Feasibility of a Smartphone-Based Health Coaching Intervention for Patient Self-Management of Risk Prevention After Acute Myocardial Infarction

Introduction: While the ubiquity and user-friendliness of smartphone devices offer a novel means by which patients can access health information, there is little research on the acceptability and effectiveness of using smartphones to deliver health coaching for patients after acute MI. Methods: Participants (patients and family caregivers) were recruited during hospitalization for an acute MI at a tertiary academic hospital. Before discharge, each loaded Day-by-Day, a program hosted on a smartphone application Vida Health, which allowed participants to engage in one-on-one video-, phone-, or text-based interactions with a live health coach and to access app-based patient education, data tracking, and self-management tools related to medication adherence and healthy lifestyle modification for 4 weeks post-discharge. Patient Activation Measure (PAM-6) scores were measured pre- and post-intervention. Results: A total of 18 participants (10 patients, 8 caregivers) completed the 4-week intervention. Mean age of patients was 57 (SD 12) years, and 20% were women; caregivers had a mean age of 54 years (SD12) and the majority (88%) were women. Participants engaged in a mean of 1 (SD 0.6) live video/phone consultations per week and opened the app 5 (SD 2) times/week. Patients and caregivers texted an average of 24 (SD 33) and 8 (SD 4) times/week, respectively. Patient PAM-6 scores improved significantly after coaching ( mean improvement = 16.57, p = .009), corresponding to a large standardized effect size ( Hedges’ g = 1.22). Patients were significantly more likely to agree with the statements “I have been able to maintain lifestyle changes, like eating right or exercising” ( p = .048), and “I know what treatments are available for my heart attack” ( p = .015). Participants rated the program favorably: mean 8.6/10 for overall satisfaction and mean app customer loyalty (net promoter) score of 53 (high u003e50). Conclusions: Digital health coaching was well received among post-MI patients and caregivers, and patients reported increased levels of activation in self-management of healthy behaviors. These preliminary findings demonstrate the value of mobile phone-based health coaching in augmenting secondary prevention attitudes and behaviors in post-MI patients.