Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up

Background and aims: Adherence to treatment is a significant challenge for patients with cardiac disease. Optimizing health literacy (HL) is essential in this context. Mobile health (mHealth) interventions have been suggested to improve both treatment adherence and HL. This study aimed to examine th...

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Main Authors: Pernille Lunde, Hanne Søberg Finbråten, Are Hugo Pripp, Birgitta Blakstad Nilsson, Jostein Grimsmo, Asta Bye
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:International Journal of Cardiology. Cardiovascular Risk and Prevention
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772487525000832
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author Pernille Lunde
Hanne Søberg Finbråten
Are Hugo Pripp
Birgitta Blakstad Nilsson
Jostein Grimsmo
Asta Bye
author_facet Pernille Lunde
Hanne Søberg Finbråten
Are Hugo Pripp
Birgitta Blakstad Nilsson
Jostein Grimsmo
Asta Bye
author_sort Pernille Lunde
collection DOAJ
description Background and aims: Adherence to treatment is a significant challenge for patients with cardiac disease. Optimizing health literacy (HL) is essential in this context. Mobile health (mHealth) interventions have been suggested to improve both treatment adherence and HL. This study aimed to examine the effect of a one-year mHealth intervention on HL and to compare HL changes between the intervention- and the control group. Methods: This randomized controlled trial included patients completing cardiac rehabilitation, who were randomly allocated to either an intervention group receiving individualized follow-up via an app for one year or a control group receiving usual care. From one-year follow-up to the five-year follow-up, both groups received usual care. HL was measured using the HLS-Q12. Mixed model for repeated measurements and Wilcoxon signed rank test were used to analyse differences between groups, while paired sample t-test and Kendall's Tau b correlation analysed within-group changes. Results: A total of 113 patients were included in the study. No statistically significant differences between the groups were found in total HLS-Q12 score or at item level at any follow-up. However, a statistically significant within-group improvement was observed in the intervention group for the total score (mean change of 2.5 ± 4.6, p < 0.01) and several HLS-Q12 items from baseline to one-year follow-up. Conclusions: The one-year mHealth intervention did not show an effect on HL levels at one- or five-year follow-ups. However, significant within-group HL improvement from baseline to one-year follow-up suggests that mHealth interventions may have the potential to enhance HL.
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spelling doaj-art-d4f72fe5eb9b41b6b6c1137fdcc8f73f2025-08-24T05:15:17ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-09-012620044510.1016/j.ijcrp.2025.200445Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-upPernille Lunde0Hanne Søberg Finbråten1Are Hugo Pripp2Birgitta Blakstad Nilsson3Jostein Grimsmo4Asta Bye5Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, PB 4, St.Olavs plass, Oslo, 0130, Norway; Corresponding author.Department of Health and Nursing Sciences, University of Inland Norway, PB 400, Elverum, N-2418, NorwayDepartment of Rehabilitation Science and Health Technology, Oslo Metropolitan University, PB 4, St.Olavs plass, Oslo, 0130, Norway; Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, PB 4950 Nydalen, Oslo, 0424, NorwayDepartment of Rehabilitation Science and Health Technology, Oslo Metropolitan University, PB 4, St.Olavs plass, Oslo, 0130, Norway; Division of Medicine, Department of Clinical Services, Oslo University Hospital, PB 4950 Nydalen, Oslo, 0424, NorwayDepartment of Cardiac and pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldberg's Hospital, Ragnar Strøms Veg 10, Jessheim, 2067, NorwayDepartment of Nursing and Health Promotion, Oslo Metropolitan University, PB 4 St.Olavs plass, Oslo, 0130, Norway; European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital and University of Oslo, PB 4950, Nydalen, Oslo, 0424, NorwayBackground and aims: Adherence to treatment is a significant challenge for patients with cardiac disease. Optimizing health literacy (HL) is essential in this context. Mobile health (mHealth) interventions have been suggested to improve both treatment adherence and HL. This study aimed to examine the effect of a one-year mHealth intervention on HL and to compare HL changes between the intervention- and the control group. Methods: This randomized controlled trial included patients completing cardiac rehabilitation, who were randomly allocated to either an intervention group receiving individualized follow-up via an app for one year or a control group receiving usual care. From one-year follow-up to the five-year follow-up, both groups received usual care. HL was measured using the HLS-Q12. Mixed model for repeated measurements and Wilcoxon signed rank test were used to analyse differences between groups, while paired sample t-test and Kendall's Tau b correlation analysed within-group changes. Results: A total of 113 patients were included in the study. No statistically significant differences between the groups were found in total HLS-Q12 score or at item level at any follow-up. However, a statistically significant within-group improvement was observed in the intervention group for the total score (mean change of 2.5 ± 4.6, p < 0.01) and several HLS-Q12 items from baseline to one-year follow-up. Conclusions: The one-year mHealth intervention did not show an effect on HL levels at one- or five-year follow-ups. However, significant within-group HL improvement from baseline to one-year follow-up suggests that mHealth interventions may have the potential to enhance HL.http://www.sciencedirect.com/science/article/pii/S2772487525000832Health literacyCardiac rehabilitationSecondary preventionmHealthRandomized controlled trial
spellingShingle Pernille Lunde
Hanne Søberg Finbråten
Are Hugo Pripp
Birgitta Blakstad Nilsson
Jostein Grimsmo
Asta Bye
Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up
International Journal of Cardiology. Cardiovascular Risk and Prevention
Health literacy
Cardiac rehabilitation
Secondary prevention
mHealth
Randomized controlled trial
title Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up
title_full Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up
title_fullStr Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up
title_full_unstemmed Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up
title_short Effect of a mHealth intervention on health literacy in patients completing cardiac rehabilitation: A randomized controlled trial with one- and five-year follow-up
title_sort effect of a mhealth intervention on health literacy in patients completing cardiac rehabilitation a randomized controlled trial with one and five year follow up
topic Health literacy
Cardiac rehabilitation
Secondary prevention
mHealth
Randomized controlled trial
url http://www.sciencedirect.com/science/article/pii/S2772487525000832
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