Can a behavioural smartphone application decrease sedentary behaviour in cardiac rehabilitation?: the ToDo-CR feasibility study.

Study design The feasibility study will be conducted over 6-months within the Canberra Hospital Cardiac Rehabilitation (CR) program. Participants will be assessed on admission and at the end of the 6-week traditional phase II hospital-based CR program. They will also complete a follow-up assessment post discharge from the CR program, approximately 6-months post admission to the CR program. Intervention On entry into the CR program, eligible participants will be given a Fitbit Flex, shown how to install the ToDo and Moves apps on their smartphone and how to use them by an exercise physiologist. Participants will be required to wear the Fitbit Flex for the 6-month study period and will be able to keep the Fitbit Flex on completion of the study. ToDo is a cloud-based behaviour change service delivered through a smartphone application created by Onmi in collaboration with Do Something Limited and is currently being trialed in Europe. The ToDo program helps people learn new behaviours so they have more choice over how they react to different situations. The system suggests micro behavioural alternatives that gradually change people’s habits. This is based on evidence that these small behavioural changes effect health outcomes. Each program is personalised and consists of different types of Do’s: Core Do’s and Data Driven Do’s. CORE Do’s address the individual’s psychology and the factors that often prevent healthy changes. DATA DRIVEN Do’s, address their everyday context that traps them in habitual behaviour, fusing data from the Fitbit Flex (acceleration) and the Moves app (GPS) to create a comprehensive digital profile of the individual, with near real-time analysis algorithms. At the intake of the program a set of diagnostic questions will be answered by the patient on the Do Something Different website. The unique program of behavioural prompts (Do’s) will be based on the person’s answers to the diagnostic questions. For a duration of one week baseline measurements will be collected. This is used to calibrate the program triggers for sending Data driven Do’s. The calibration uses absolute and relative behaviour (i.e. actual amount of steps and relative increases or decreases). The system computes variable scores based on the persons behaviour. When the system identifies a need for improvement, an appropriate Do is sent. By combining technology, evidence-based guidelines and psychology, the program aims to increase the patient’s self-efficacy, with the goal to decrease their sedentary behaviour and increase their moderate-vigorous physical activity.