Effectiveness of an Avatar application for teaching heart attack recognition and response: A pragmatic randomized control trial.

AIMS: To evaluate the effectiveness of an Avatar application for educating people with acute coronary syndrome (heart attack). BACKGROUND: A lack of understanding of Acute Coronary Syndrome symptoms and appropriate responses often contribute to delay in seeking medical treatment. DESIGN: A single-centre, non-blinded, pragmatic randomized controlled trial. METHODS: Seventy Acute Coronary Syndrome patients were randomly assigned to the intervention (Avatar application) or usual care groups. Participants were followed up at 0, 1, and 6 months. Tobit Growth Curve Model was used to analyse the primary outcome-symptom knowledge; and the secondary outcomes-attitudes and beliefs. Heart attack action plan implementation and health care utilisation were analysed using Chi-square and Mann-Whitney U test. RESULTS: Of the 70 participants, 63% were male and the mean age of the participants was 64.7 (SD 11.7) years. Sixty-six (94.2%) participants completed follow-up. Between group differences on acute coronary syndrome (ACS) Response Index scores were statistically significant at 1-month and 6-month follow-ups (p < .01). The intervention group had a significant improvement in symptom knowledge, attitudes, and beliefs over the 6-month period (p < .001, p = .009, p < .001 respectively); and no significant improvement in the usual care group participants (p = .152, p = .068, p = .228). For healthcare use, at follow-up, there was a significant difference in ambulance use, between the intervention group and the usual care group (33.33% vs. 18.18%, p = .008; cardiac: 88.89% vs. 42.86%; p = .049); 85.14% of participants reported that the application helped them to feel more confident in recognizing and responding to symptoms in the future. CONCLUSION: The education app was effective in improving individuals' ACS knowledge, attitudes, and beliefs. A large multi-centre trial with a longer follow-up to evaluate the intervention's effectiveness on clinical outcomes will be our next step in evaluation. IMPACT: The content of AVATARS (Nurse Cora) app can be translated into different languages and evaluated for patients from different health settings and linguistic backgrounds. TRIAL REGISTRATION: This study has been registered with Australian New Zealand Clinical Trials Registry (ANZCTR). The trial registration number is ACTRN12616000803493.

An avatar-based education application to improve patients' knowledge of and response to heart attack symptoms: A pragmatic randomized controlled trial protocol.

AIM: To evaluate the effectiveness of an interactive, avatar-based education application to improve knowledge of and response to heart attack symptoms in people who are at risk of a heart attack. BACKGROUND: Poor knowledge of heart attack symptoms is recognized as a significant barrier to timely medical treatment. Numerous studies have demonstrated that technology can assist in patient education to improve knowledge and self-care. DESIGN: A single-center, non-blinded, two parallel groups, pragmatic randomized controlled trial. METHODS: Seventy patients will be recruited from the coronary care unit of a public hospital. Eligible participants will be randomized to either the usual care or the intervention group (usual care plus avatar-based heart attack education app). The primary outcome of this study is knowledge. Secondary outcomes include response to heart attack symptoms, health service use and satisfaction. Study participants will be followed up for 6 months. DISCUSSION: This study will evaluate the avatar-based education app as a method to deliver vital information to patients. Participants' knowledge of and response to heart attack symptoms, and their health service use, will be assessed to evaluate the intervention effectiveness.

Development and feasibility testing of an avatar-based education application for patients with acute coronary syndrome.

AIMS: To develop and evaluate an interactive, avatar-based education application, for improving patients' knowledge of, and response to, acute coronary syndrome (ACS) symptoms. BACKGROUND: A patient's ability to recognise and respond to the symptoms of ACS is imperative for seeking timely medical intervention. Innovative patient education interventions are needed to support patient education and patient self-care. METHODS: Participatory action research methods were used to engage consumers with cardiac and information technology (IT) experts to develop an avatar-based education application. The avatar-based education application was developed according to evidence-based guidelines. The effect on ACS knowledge was evaluated in a group of ten patients with ACS. RESULTS: In total, 10 consumers with ACS and 12 cardiovascular clinical and IT experts participated in the designing and development of the education application. An additional 10 consumers (mean age was 52.2 ± 10.4 years) were recruited for testing the feasibility of the application on improving ACS knowledge. A high level (87.3%) of satisfaction was reported with a 15.7% increase in the knowledge subscale score of the ACS Response Index and 25.7% increase in belief scores, while symptom recognition scores increased by 24.2%. CONCLUSION: An avatar-based application for heart attack education is feasible and has the potential to support patient education by enhancing engagement and improving health literacy. These outcomes will provide preliminary data for an effectiveness trial. RELEVANCE TO CLINICAL PRACTICE: Nurses frequently experience obstacles in providing patient education, such as health literacy and language barriers. Utilising avatar-based technology could potentially support the delivery of patient education. Involving consumers in the development these innovative educational tools is essential. Consumer participation in design has improved the engagement, satisfaction and outcomes of our app.

Six-Minute Walk Test for Assessing Physical Functional Capacity in Chronic Heart Failure.

PURPOSE OF THE REVIEW: The six-minute walk test (6MWT) is a submaximal exercise test for evaluating physical functional capacity. This review aims to report the research on the use of the 6MWT in chronic heart failure (CHF) that has been published in the past 5 years. RECENT FINDINGS: The 6MWT distance does not accurately reflect peak VO2. Minimal clinically important difference in the 6MWT distance, and additional measurements, such as heart rate recovery, can assist in the interpretation of the 6MWT distance, so management decisions can be made. Incorporating mobile apps and information technology in measuring the 6MWT distance extends the usefulness of this simple walk test and improve remote monitoring of patients with CHF. The 6MWT is a useful tool in CHF programs. However, interpretation of the 6MWT distance must be with caution. With the advancement in technology, the 6MWT has the potential to facilitate the monitoring of people living in rural and remote areas.

Effectiveness of using avatar-based technology in patient education for the improvement of chronic disease knowledge and self-care behavior: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE: The objective of this review is to investigate the effectiveness of using avatar-based technology in patient education for the improvement of knowledge and self-care behaviors for chronic disease.