution: proposals for more effectively realizing untapped potential. J Behav Med. 2017 Feb;40(1):85–98. doi: 10.1007/s10865-016-9818-7.
    1. Habibović M, Burg MM, Pedersen SS. Behavioral interventions in patients with an implantable cardioverter defibrillator: lessons learned and where to go from here? Pacing Clin Electrophysiol. 2013 May;36(5):578–90. doi: 10.1111/pace.12108.
    1. Moltu C, Stefansen J, Svisdahl M, Veseth M. Negotiating the coresearcher mandate - service users' experiences of doing collaborative research on mental health. Disabil Rehabil. 2012;34(19):1608–16. doi: 10.3109/09638288.2012.656792.
    1. Pine K, Fletcher BC. Time to shift brain channels to bring about effective changes in health behaviour. Perspect Public Health. 2014 Jan;134(1):16–7. doi: 10.1177/1757913913514705.
    1. Baumeister RF, Bratslavsky E, Muraven M, Tice DM. Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology. 1998;74(5):1252–1265. doi: 10.1037/0022-3514.74.5.1252.
    1. Fletcher B(, Hanson J, Page N, Pine K. FIT – Do Something Different. Swiss Journal of Psychology. 2011 Jan;70(1):25–34. doi: 10.1024/1421-0185/a000035.
    1. Walker S, Sechrist K, Pender N. University of Michigan. 1995. [2018-01-24]. Health Promotion Model - Instrumentsto measure health promoting lifestyle: Health Promoting Lifestyle Profile (HPLP-II) (Adult Version) .
    1. Trompenaars FJ, Masthoff ED, Van HGL, Hodiamont PP, De VJ. Content validity, construct validity, and reliability of the WHOQOL-Bref in a population of Dutch adult psychiatric outpatients. Qual Life Res. 2005 Feb;14(1):151–60.
    1. Venkatesh V, Thong J, Xu X. Forthcoming in MIS Quarterly;36(1) 2012. Mar, Consumer acceptance and use of information technologyxtending the unified theory of acceptance and use of technology .
    1. Lamers LM, McDonnell J, Stalmeier PFM, Krabbe PFM, Busschbach JJV. The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies. Health Econ. 2006 Oct;15(10):1121–32. doi: 10.1002/hec.1124.
    1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606–13.
    1. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092–7. doi: 10.1001/archinte.166.10.1092.
    1. Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med. 2005;67(1):89–97. doi: 10.1097/01.psy.0000149256.81953.49.
    1. Clifford A. CSQ Subscales. [2018-01-24]. .
    1. Fitbit Inc. 2018. [2018-01-24]. Fitbit .
    1. Paalasmaa J, Toivonen H, Partinen M. Adaptive Heartbeat modeling for beat-to-beat heart rate measurement in ballistocardiograms. IEEE J Biomed Health Inform. 2015 Nov;19(6):1945–52. doi: 10.1109/JBHI.2014.2314144.
    1. Vermunt J. Applications of latent class analysis in social science research. Lect Notes Artif Int. 2003;2711:22–36. doi: 10.1007/978-3-540-45062-7_2.
    1. Vermunt JK, Magidson J. Latent class models for classification. Computational Statistics & Data Analysis. 2003 Jan;41(3-4):531–537. doi: 10.1016/S0167-9473(02)00179-2.
    1. World Health Organization. 2018. Global action plan for the prevention and control of noncommunicable diseases 2013-2020 .

Source: PubMed

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