Development of a Health Behavioral Digital Intervention for Patients With Hypertension Based on an Intelligent Health Promotion System and WeChat: Randomized Controlled Trial.

BACKGROUND: The effectiveness of timely medication, physical activity (PA), a healthy diet, and blood pressure (BP) monitoring for promoting health outcomes and behavioral changes among patients with hypertension is supported by a substantial amount of literature, with "adherence" playing a pivotal role. Nevertheless, there is a lack of consistent evidence regarding whether digital interventions can improve adherence to healthy behaviors among individuals with hypertension. OBJECTIVE: The aim was to develop a health behavioral digital intervention for hypertensive patients (HBDIHP) based on an intelligent health promotion system and WeChat following the behavior change wheel (BCW) theory and digital micro-intervention care (DMIC) model and assess its efficacy in controlling BP and improving healthy behavior adherence. METHODS: A 2-arm, randomized trial design was used. We randomly assigned 68 individuals aged >60 years with hypertension in a 1:1 ratio to either the control or experimental group. The digital intervention was established through the following steps: (1) developing digital health education materials focused on adherence to exercise prescriptions, Dietary Approaches to Stop Hypertension (DASH), prescribed medication, and monitoring of BP; (2) using the BCW theory to select behavior change techniques; (3) constructing the intervention's logic following the guidelines of the DMIC model; (4) creating an intervention manual including the aforementioned elements. Prior to the experiment, participants underwent physical examinations at the community health service center's intelligent health cabin and received intelligent personalized health recommendations. The experimental group underwent a 12-week behavior intervention via WeChat, while the control group received routine health education and a self-management manual. The primary outcomes included BP and adherence indicators. Data analysis was performed using SPSS, with independent sample t tests, chi-square tests, paired t tests, and McNemar tests. A P value <.05 was considered statistically significant. RESULTS: The final analysis included 54 participants with a mean age of 67.24 (SD 4.19) years (n=23 experimental group, n=31 control group). The experimental group had improvements in systolic BP (-7.36 mm Hg, P=.002), exercise time (856.35 metabolic equivalent [MET]-min/week, P<.001), medication adherence (0.56, P=.001), BP monitoring frequency (P=.02), and learning performance (3.23, P<.001). Both groups experienced weight reduction (experimental: 1.2 kg, P=.002; control: 1.11 kg, P=.009) after the intervention. The diet types and quantities for both groups (P<.001) as well as the subendocardial viability ratio (0.16, P=.01) showed significant improvement. However, there were no statistically significant changes in other health outcomes. CONCLUSIONS: The observations suggest our program may have enhanced specific health outcomes and adherence to health behaviors in older adults with hypertension. However, a longer-term, larger-scale trial is necessary to validate the effectiveness. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2200062643; https://www.chictr.org.cn/showprojEN.html?proj=172782. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/46883.

Relative validity of an indirect calorimetry device for measuring resting energy expenditure and respiratory quotient.

BACKGROUND AND OBJECTIVES: Resting energy expenditure (REE) and respiratory quotient (RQ) are important for optimal nutritional care. The purpose of this study was to assess the accuracy and repeatability of an indirect calorimetry device (IIM-IC-100) in the measurement of REE and RQ in healthy Chinese adults. METHODS AND STUDY DESIGN: A total of 38 healthy adults (19 male and 19 female) aged 18-52 years (25±6 years) were enrolled in this study. REE and RQ were measured by IIM-IC-100 and by VO2000, alternately and in duplicate. RESULTS: There was a highly significant correlation between IIM-IC-100 REE and VO2000 REE (r=0.906, p<0.001), with mean IIM-IC-100 REE significantly higher than that of VO2000 (1475±269 vs 1394±313 kcal/d, p=0.002). Bland- Altman analysis revealed that the mean difference between IIM-IC-100 REE and VO2000 REE was 81.3 kcal/d, with limits of agreement of -185 to +347 kcal/d. There was no significant difference in RQ between the two devices. No significant differences were observed between the repeated measurements for both devices. Intrasubject coefficients of variation (CVs) of REE were smaller for IIM-IC-100 (5.8%) than for VO2000 (10.5%), while CVs of RQ were similar for IIM-IC-100 (7.2%) and VO2000 (6.9%). CONCLUSIONS: These preliminary data indicated that the IIM-IC-100 showed promise as an accurate and precise tool in the assessment of REE and RQ in healthy Chinese adults.