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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Mobile health (mHealth) interventions may enhance positive health behaviors, but randomized trials evaluating their efficacy are uncommon. Our goal was to determine if a mHealth intervention augmented and extended benefits of center-based cardiac rehabilitation (CR) for physical activity levels at 6-months. We delivered a randomized clinical trial to low and moderate risk patients with a compatible smartphone enrolled in CR at two health systems. All participants received a compatible smartwatch and usual CR care. Intervention participants received a mHealth intervention that included a just-in-time-adaptive intervention (JITAI) as text messages. The primary outcome was change in remote 6-minute walk distance at 6-months stratified by device type. Here we report the results for 220 participants enrolled in the study (mean [SD]: age 59.6 [10.6] years; 67 [30.5%] women). For our primary outcome at 6 months, there is no significant difference in the change in 6\u2009min walk distance across smartwatch types (Intervention versus control: +31.1 meters Apple Watch, \u22127.4 meters Fitbit; <jats:italic>p<\/jats:italic>\u2009=\u20090.28). Secondary outcomes show no difference in mean step counts between the first and final weeks of the study, but a change in 6\u2009min walk distance at 3 months for Fitbit users. Amongst patients enrolled in center-based CR, a mHealth intervention did not improve 6-month outcomes but suggested differences at 3 months in some users.<\/jats:p>","DOI":"10.1038\/s41746-023-00921-9","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T18:03:47Z","timestamp":1694714627000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["A randomized trial of a mobile health intervention to augment cardiac rehabilitation"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9538-3926","authenticated-orcid":false,"given":"Jessica R.","family":"Golbus","sequence":"first","affiliation":[]},{"given":"Kashvi","family":"Gupta","sequence":"additional","affiliation":[]},{"given":"Rachel","family":"Stevens","sequence":"additional","affiliation":[]},{"given":"V.Swetha E.","family":"Jeganathan","sequence":"additional","affiliation":[]},{"given":"Evan","family":"Luff","sequence":"additional","affiliation":[]},{"given":"Jieru","family":"Shi","sequence":"additional","affiliation":[]},{"given":"Walter","family":"Dempsey","sequence":"additional","affiliation":[]},{"given":"Thomas","family":"Boyden","sequence":"additional","affiliation":[]},{"given":"Bhramar","family":"Mukherjee","sequence":"additional","affiliation":[]},{"given":"Sarah","family":"Kohnstamm","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0555-8967","authenticated-orcid":false,"given":"Vlad","family":"Taralunga","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-4229","authenticated-orcid":false,"given":"Vik","family":"Kheterpal","sequence":"additional","affiliation":[]},{"given":"Susan","family":"Murphy","sequence":"additional","affiliation":[]},{"given":"Predrag","family":"Klasnja","sequence":"additional","affiliation":[]},{"given":"Sachin","family":"Kheterpal","sequence":"additional","affiliation":[]},{"given":"Brahmajee K.","family":"Nallamothu","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,9,14]]},"reference":[{"key":"921_CR1","doi-asserted-by":"publisher","first-page":"2675","DOI":"10.1161\/CIRCULATIONAHA.106.180945","volume":"115","author":"GJ Balady","year":"2007","unstructured":"Balady, G. 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Dr. Nallamothu is a principal investigator or co-investigator on research grants from the NIH, VA HSR&D and the American Heart Association. He also receives compensation as Editor-in-Chief of Circulation: Cardiovascular Quality & Outcomes, a journal of the American Heart Association. Finally, he is a co-inventor on U.S. Utility Patent Number US15\/356,012 (US20170148158A1) entitled \u201cAutomated Analysis of Vasculature in Coronary Angiograms\u201d that uses software technology with signal processing and machine learning to automate the reading of coronary angiograms, held by the University of Michigan. The patent is licensed to AngioInsight, Inc., in which Dr. Nallamothu holds ownership shares and receives consultancy fees. Dr. Sachin Kheterpal is a principal investigator or co-investigator on research grants from the US NIH, Blue Cross Blue Shield of Michigan, the American Heart Association, Apple, Merck & Co, and Becton Dickinson & Company; and is a co-inventor on US patent number 62\/791,257 entitled \u201cAutomated System To Medical Procedures\u201d, which is held by the University of Michigan. Dr. Klasnja is a principal investigator or a co-investigator on research grants from NIH. Dr. Murphy is a principal investigator or a co-investigator on research grants from NIH. Dr. Vik Kheterpal is a Principal and employee of CareEvolution. Mr. Taralunga is a Software Architect employed by CareEvolution.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"173"}}