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Effectiveness of Applying Green Heart, a Smartphone-Based Self-Management Intervention to Control Smoking: A Randomized Clinical Trial Publisher Pubmed



Ghavami M1 ; Abdshah A2 ; Ahmadi A3 ; Akbarzadeh D4 ; Mofidi A4 ; Ashoorkhani M5 ; Sadeghian S1
Authors
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Authors Affiliations
  1. 1. Cardiovascular Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
  3. 3. Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Archives of Iranian medicine Published:2024


Abstract

BACKGROUND: Cardiovascular diseases (CVDs) pose a significant global health concern and are the most common cause of death and disability, necessitating preventive interventions targeting modifiable risk factors. Recently, mobile-health technology has been developed to improve the delivery of cardiovascular prevention by risk factor modification. The Green Heart mobile application (app) was designed to aid in risk factor control among coronary artery disease (CAD) patients. METHODS: This parallel-group, single-blinded randomized controlled trial enrolled 1590 CAD patients, including 668 current smokers, randomly assigned to control (paper-based education) and intervention (application-based) groups. The app encompassed three modules targeting smoking cessation, dyslipidemia control, and blood pressure management. This study evaluated the impact of the smoking cessation module on behavioral change among current smokers. Green Heart assesses nicotine dependence, offering personalized quit plans, educational content, motivational messages, and automated progress tracking. The odds of smoking behavior changes during the 24-week follow-up underwent assessment. RESULTS: The intention-to-treat analysis highlighted significantly elevated rates of smoking cessation and reductions in the intervention group versus the control group. Adherence to the app (per-treatment analysis) also demonstrated significantly more favorable smoking behavior changes among the application users. Logistic regression emphasized higher odds of quitting and reduction in smoking in the application group, showing an odds ratio of 2.14 (95% CI: 1.16-3.97) compared to those not using the app (P=0.015). CONCLUSION: Our results confirmed that complete adherence to the app for at least 24 weeks was linked to alterations in cigarette smoking behavior among CAD patients. Trial Registration Number: IRCT20221016056204N1. © 2024 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.