Effectiveness of an E-health Educational Intervention for Cardiovascular Disease Adults in Improving Outcomes
Condition: Cardiovascular Disease
MeSH terms: Cardiovascular Diseases
Study type: Interventional

Summary: 
      Cardiovascular disease (CVD) is the leading cause of death globally and e-health educational
      programs have been proved to be effective support to CVD clients. However, most e-health
      programs lack personalization and this seldom results in exercise behavioral change.
      Considering the advantages of e-health programs, as well as the widespread internet use and
      the rising trend of younger patients having CVD in Hong Kong, we conducted a Randomized
      Controlled Trial (RCT) to investigate the effectiveness of a home-based interactive e-health
      educational intervention versus usual care for middle aged cardiac vascular (CV) patients on
      their total physical exercise, exercise adherence and quality of life.
    

Detailed description: 
      Introduction:

      Cardiovascular disease (CVD) is the leading cause of death globally and e-health educational
      programs have been proved to be effective support to CVD clients. However, most e-health
      programs lack personalization and this seldom results in exercise behavioral change.
      Considering the advantages of e-health programs, as well as the widespread internet use and
      the rising trend of younger patients having CVD in Hong Kong, we conducted a Randomized
      Controlled Trial (RCT) to investigate the effectiveness of a home-based interactive e-health
      educational intervention versus usual care on total physical exercise, exercise adherence and
      self efficacy, risk factor profile, psychological outcomes and quality of life for middle
      aged cardiac vascular (CV) patients.

      Methods and analysis:

      This is a prospective randomised clinical trial investigating effectiveness of a home-based
      interactive e-health educational intervention for middle-aged cardiovascular disease (CVD)
      adults in improving total exercise, adherence rate, exercise efficacy and outcomes. The
      hypothesis is that the middle-aged CVD patients (those who are 40-65 years old) would be more
      likely to adhere to exercise-based behavior that improves their total exercise, exercise
      adherence rate, cardiac risk profile , psychological outcomes and quality of life with the
      support of an interactive e-health educational intervention.

      The RCT was conducted in two government cardiac clinics in Hong Kong. 438 eligible CV clients
      were randomized to either the control group (C) or the intervention group (I) using block
      randomization method. All participants received usual care while (I) additionally received
      the e-health educational intervention (eHEI) programme. This programme comprised of one-hour
      educational session, one telephone follow up and e-health link on self monitoring including
      record of health measures and physical exercise across 6 months. Data was collected at
      baseline, three months and six months intervals. The primary outcome was total physical
      exercise (GSLTPAQ). Secondary outcomes consisted of: exercise efficacy and adherence rate; CV
      risk profile; physical and psychological health outcomes (SF12 & HAD); biological parameter.
      Data was analyzed using generalized linear models.

      Ethics and dissemination: The study complies with the Declaration of Helsinki and was
      approved by the University and hospital ethics committee. Study findings will be disseminated
      in international conferences and publications.

      Key messages:

      Cardiovascular disease (CVD) is the leading cause of death globally and most e-health
      educational programs have been proved to be effective support to CVD clients. However, most
      e-health programs lack personalization and this seldom results in exercise behavioral change.

      The adopted e-health program aims to empower CVD participants by increase knowledge on
      cardiovascular risks, perceived benefits of exercise to health, as well as enhance their
      self-efficacy in exercise adherence and exercise behavior. Data analysis has been started in
      August 2015. This trial will provide evidence of e-health programs on physical and
      psychological outcomes comprehensively.

      Strengths and limitations of this study:

      The study has been designed to meet the criteria for high quality in non-pharmacological
      randomised clinical trials with randomisation, multicentre participation, blinded assessment
      and analysis with good sample size.
    

Intervention name(s): e-health educational intervention (eHEI)
Intervention type(s): Behavioral
Intervention description(s): The e-HEI link (e-health link http://ehealth.nur.cuhk.edu.hk) provides the content of culture-specific cognitive knowledge related to CVD and measures to modify risk factors. The member area and interactive platform of the e-HEI website allows the self-monitoring of individual health and exercise records. Members can view and retrieve their own exercise records daily, and health measures trend regularly.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Supportive Care
Keywords: ehealth; intervention; effectiveness; randomized controlled trial