Background Cardiac rehabilitation programs aim to avoid further progression and relapse of cardiovascular diseases (CVDs). Patients with CVDs undergoing rehabilitation often experience difficulties in integrating and transferring the learned health behaviors into their daily life after returning home. This includes regular physical activity (PA) and sufficient fruit and vegetable consumption (FVC). eHealth individualized interventions have shown to be effective in increasing PA and FVC in home settings. As WeChat is the most popular social media site in China, this should be used for the intervention. The aim of this study is to develop and examine a WeChat mini program-based intervention on PA and FVC promotion among Chinese cardiovascular patients in home-based rehabilitation. Methods The study will adopt a randomized controlled trial (RCT), comprising a WeChat mini program-based intervention group and a waiting-list control group. The intervention content will be designed based on the Health Action Process Approach (HAPA). One hundred fifty-eight outpatients will be recruited from the cardiac rehabilitation center of a hospital in southern China and randomly assigned to one of the two groups. During the 10-week duration of the intervention, participants will be invited to access a WeChat mini program comprising two Modules. Module 1 provides weekly learning sessions addressing PA and FVC simultaneously for 10 weeks. Module 2 provides a platform, where participants can review their progress with Module 1 at any time and attend incentive activities aiming at promoting engagement and retention. The outcome variables include PA (mins/week), FVC (portion/day), healthy lifestyle (the synthesis of PA and FVC), social-cognitive predictors of behavior change (risk perception, outcome expectancies, self-efficacy, intention, planning, social support, and action control) as well as health outcomes (Body mass index, depression, and quality of life). Data collection will be implemented at pre-test, post-test and a post-test after 3-month respectively. Discussion The current study will be significant to understand how such a cost-effective social media mini program-based intervention enables participants to adopt and maintain a healthy lifestyle. If it is effective, it will enrich home-based cardiac rehabilitation approaches which can in turn save the lives of patients as well as much monetary, time and other investments. Trial Registration The study was registered at ClinicalTrials.gov (Identifier: NCT03636724; Last update posted: July 28, 2020).
Background: WeChat mini program-based interventions grounded in behavioral theories show promise in promoting and maintaining healthy lifestyles among patients with cardiovascular diseases (CVDs) after hospital discharge. However, limited randomized controlled trials (RCTs) have evaluated the effectiveness of such interventions among Chinese patients with CVDs in a home-based rehabilitation context. Objective: This study aimed to assess the effectiveness of a 10-week WeChat mini program-based intervention on multiple health behaviors, including moderate to vigorous physical activity (MVPA), fruit and vegetable consumption (FVC), integrated lifestyle indicator (i.e., meeting both MVPA and FVC recommendations), psychosocial outcomes (intrinsic and extrinsic), and health-related outcomes (i.e., depressive symptoms, and perceived quality of life) among Chinese patients with CVDs. Methods: This RCT recruited 166 outpatients from a cardiac rehabilitation center in China. After screening for eligibility and randomization, 124 participants (mean age 41.60±13.48 years; 61.3% female) were allocated to either (1) the intervention group, which received a 10-week health program based on the Health Action Process Approach (HAPA), or (2) a waitlist control group, which received no intervention and maintained their usual lifestyle. Both groups completed assessments at baseline, post-intervention (10 weeks), and 3 months post-intervention. Data were analyzed using generalized linear mixed models in IBM SPSS 28.0. Results: Significant time-by-group interaction effects were observed for MVPA (F2,122=6.68, P=0.002), FVC (F2,122=18.68, P<0.001), integrated lifestyle indicator (F2,122=13.83, P<0.001), intrinsic (F2,122=11.49, P<0.001) and extrinsic psychosocial resources (F2,122=5.35, P=0.006) for MVPA, intrinsic resources for FVC (F2,122=12.66, P<0.001), and perceived quality of life (F2,122=6.99, P=0.001). The intervention group showed significant improvements in these outcomes compared to the control group, with medium-to-large effects sizes for behavior-related outcomes (d=0.57-0.88), and small-to-medium effect sizes for psychosocial and health-related outcomes (d=0.28-0.52). However, no significant effects were found for extrinsic resource for FVC (F2,122=1.37, P=0.26) or depressive symptoms (F2,122=0.44, P=0.64). Sensitivity analyses confirmed the robustness of the primary findings. Conclusions: The 10-week HAPA-based WeChat mini program intervention effectively improves MVPA, FVC, integrated lifestyle indicator, psychosocial and health-related outcomes among Chinese patients with CVDs. This intervention provides a valuable addition to rehabilitation strategies aimed at promoting long-term health and activity in cardiac patients following hospital discharge. Clinical Trial: ClinicalTrials.gov NCT03636724; https://clinicaltrials.gov/study/NCT03636724?cond=%20NCT03636724&rank=1