Development of risk profiling matrix for chronic diseases and preventive smartphone application

This project aims to promote healthy ageing through a smartphone app-based intervention, specifically, by helping people prevent the onset of cardiovascular disease and type 2 diabetes mellitus.  

Collaborators

Vera Buss supervised by Margo Barr, Mark Harris and Marlien Varnfield

Rationale

Non-communicable diseases are posing the greatest burden – in terms of morbidity and mortality as well as costs – on the worldwide healthcare systems. The number of people developing chronic diseases is still rising; therefore, it is time to increase efforts aiming at chronic disease prevention. These interventions should target prevention or at least delay the onset of the diseases. Since the current strategies seem to be insufficient, new ways need to be explored that can reach large proportions of the population. 

Aim/s

1. Which of the existing prognostic risk models for cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are suited for use by Australians aged 45 years and older to determine their risk of developing any one of these two conditions?
2. How well do lifestyle-based risk prediction models for CVD and T2DM perform in an Australian cohort aged 45 years and older?
3. What is the current evidence for CVD and T2DM prevention through mobile health interventions?
4. Is it feasible to deliver a preventative intervention for CVD and T2DM through a smartphone application to people aged 45 years and older?

Design and Method

In a scoping review, we looked at existing prognostic risk models for CVD and T2DM and assessed which of these might be suitable for Australians aged 45 years and older. Next, we identified two risk scores, one for CVD and one for T2DM, which are based on lifestyle-related predictors. We used the 45 and Up Study cohort and linked datasets to externally validate the performance of these models in the Australian setting. Simultaneously, we developed the prototype of an app for the primary prevention of CVD and T2DM. We based the app design on the theory of behaviour change and other evidence from the literature. To collate the current evidence, we performed a systematic literature review in which we evaluate the effectiveness of mobile health-based interventions for the primary prevention of CVD and T2DM.

In the next step, we will test the usability of the app in a small group of participants to ensure a user-friendly design. Then, we will assess the feasibility of an intervention that is based on the app in a single-arm observational study with three months follow-up. Recruitment will be via purposeful sampling to get a sample size of 40 participants that includes both males and females, and people aged 45-64 years and 65 years and over. We aim to use the results of the feasibility study to improve the app design and develop implementation strategies to achieve maximum uptake and overall benefit of the app. In the future, we envisage conducting an effectiveness study in which participants will be followed up over several years to measure long-term effects.

Publication

• Primary Prevention of Cardiovascular Disease and Type 2 Diabetes Mellitus Using Mobile Health Technology: Systematic Review of the Literature, Buss VH, Leesong S, Barr M, Varnfield M, Harris M, J Med Internet Res 2020;22(10):e21159; URL: https://www.jmir.org/2020/10/e21159; DOI: 10.2196/21159; PMID: 33118936

Contact

Margo Barr Phone: 02 9065 6041 Email: margo.barr@unsw.edu.au

Key Partners

The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Centre (CSIRO)