You are here

  • Home
  • Archive
  • Volume 32, Issue 11
  • Engagement and fidelity of a cardiovascular disease prevention-focused digital health intervention in cardiology outpatient waiting rooms: a mixed-methods study

Article Text

Article menu
Download PDFPDF
Original research
Engagement and fidelity of a cardiovascular disease prevention-focused digital health intervention in cardiology outpatient waiting rooms: a mixed-methods study
  1. Daniel Mcintyre1,
  2. Jason Chiang1,
  3. Aravinda Thiagalingam1,2,
  4. Allison Tong3,4,
  5. Clara Kayei Chow1,2
  1. 1 Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
  2. 2 Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
  3. 3 Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  4. 4 Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  1. Correspondence to Dr Daniel Mcintyre, The University of Sydney Westmead Applied Research Centre, Westmead, NSW 2145, Australia; daniel.mcintyre{at}sydney.edu.au

Abstract

Introduction We delivered a video-based, cardiovascular disease prevention focused intervention in cardiology waiting rooms that increased motivation to improve cardiovascular risk behaviours and satisfaction with clinic services. To better understand the potential generalisability and scalability of such waiting room interventions, this study evaluated the fidelity of intervention delivery and barriers and enablers to implementation.

Methods Mixed-methods process evaluation conducted among intervention participants in a randomised clinical trial. Data sources included (1) Participant screening logs, (2) Intervention delivery platform data and (3) Semi structured interviews performed with participants. Qualitative data were described using inductive thematic analysis.

Results The tablet-based intervention was delivered to 220 patients (112 (50.9%) male, mean age 54.2 (SD 15.4) years). Of 765 videos opened, 636 (83.1%) were watched to completion. Most videos opened were rated (738/765, 96.5%) and video ratings were predominantly positive (661/738, (89.6%) satisfied or highly satisfied). Younger and more educated participants were more likely to rate videos highly (relative risk (RR) 1.73 (95% CI 1.28 to 2.32) and RR 1.26 (95% CI 1.07 to 1.49)) but less likely to watch videos to completion (younger: RR 0.27 (95% CI 0.17 to 0.43), more educated: RR 0.90 (95% CI 0.85 to 0.96)). Of 39 invited, 21 (53.8%) participated in semistructured interviews. Thematic analysis of responses suggested reported behaviour change post intervention may be due to increased awareness of cardiovascular risk, reduced anxiety and intrinsic motivation from delivery within a cardiology waiting room. Lack of reinforcement and limited personalisation were barriers.

Conclusion The current analysis demonstrates that engagement with a digitally delivered clinic waiting room educational intervention was high, providing explanation for its efficacy in improving motivation to change cardiovascular risk behaviours. The high fidelity of delivery demonstrates potential for scaling of such interventions across waiting rooms. Recall bias and low response rate may bias self-reported engagement measures.

Trial registration number ANZCTR12618001725257.

  • Healthcare quality improvement
  • Information technology
  • Patient-centred care
  • Patient education
  • Qualitative research

Data availability statement

Data are available upon reasonable request. Data are available on reasonable request. De-identified study data will be made available to researchers who provide a methodologically sound proposal and after the signing of a non-disclosure agreement. To submit a data use proposal, please email the principal investigator at clara.chow@sydney.edu.au.

http://dx.doi.org/10.1136/bmjqs-2021-014664

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request. Data are available on reasonable request. De-identified study data will be made available to researchers who provide a methodologically sound proposal and after the signing of a non-disclosure agreement. To submit a data use proposal, please email the principal investigator at clara.chow@sydney.edu.au.

    View Full Text

    Footnotes

    • Twitter @daniel_mci

    • Contributors Study concept and design: DM, CKC, ATh. Acquisition, analysis or interpretation of data: DM, JC. Drafting of manuscript: DM, JC, ATo, CKC. Critical revision of manuscript: all authors. Obtained funding: DM, CKC, ATh. Study supervision: CKC, ATh. Study guarantor: CKC

    • Funding This work was supported by the Agency for Clinical Innovation Research Grants Scheme. CKC is supported by a National Health and Medical Research Council of Australia Investigator Fellowship.

    • Disclaimer Study funders had no role in the design, delivery, analysis, preparation and approval of the manuscript or decision to submit the study for publication.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.