Abstract 4122840: Patient activation improves with a multi-component personalized mHealth intervention in older adults at risk of cardiovascular disease

Background: Patient activation, a person’s level of confidence, comprehension, and autonomy toward their health, is an essential goal of cardiovascular disease therapy. Previous research has shown a link between high levels of patient activation and better patient outcomes and experiences. However, whether individualized interventions such as a text-based mobile health (mHealth), improve patient activation is unclear. Research on patient activation in people at risk for cardiovascular disease and influential factors is minimal. Aims: This study aimed to 1) determine the effect of a multi-component mHealth intervention on patient activation and 2) examine its predictors among older adults at risk for cardiovascular disease. Methods: In this pilot randomized controlled trial, community-dwelling older adults with poor eating behaviors and reduced physical activity (n=54) were randomly assigned to the GetFIT (control) or GetFIT+ (intervention) groups, with three- and six-month follow-up periods. The GetFIT group received healthy lifestyle counseling from a licensed health coach, a free commercial mHealth app with push alerts on physical activity, and an activity tracker for physical activity monitoring. The GetFIT + group received the same components but had personalized text messages instead of push alerts. The 13-item Patient Activation Measure assessed patient activation; higher scores indicate better activation. Linear mixed-effects models were used to investigate between-group changes in outcomes across time. Results: The mean age was 65.4 ± 6.0 years; 61% were females and 61% were married. Baseline characteristics were comparable between groups. Significant improvements were observed in the GetFIT+ group at three months (mean 3.53, 95% CI 0.11, 6.96; p=0.043) and six months (mean 4.37, 95% CI 0.91, 7.83; p=0.014), whereas improvements in the GetFIT group were non-significant. Adjusting for age, gender, education, employment, marital status, social support, smartphone confidence, and self-perceived health did not alter the results. Nevertheless, only social support was associated with higher patient activation overall (B=5.14, 95% CI 1.00, 9.27; p=0.015). Conclusions: People at risk for cardiovascular disease can improve their self-management abilities, knowledge, and confidence through personalized text messaging. Possessing social support is critical for maximizing the benefits of mHealth interventions.