A Smartphone App (AnSim) With Various Types and Forms of Messages Using the Transtheoretical Model for Cardiac Rehabilitation in Patients With Coronary Artery Disease: Development and Usability Study

A Smartphone App (AnSim) With Various Types and Forms of Messages Using the Transtheoretical Model for Cardiac Rehabilitation in Patients With Coronary Artery Disease: Development and Usability Study

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BackgroundDespite strong evidence of clinical benefit, cardiac rehabilitation (CR) programs are currently underutilized and smartphone-based CR strategies are thought to address this unmet need.However, data regarding the detailed process of development are scarce.ObjectiveThis study focused on the development of a smartphone-based, patient-specific, messaging app for patients who have undergone percutaneous coronary intervention (PCI).MethodsThe AnSim app was developed in collaboration with a multidisciplinary team that included cardiologists, psychiatrists, nurses, pharmacists, nutritionists, and rehabilitation doctors and therapists.

First, a focus group interview was conducted, and the narratives of the patients were analyzed to identify their needs and preferences.Based on the results, health care experts and clinicians drafted messages into 5 categories: (1) general information U-Base Acrylic LED Night Light regarding cardiovascular health and medications, (2) nutrition, (3) physical activity, (4) destressing, and (5) smoking cessation.In each category, 90 messages were developed according to 3 simplified steps of the transtheoretical model of behavioral change: (1) precontemplation, (2) contemplation and preparation, and (3) action and maintenance.After an internal review and feedback from potential users, a bank of 450 messages was developed.

ResultsThe focus interview was conducted with 8 patients with PCI within 1 year, and 450 messages, including various forms of multimedia, were developed based on the transtheoretical model of behavioral change in each category.Positive feedback was obtained from the potential users (n=458).The mean Likert scale score Incontinence/Catheters was 3.95 (SD 0.

39) and 3.91 (SD 0.39) for readability and usefulness, respectively, and several messages were refined based on the feedback.Finally, the patient-specific message delivery system was developed according to the baseline characteristics and stages of behavioral change in each participant.

ConclusionsWe developed an app (AnSim), which includes a bank of 450 patient-specific messages, that provides various medical information and CR programs regarding coronary heart disease.The detailed process of multidisciplinary collaboration over the course of the study provides a scientific basis for various medical professionals planning smartphone-based clinical research.