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Workplace Digital Health Is Associated with Improved Cardiovascular Risk Factors in a Frequency-Dependent Fashion: A Large Prospective Observational Cohort Study.

Widmer RJ, Allison TG, Keane B, Dallas A, Bailey KR, Lerman LO, Lerman A - PLoS ONE (2016)

Bottom Line: DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date.Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001).The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, United States of America.

ABSTRACT
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the US. Emerging employer-sponsored work health programs (WHP) and Digital Health Intervention (DHI) provide monitoring and guidance based on participants' health risk assessments, but with uncertain success. DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date. We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a WHP across 81 organizations in 42 states between 2011 and 2014, stratified by participation log-ins categorized as no (n = 14,173), very low (<12/yr, n = 12,260), monthly (n = 3,360), weekly (n = 651), or semi-weekly (at least twice per week). We assessed changes in weight, waist circumference, body mass index (BMI), blood pressure, lipids, and glucose at one year, as a function of participation level. We utilized a Poisson regression model to analyze variables associated with increased participation. Those with the highest level of participation were slightly, but significantly (p<0.0001), older (48.3±11.2 yrs) than non-participants (47.7±12.2 yr) and more likely to be females (63.7% vs 37.3% p<0.0001). Significant improvements in weight loss were demonstrated with every increasing level of DHI usage with the largest being in the semi-weekly group (-3.39±1.06 lbs; p = 0.0013 for difference from weekly). Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001). The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate. Furthermore, participants previously underrepresented in WHPs (females and Hispanics) and those with an increased number of CVD risk factors including age and elevated BMI show increased adherence to DHI, supporting the use of this low-cost intervention to improve CVD health.

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Related in: MedlinePlus

Smartphone (left) and online (right) versions of the digital health intervention.The online version (right) shows the “Lifestyle” dashboard comprised of CVD risk factors such as smoking status, physical activity, dietary habits, and medication adherence. Patients are able to learn about these habits individually, and note their progress over time. The smartphone version (left) demonstrates the home page of the mobile platform allowing patients to navigate to any portion of the program and enter their own data.
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pone.0152657.g001: Smartphone (left) and online (right) versions of the digital health intervention.The online version (right) shows the “Lifestyle” dashboard comprised of CVD risk factors such as smoking status, physical activity, dietary habits, and medication adherence. Patients are able to learn about these habits individually, and note their progress over time. The smartphone version (left) demonstrates the home page of the mobile platform allowing patients to navigate to any portion of the program and enter their own data.

Mentions: The DHI, previously described [7], is an online and smartphone-based portal which tracks and logs, contains educational, non-commercial material, and gives the user actionable tasks to improve their health (Fig 1). Participants are instructed on uploading baseline information, then tracking and inserting their own health information as they progress through the program. Individualized care plans are offered based on medical diagnoses and comorbidities. It provides user-friendly and interactive access to health status information, tasks, targets, and plans that encourage the adoption and maintenance of a healthier lifestyle for improved wellness. Reminders to complete tasks may be received via email or SMS text messaging. The software is linked with an electronic health record affiliated with CareHere, LLC and with the respective employer, to provide continuity of information and healthcare. This record is able to capture ICD codes and medical diagnoses, medication information, demographic information, as well as vital signs/lab information. This particular program integrated with the workplace health program electronic medical record (EMR), and data gathered are a combination of patient reported and EMR-derived information.


Workplace Digital Health Is Associated with Improved Cardiovascular Risk Factors in a Frequency-Dependent Fashion: A Large Prospective Observational Cohort Study.

Widmer RJ, Allison TG, Keane B, Dallas A, Bailey KR, Lerman LO, Lerman A - PLoS ONE (2016)

Smartphone (left) and online (right) versions of the digital health intervention.The online version (right) shows the “Lifestyle” dashboard comprised of CVD risk factors such as smoking status, physical activity, dietary habits, and medication adherence. Patients are able to learn about these habits individually, and note their progress over time. The smartphone version (left) demonstrates the home page of the mobile platform allowing patients to navigate to any portion of the program and enter their own data.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836693&req=5

pone.0152657.g001: Smartphone (left) and online (right) versions of the digital health intervention.The online version (right) shows the “Lifestyle” dashboard comprised of CVD risk factors such as smoking status, physical activity, dietary habits, and medication adherence. Patients are able to learn about these habits individually, and note their progress over time. The smartphone version (left) demonstrates the home page of the mobile platform allowing patients to navigate to any portion of the program and enter their own data.
Mentions: The DHI, previously described [7], is an online and smartphone-based portal which tracks and logs, contains educational, non-commercial material, and gives the user actionable tasks to improve their health (Fig 1). Participants are instructed on uploading baseline information, then tracking and inserting their own health information as they progress through the program. Individualized care plans are offered based on medical diagnoses and comorbidities. It provides user-friendly and interactive access to health status information, tasks, targets, and plans that encourage the adoption and maintenance of a healthier lifestyle for improved wellness. Reminders to complete tasks may be received via email or SMS text messaging. The software is linked with an electronic health record affiliated with CareHere, LLC and with the respective employer, to provide continuity of information and healthcare. This record is able to capture ICD codes and medical diagnoses, medication information, demographic information, as well as vital signs/lab information. This particular program integrated with the workplace health program electronic medical record (EMR), and data gathered are a combination of patient reported and EMR-derived information.

Bottom Line: DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date.Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001).The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate.

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, United States of America.

ABSTRACT
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the US. Emerging employer-sponsored work health programs (WHP) and Digital Health Intervention (DHI) provide monitoring and guidance based on participants' health risk assessments, but with uncertain success. DHI--mobile technology including online and smartphone interventions--has previously been found to be beneficial in reducing CVD outcomes and risk factors, however its use and efficacy in a large, multisite, primary prevention cohort has not been described to date. We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a WHP across 81 organizations in 42 states between 2011 and 2014, stratified by participation log-ins categorized as no (n = 14,173), very low (<12/yr, n = 12,260), monthly (n = 3,360), weekly (n = 651), or semi-weekly (at least twice per week). We assessed changes in weight, waist circumference, body mass index (BMI), blood pressure, lipids, and glucose at one year, as a function of participation level. We utilized a Poisson regression model to analyze variables associated with increased participation. Those with the highest level of participation were slightly, but significantly (p<0.0001), older (48.3±11.2 yrs) than non-participants (47.7±12.2 yr) and more likely to be females (63.7% vs 37.3% p<0.0001). Significant improvements in weight loss were demonstrated with every increasing level of DHI usage with the largest being in the semi-weekly group (-3.39±1.06 lbs; p = 0.0013 for difference from weekly). Regression analyses demonstrated that greater participation in the DHI (measured by log-ins) was significantly associated with older age (p<0.001), female sex (p<0.001), and Hispanic ethnicity (p<0.001). The current study demonstrates the success of DHI in a large, community cohort to modestly reduce CVD risk factors in individuals with high participation rate. Furthermore, participants previously underrepresented in WHPs (females and Hispanics) and those with an increased number of CVD risk factors including age and elevated BMI show increased adherence to DHI, supporting the use of this low-cost intervention to improve CVD health.

Show MeSH
Related in: MedlinePlus