在有心血管疾病风险的老年患者中，多组分个性化移动健康干预可改善患者激活度：一项随机对照试验试点研究

Patient activation improves with a multi-component personalized mHealth intervention in older patients at risk of cardiovascular disease: a pilot randomized controlled trial.

作者信息

Candelaria Dion, Cacciata Marysol, Serafica Reimund, Reyes Andrew Thomas, Lee Jung-Ah, Hildebrand Janett A, Sta Maria Axel, Strömberg Anna, Evangelista Lorraine S

机构信息

Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, D18, Western Avenue, Sydney, NSW 2006, Australia.

Veterans Affairs Long Beach Healthcare System, 5901 East Seventh Street, Long Beach, CA 90822-5201, USA.

出版信息

Eur J Cardiovasc Nurs. 2025 Mar 3;24(2):316-322. doi: 10.1093/eurjcn/zvae159.

DOI:10.1093/eurjcn/zvae159

PMID:39756174

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11879151/

Abstract

AIMS

This study aimed to determine the effect of a multi-component mHealth intervention on patient activation and examine its predictors among older adults at risk of cardiovascular disease (CVD).

METHODS AND RESULTS

This pilot randomized controlled trial compared two groups: Get FIT (control), who received healthy lifestyle counselling from a licensed health coach, a mHealth app (MyFitnessPal) with push alerts, and an activity tracker, and Get FIT + (intervention), who received the same interventions and had personalized text messages with 3- and 6-month follow-up periods. Patient activation was measured using the 13-item Patient Activation Measure; higher scores indicated better activation. Linear mixed-effects models were used to investigate between-group changes in outcomes across time. The participants' (n = 54) mean age was 65.4 ± 6.0 years; 61% were female; and 61% were married. Baseline characteristics were comparable between groups. Significant improvements in mean patient activation scores were observed in the Get FIT + group at 3 months [mean 3.53 points, 95% confidence interval (CI) 0.11, 6.96; P = 0.043] and 6 months (mean 4.37 points, 95% CI 0.91, 7.83; P = 0.014), whereas improvements in the Get FIT group were non-significant. Adjusting for age, gender, education, employment, marital status, social support, smartphone confidence, and self-perceived health, we found that only social support was associated with higher patient activation overall (B = 5.14, 95% CI 1.00, 9.27; P = 0.015).

CONCLUSION

The findings indicate that personalized text messaging can improve the self-care of older adults at risk of CVD. Findings also emphasize the importance of social support in the success of mHealth interventions for older adults.

REGISTRATION

The study is registered in ClinicalTrials.gov (NCT03720327).

摘要

目的

本研究旨在确定多成分移动健康干预对患者激活度的影响，并在有心血管疾病（CVD）风险的老年人中检验其预测因素。

方法与结果

这项试点随机对照试验比较了两组：“获得健康”组（对照组），他们接受了来自持牌健康教练的健康生活方式咨询、带有推送提醒的移动健康应用程序（MyFitnessPal）以及活动追踪器；“获得健康加强版”组（干预组），他们接受相同的干预措施，并在3个月和6个月的随访期收到个性化短信。使用13项患者激活度量表测量患者激活度；得分越高表明激活度越好。采用线性混合效应模型研究不同组随时间的结果变化。参与者（n = 54）的平均年龄为65.4±6.0岁；61%为女性；61%已婚。两组之间的基线特征具有可比性。“获得健康加强版”组在3个月时平均患者激活度得分有显著改善[平均3.53分，95%置信区间（CI）0.11，6.96；P = 0.043]，在6个月时也有显著改善（平均4.37分，95%CI 0.91，7.83；P = 0.014），而“获得健康”组的改善不显著。在对年龄、性别、教育程度、就业情况、婚姻状况、社会支持、智能手机使用信心和自我感知健康进行调整后，我们发现总体上只有社会支持与更高的患者激活度相关（B = 5.14，95%CI 1.00，9.27；P = 0.015）。