Text Messages Show Promise as Next Step for Improving Heart Health in China

Motivational text messages are a well-liked, feasible new way to provide additional support to Chinese patients with heart disease, reports a preliminary study by researchers at Yale and in China. However, the study did not prove that these targeted text messages led to an improvement in blood pressure control amongst the recipients, the intended outcome.

Published in Circulation: Cardiovascular Quality and Outcomes, this study is the first of its kind to test a text message intervention aimed at improving heart health in a developing country.

"Text messaging is a promising strategy to reach patients outside of the office," said co-lead author, Erica Spatz, Yale cardiologist and researcher at the Center for Outcomes Research and Evaluation. "Most people have a cell phone, and with patients' permission, text messaging can be used to support specific health goals. We don't have to crunch all of health care into 20-minute visit slots."

With input from psychologists and motivational interviewing experts, the researchers developed a bank of text messages that would be culturally relevant for patients with heart disease living across diverse regions of China. Both educational and motivational in content, these near-daily text messages either provided patients with facts about heart disease or encouraged them to adhere to the standard secondary prevention strategies for heart disease, including healthy diet, regular exercise, and taking prescribed medications.

Although the texts ultimately did not produce the desired health outcome in this initial study - the effect on participants' blood pressure was modest - the patients "really liked the text messages," and nearly all indicated that they wanted the messages to continue past the six-month study period, said the researchers.

"Text messaging has the potential to support cardiovascular disease prevention, especially in China - a geographically large, populous country with high rates of heart disease," said Spatz. "But we need to target the text messages to the right patients, and we need to ensure that patients have opportunities to put health messages into action."

Xin Zheng, Erica S Spatz, Xueke Bai, Xiqian Huo, Qinglan Ding, Paul Horak, Xuekun Wu , Wenchi Guan, Clara K Chow, Xiaofang Yan, Ying Sun, Xiuling Wang, Haibo Zhang, Jiamin Liu, Jing Li, Xi Li, John A Spertus, Frederick A Masoudi, Harlan M Krumholz
Effect of Text Messaging on Risk Factor Management in Patients With Coronary Heart DiseaseChemical synthesis rewriting of a bacterial genome to achieve design flexibility and biological functionality.
Circulation: Cardiovascular Quality and Outcomes. 2019;12. doi: 10.1161/CIRCOUTCOMES.119.005616.

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