Usability and effectiveness of a self-care mobile health app in individuals with heart failure

Re-hospitalization is one of the challenges that the medical community encounters when treating individuals with heart failure (HF). The hospitalization is an independent risk factor of mortality in this population. Patients often describe the HF symptoms as minor deviations in their health, neglect them, and delay in seeking early medical care. Therefore, establishing a novel self-care strategy to monitor symptoms is important, which may subsequently reduce hospital readmission and minimize negative consequences of hospitalization. Mobile health (mHealth) apps have features to actively engage individuals, such as real-time adjustments, graphic feedback, and social interaction functionalities, which may make the apps a convenient tool for promoting self-care management and improving health outcomes. The Heart Failure Health Storylines (HFHS), a mHealth app, is created specifically for people with HF for self-care management. However, its clinical effectiveness on people with HF has not been reported yet. Purposes. This study will assess the usability and the effectiveness of HFHS app on self-care management and physical activity promotion in people with HF. Participants. A total of 60 ambulatory participants with stable HF will be enrolled. Methods. In terms of studying the usability of the HFHS app, the study will provide a description of the frequency of tracking health habits by participants and their responses toward alert messages sent. The other part of this study will be a randomized controlled trial in which participants will be randomized into a self-care intervention group (App group) and control group (No App group). All participants will complete the SF-36 Quality of Life survey and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after 4 weeks of intervention. All participants will learn how to monitor their daily physical activity with a pedometer and receive weekly follow up phone calls from the research team. The App group will also be trained to use the HFHS app to track their resting heart rate and resting blood pressure in the morning, medication schedule, body weight, and physical activity over 4 weeks, and to complete the Quality of Experience (QoE) survey about the app after 4 weeks. The research team will monitor participants’ data entry on the HFHS app over 4 weeks. Clinical Relevance. The experience of this study may provide us a better understanding on the usability and the effectiveness of the HFHS app on self-care management and physical activity promotion in people with HF at a community setting. Results of this study can provide preliminary data for future larger interventional studies with a longer duration on the effects of self-care management apps in decreasing hospitalization rate among people with HF.