The process evaluation of MyHeartMate: How did they really use it?

Abstract

Introduction: The MyHeartMate (MHM) app is a codesigned gamified smartphone app for cardiovascular disease secondary prevention. The MHM app uses gamified elements to encourage behaviour change. The results of a recent randomised control trial (RCT) showed MHM had limited effectiveness in changing secondary prevention behaviours. This study reports the process evaluation results to understand why MHM had limited effectiveness in this population.   Methods: The process evaluation included: 1) app data logs of use of app components: baseline data entry, data tracking, and missions undertaken; and 2) self-reported surveys on frequency and duration of use. MHM was expected to have an effect after 30 days of usage.   Results: 196 participants were allocated to MHM, age 60.9±11.9 years, 81.4% male. App data logs showed diabetes and smoking status were most often entered at baseline (80.4% of those allocated to MHM), whereas data tracked most often to 30 days was body mass index at 24.7%. Of the eight mission domains, healthy eating was completed most often for at least 4 days (47.5%). 63.9% of participants completed self-reported surveys. The most common frequency of use was twice a week (34.3%) and the length of use was 5 minutes (33.1%). Of all participants, 26.5% used the app for ≥30 days.   Conclusion: Use of the MHM app was extremely varied though few engaged for sufficient time to achieve an intervention effect (≥30 days). A gamified app did not engage most participants and therefore the target audience for MHM requires further clarification.