Improving Awareness, Knowledge and Heart-related Lifestyle of Coronary Heart Disease Among Working Population Through a mHealth Programme

The study aims to develop a mHealth programme, entitled "Care4Heart" for the working population in Singapore and examine its feasibility and effectiveness in increasing the awareness and knowledge of coronary heart disease (CHD) as well as improving their heart-related lifestyle.

The objectives are:

1. To develop a mHealth programme using the smartphone app, entitled "Care4Heart" for the working population in Singapore to assist them in establishing a healthy lifestyle.
2. To test the effectiveness of the "Care4Heart" app in increasing the awareness and knowledge of CHD among the working population in Singapore.
3. To test the effectiveness of the "Care4Heart" app in eliciting a positive heart-related lifestyle modification, including stress reduction among the working population in Singapore.

Background Deaths caused by CHD are often preventable. Deranged serum lipid profile, hypertension, obesity, physical inactivity and excess working stress are the well-known preventable risk factors of CHD, and the reduction of these risk factors will improve physical and psychological health and prevent future adverse and fatal cardiac events. Sedentary lifestyles and unhealthy diets are common reasons that may predispose Singaporeans to the risk of developing CHD, especially the majority of the workforce working in offices who engage in little or no physical activity. It was reported that about 40% of the working population (i.e. 21 to 65 years old) in Singapore do not engage in regular physical exercise. The increasing popularity of high fat diet and eating out and the high levels of stress experienced by the working population may further increase their risk of developing CHD.

Many of risk factors of CHD are modifiable and can be greatly reduced by adopting a healthy lifestyle. Exercising regularly and following a healthy diet plan are effective strategies in lowering cardiovascular risk factors. Obviously there is a need for an updated educational programme aimed at teaching and encouraging people in the working population to adopt a healthier lifestyle, which would result in them changing their behaviours and sustaining a healthy lifestyle to reach optimal health. Even though, health promotion programmes including the traditional face-to-face cardiac education sessions have been developed to be accessed by the general population, a known barrier for not reaching the working population is the lack of time as a result of long work hours. With a substantial increase in the number of people owning smartphones and a sharp increase in the usage of smartphones in recent years, the smartphone is a device most people in Singapore own. Recently the Infocomm Development Authority of Singapore (2013) announced plans for a well-connected mobile network to support major industries including healthcare. Hence the promotion of mobile health (mHealth) is the next logical wave of healthcare support tools to prevent and manage chronic diseases like CHD. A recent whitepaper based on market research conducted in Singapore reported that about 92% of Singaporeans aged between 25 to 39 years owned smartphones. While 83% of the older population aged from 55 years onwards owned smartphones as well. Based on this report, it is widely expected that mHealth will reach many Singaporeans as tools to maintain and improve their health.