Effects of an Individualized mHealth-Based Intervention on Health Behavior Change and Cardiovascular Risk Among People With Metabolic Syndrome Based on the Behavior Change Wheel: Quasi-Experimental Study

• Published in: Journal of medical Internet research 2023-11, Vol.25 (12), p.e49257-e49257
• Main Authors: Chen, Dandan, Zhang, Hui, Wu, Jingjie, Xue, Erxu, Guo, Pingping, Tang, Leiwen, Shao, Jing, Cui, Nianqi, Wang, Xiyi, Chen, Liying, Ye, Zhihong
• Format: Article
• Language: English
• Subjects: Adult; Atherosclerosis; Behavior; Behavior change; Behavior modification; Blood pressure; Cardiovascular diseases; Cardiovascular Diseases - prevention & control; Carotid Artery Diseases - prevention & control; Change agents; Changes; Cholesterol; Clinical outcomes; Consent; Diabetes; Diet; Disease management; Efficiency; Exercise; Groups; Health Behavior; Health education; Health promotion; Health status; Heart Disease Risk Factors; Humans; Information management; Intervention; Lifestyles; Medical personnel; Mental health services; Metabolic syndrome; Metabolic Syndrome - therapy; Nurses; Nutrition research; Original Paper; Patients; Physical activity; Physical education; Professional training; Public health; Quality of Life; Quasi-experimental methods; Risk; Risk Factors; Self-efficacy; Telemedicine; Text messaging; Type 2 diabetes; Womens health
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/49257

Metabolic syndrome (MetS) is a common public health challenge. Health-promoting behaviors such as diet and physical activity are central to preventing and controlling MetS. However, the adoption of diet and physical activity behaviors has always been challenging. An individualized mobile health (mHealth)-based intervention using the Behavior Change Wheel is promising in promoting health behavior change and reducing atherosclerotic cardiovascular disease (ASCVD) risk. However, the effects of this intervention are not well understood among people with MetS in mainland China. We aimed to evaluate the effects of the individualized mHealth-based intervention using the Behavior Change Wheel on behavior change and ASCVD risk in people with MetS. We conducted a quasi-experimental, nonrandomized study. Individuals with MetS were recruited from the health promotion center of a tertiary hospital in Zhejiang province, China. The study involved 138 adults with MetS, comprising a control group of 69 participants and an intervention group of 69 participants. All participants received health education regarding diet and physical activity. The intervention group additionally received a 12-week individualized intervention through a WeChat mini program and a telephone follow-up in the sixth week of the intervention. Primary outcomes included diet, physical activity behaviors, and ASCVD risk. Secondary outcomes included diet self-efficacy, physical activity self-efficacy, knowledge of MetS, quality of life, and the quality and efficiency of health management services. The Mann-Whitney U test and Wilcoxon signed rank test were primarily used for data analysis. Data analysis was conducted based on the intention-to-treat principle using SPSS (version 25.0; IBM Corp). Baseline characteristics did not differ between the 2 groups. Compared with the control group, participants in the intervention group showed statistically significant improvements in diet behavior, physical activity behavior, diet self-efficacy, physical activity self-efficacy, knowledge of MetS, physical health, and mental health after a 12-week intervention (P=.04, P=.001, P=.04, P=.04, P=.001, P=.04, P=.04, and P