Evaluation of the effectiveness of an interactive avatar-based education application for improving heart failure patients’ knowledge and self-care behaviours: A pragmatic randomised controlled trial
- Conditions
- Heart failureCardiovascular - Other cardiovascular diseases
- Registration Number
- ACTRN12617001403325
- Lead Sponsor
- Flinders University
- Brief Summary
Aim: To evaluate the effectiveness of education using avatars for improving patients’ heart failure knowledge and self-care. Background: A lack of knowledge and self-care can contribute to poor outcomes and rehospitalization for people with heart failure. Design: A multi-centered, non-blinded pragmatic randomized controlled trial. Methods: Heart failure patients were randomly assigned to intervention (avatar education application) or usual care groups. Participants were followed up at baseline, 30 days and 90 days. ANCOVA was used to compare the scores of heart failure knowledge and self-care, between the two groups. Fisher’s Exact test was used to compare the two groups’ differences in terms of HF-cause readmission. Bivariate exact binary logistic regression was used to identity the predictors associated with baseline levels of knowledge. Results: The mean age of the 36 participants was 67.5 (SD 11.3) years; 34 (80.6%) male; At enrollment, approximately half (47.2%) have been living with Heart Failure for over five years and 50% were in NYHA functional class I. Two groups were comparable at baseline in their demographic and clinical characteristics. At 90 days, the intervention group participants had a higher increased in Knowledge score on the Dutch Heart Failure Knowledge Scales (DHFKS) compared to the control group (22.2% vs. 3.7%). There was no between-group difference observed at 30-day or 90-day follow-up, on participants’ self-care behaviour (the self-care of heart failure index [SCHFI]) or healthcare utilisation. Overall satisfaction with the avatar app was 91.3%. Conclusion: The addition of a co-designed avatar app to usual care improved knowledge in our group of Heart Failure participants at 30 days and continued to increase up to 90 days. Collectively, the results presented here suggest that our avatar app was perceived as an enjoyable and engaging means of delivering critical knowledge and self-care information.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- All
- Target Recruitment
- 36
1. A confirmed diagnosis of HF
2. Individuals with a newly diagnosed HF within 1 year; with a previous hospitalisation for HF
2. New York Heart Association Functional Class (NYHA-FC) I-IV
3. Normal cognitive function. Normal cognitive function is defined as a score of 26 or higher on the Montreal Cognitive Assessment (MOCA-Test).
4. Sufficient English language ability to communicate and to follow the study procedure
5. Willing to give informed consent.
1. Clinically unstable. Clinically unstable is defined as patients who do not achieve the five normal vital signs (i.e. heart rate, systolic blood pressure, respiratory rate, oxygen saturation, and temperature) plus normal mental status and ability to eat, for at least 24 hours prior to enrol in the study.
2. Cognitive impairment
3. Refuse to give informed consent.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Knowledge<br>Knowledge will be assessed with the Dutch Heart Failure Knowledge (DHFKS). <br>[Baseline, 1-month (primary timepoint) and 3-month ]
- Secondary Outcome Measures
Name Time Method Self-care behaviours<br>Self-care behaviours will be assessed with The Self-care Heart Failure Index (SCHFI) Version 6.2.<br><br>[Baseline, 1-month and 3-month ];Readmission<br>Readmission will be assessed for HF-cause readmission including both emergency and elective admissions to hospital and unplanned visit general physician units as measured by self-reporting and review of the medical records for verification of the information. <br>[Baseline, 1-month and 3-month ];Satisfaction<br>Satisfaction will be assessed by the investigator developed Avatar-based application satisfaction questionnaire, which is adapted from validated education material acceptability surveys.<br>[Baseline, 1-month and 3-month ]