Getting Back on Track after a cardiac event: Trial of an online patient self-management program comparing self-directed and health-professional supported delivery options

The Australian Centre for Heart Health (ACHH) developed the Back on Track online program to support patients who have had an acute cardiac event. The program was developed using the principles of self-management, patient centred care, cognitive behaviour therapy and motivational interviewing. The Back on Track program is designed to help patients manage their health behaviours and emotional wellbeing. The online Back on Track program begins with a mandatory goal-setting module, followed by four self-selected modules relating to a) dietary change; b) physical activity and reduced sitting; c) smoking cessation; and d) cardiac blues, anxiety and depression. Each module includes written information as well as motivational interviewing tasks such as comparing advantages and disadvantages of each behaviour change, and preparing action plans and coping plans for making changes. Each module takes up to one hour to complete. This project will trial the Back on Track online program, and test two methods of program delivery – one self-directed by the patient (Group 1), and one supported with two telephone sessions with a health psychologist (Group 2). Both Group 1 and Group 2 patients will be asked to complete online modules that are relevant to them, in their own time and in any order. Group 2 patients will also be offered two telephone sessions (each up to 45 minutes duration) with a registered and experienced Health Psychologist to assist them in goal-setting and overall self-management while undertaking program modules. The health psychologist(s) will be trained by Associate Professor Rosemary Higgins who designed the Back on Track program and prepared the telephone scripts for the two support sessions. The first telephone session will occur when patients are completing the mandatory online goal-setting module. The health psychologist will use motivational interviewing strategies to support patients to articulate clear and achievable goals and to identify areas of behavioural and emotional self-management that they want to address. At completion of the first session, the second telephone session will be scheduled for a mutually agreed time. An SMS reminder will be sent 24-hours prior to each telephone session appointment to facilitate engagement. Assessing adherence. Both Group 1 and 2 participants will be asked in the post-program questionnaire to indicate which Back on Track modules they completed. In addition, website analytics will be recorded, including number of modules started and completed, number of logins, time spent online for each module. Completion and time of each telephone session will be recorded for Group 2 participants.