Needs and demands for mHealth cardiac health promotion among individuals with cardiac diseases: a patient-centred design approach.

Aims: Cardiovascular diseases are one of the main contributors to disability and mortality worldwide. Meanwhile, risk factors can be modified by lifestyle changes. mHealth is an innovative and effective way to deliver cardiac health promotion. This study aims to examine the needs and demands regarding the design and contents of an mHealth intervention for cardiac health promotion among individuals with cardiac diseases. Different clusters were determined and analysed in terms of the intention to use an mHealth intervention. Methods and results: A cross-sectional study was conducted via a web-based survey. Three hundred and four individuals with coronary artery diseases (CADs) and/or congestive heart failure (CHF) were included in the data analysis. Descriptive statistics were applied to evaluate needs and demands regarding an mHealth intervention. A k-medoids cluster analysis was performed. Individuals with CAD and CHF favoured an mHealth intervention that supports its users permanently and is easily integrated into everyday life. Handheld devices and content formats that involve active user participation and regular updates were preferred. Three clusters were observed and labelled high, moderate, and low burden, according to their psychometric properties. The high burden cluster indicated higher behavioural intention towards use of an mHealth intervention than the other clusters. Conclusion: The results of the study are a valuable foundation for the development of an mHealth intervention for cardiac health promotion following a user-centred design approach. Individuals with cardiac diseases report positive attitudes in the form of high usage intention regarding mHealth. Highly burdened individuals report a high intention to use such interventions.

Psychometric properties of the German revised version of the eHealth literacy scale in individuals with cardiac diseases: Validation and test of measurement invariance.

Background: The internet is most people's primary source of (health) information. However, no validated instrument exists to assess eHealth literacy in the group of patient with cardiac diseases. Objective: The objective of this study was the evaluation of the psychometric properties of the German revised version of the eHealth literacy scale (GR-eHEALS) in individuals with coronary artery disease (CAD) and congestive heart failure (CHF). Methods: A cross-sectional study was conducted. N = 455 were included in the statistical analyses. The assessment compromised the GR-eHEALS, medical history, sociodemographic data, and technology-related data. Confirmatory factor analyses, correlational analyses, and tests of measurement invariance were performed. Results: The two-factorial model reached a good model fit. The sub-scales information seeking and information appraisal, as well as the eHealth literacy total score, reached high reliability coefficients. Construct and criterion validity was fully confirmed For the two-factorial model, measurement invariance up to the scalar level could be confirmed regarding the sociodemographic characteristics sex, age, and educational level. Conclusions: This study confirmed the two-factor structure, construct, and criterion validity as well as measurement invariance at the scalar level for sex, age, and educational level of the GR-eHEALS scale in a sample of individuals with CAD and CHF.

Determining the Acceptance of Digital Cardiac Rehabilitation and Its Influencing Factors among Patients Affected by Cardiac Diseases.

BACKGROUND: Cardiac diseases are a major global health issue with an increasing prevalence of affected people. Rehabilitation following cardiac events is underutilized, despite its proven effectiveness. Digital interventions might present a useful addition to traditional cardiac rehabilitation. AIMS: This study aims to assess the acceptance of mobile health (mHealth) cardiac rehabilitation and to investigate the underlying factors of acceptance in patients with ischemic heart disease and congestive heart failure. METHODS: A cross-sectional study was conducted from November 2021 to September 2022 with N = 290 patients. Sociodemographic, medical, and eHealth-related data were assessed. The Unified Theory of Acceptance and Use of Technology (UTAUT) was applied. Group differences in acceptance were examined and a multiple hierarchical regression analysis was conducted. RESULTS: The overall acceptance of mHealth cardiac rehabilitation was high (M = 4.05, SD = 0.93). Individuals with mental illness reported significantly higher acceptance (t(288) = 3.15, padj = 0.007, d = 0.43). Depressive symptoms (ß = 0.34, p < 0.001); digital confidence (ß = 0.19, p = 0.003); and the UTAUT predictors of performance expectancy (ß = 0.34, p < 0.001), effort expectancy (ß = 0.34, p < 0.001), and social influence (ß = 0.26, p < 0.001) significantly predicted acceptance. The extended UTAUT model explained 69.5% of the variance in acceptance. CONCLUSIONS: As acceptance is associated with the actual use of mHealth, the high level of acceptance found in this study is a promising basis for the future implementation of innovative mHealth offers in cardiac rehabilitation.