The effect of a game-based mobile app “MyHeartMate” to promote lifestyle change in coronary disease patients: a randomised controlled trial

Gallagher, Robyn; Chow, Clara K; Parker, Helen; Neubeck, L.; Celermajer, D.; Redfern, J.; Tofler, G.; Buckley, T.; Schumacher, T.; Hyun, K; Bouramond, F.; Figtree, G.

Abstract

Aims
Secondary prevention reduces coronary heart disease (CHD) progression. Traditional prevention programs including cardiac rehabilitation are under-accessed, which smartphone apps may overcome. To evaluate the effect of a game-based mobile app intervention (MyHeartMate) to improve cardiovascular risk factors and lifestyle behaviours.

Methods and results
Single-blind randomized trial of CHD patients in Sydney, 2017–2021. Intervention group were provided the MyHeartMate app for 6 months. Co-designed features included an avatar of the patient’s heart and tokens earned by risk factor work (tracking, challenges, and quizzes). The control group received usual care. Primary outcome was self-reported physical activity [metabolic equivalents (METs), Global Physical Activity Questionnaire] and secondary outcomes included lipid levels, blood pressure (BP), body mass index, and smoking. Pre-specified sample size was achieved (n = 390), age 61.2 ± 11.5 years; 82.5% men and 9.2% current smokers. At 6 months, adjusted for baseline levels, the intervention group achieved more physical activity than control (median difference 329 MET mins/wk), which was not statistically significant (95% CI −37.4, 696; P = 0.064). No differences occurred between groups on secondary outcomes except for lower triglyceride levels in the intervention [mean difference −0.3 (95% CI −0.5, −0.1 mmoL/L, P = 0.004)]. Acceptability was high: 94.8% of intervention participants engaged by tracking exercise or BP and completing missions; 26.8% continued to engage for ≥30 days. Participants (n = 14) reported the app supported tracking behaviours and risk factors, reinforcing and improving self-care confidence, and decreasing anxiety.

Conclusion
A game-based app proved highly acceptable for patients with CHD but did not improve risk factors or lifestyle behaviours other than triglyceride levels.

Citation

Gallagher, R., Chow, C. K., Parker, H., Neubeck, L., Celermajer, D., Redfern, J., Tofler, G., Buckley, T., Schumacher, T., Hyun, K., Bouramond, F., & Figtree, G. (2023). The effect of a game-based mobile app “MyHeartMate” to promote lifestyle change in coronary disease patients: a randomised controlled trial. European Heart Journal – Digital Health, 4(1), 33-42. https://doi.org/10.1093/ehjdh/ztac069

• Journal Article Type: Article
• Acceptance Date: Oct 24, 2022
• Online Publication Date: Nov 23, 2022
• Publication Date: 2023-01
• Deposit Date: Oct 25, 2022
• Publicly Available Date: Feb 14, 2023
• Electronic ISSN: 2634-3916
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 4
• Issue: 1
• Pages: 33-42
• DOI: https://doi.org/10.1093/ehjdh/ztac069
• Keywords: Coronary heart disease, Digital health, Risk factors, Randomized controlled trial, Secondary prevention, Mobile health, Gamification
• Public URL: http://researchrepository.napier.ac.uk/Output/2939833