None listed
Conditions
Brief summary
This is a 24-week pilot randomised controlled trial of a community-based cardiac rehabilitation (CR) program for Chinese migrants in Australia. A total of 24 participants will be randomly allocated in a 1:1 ratio to the intervention or waitlist control group. People in the intervention group will be offered a CR program virtually in entirety for 24 weeks, including health education via text messages, Shared Medical Appointment (SMA), and online live Tai Chi. Participants in the waitlist control group will be given no intervention during their wait period and will be encouraged to keep their normal lifestyle and physical activity. They will receive the same CR program after their wait period. The objectives of this project are: (1) To assess the feasibility of the co-designed community-based CR program for Chinese migrants in Australia of a wider trial by measuring its adoption rate. (2) To examine the effects of the co-designed CR program on improving health outcomes among cardiac patients from Chinese migrants in Australia. (3) To explore the cost effectiveness of the community-based co-designed CR program for Chinese migrants in Australia. The expected outcomes of this pilot randomised controlled trial include: • This pilot randomised controlled trial will quantify the feasibility, cost-effectiveness, and effectiveness of the co-designed, culturally sensitive community-based CR program. • The findings from this pilot trial will be interpreted as indicators of the potential value of a fully powered randomised controlled trial and other implementation and cost-effectiveness studies for CR among Chinese migrants in Australia and other western countries.
Interventions
Participants will be given a community-based cardiac rehabilitation program for 24 weeks. This program was co-designed through a qualitative study by our research team, health care practitioners, Tai Chi instructors and patients from Chinese migrants. It includes health education via text messages, programmed Shared Medical Appointment, and online live Tai Chi class.
Participants will receive 4 messages per week (Monday to Friday between 9am to 5pm) for 24 weeks. The text message is semi-perso
Participants will be given a community-based cardiac rehabilitation program for 24 weeks. This program was co-designed through a qualitative study by our research team, health care practitioners, Tai Chi instructors and patients from Chinese migrants. It includes health education via text messages, programmed Shared Medical Appointment, and online live Tai Chi class. Participants will receive 4 messages per week (Monday to Friday between 9am to 5pm) for 24 weeks. The text message is semi-personalised, in simplified Chinese and traditional Chinese, covering topics of diet/nutrition, physical activity, smoking cessation, and general cardiac rehabilitation knowledge. Each message will take around 10 seconds to 40 seconds to read. For example, ‘[Preferred Name], research shows eating 2 serves of fruit & 5 serves of veggies reduces your risk of heart disease, stroke, diabetes & some cancers’. The messages will be semi-personalised. For example, only participants who are smokers will receive messages relevant to quitting smoking. The messages will be delivered by TextCare, a text message service developed by Westmead Applied Research Centre, University of Sydney by clinicians and researchers. It is a system that delivers customised messages to participants with their consent and provides a channel for communication, support, and education. The co-design process of the text messages included: a. Selecting messages in English from an existing text messages bank in TextCare developed based on behaviour change techniques and national cardiac rehabilitation guidelines, b. Refining messages according to the expert review including academics, clinicians, and Tai Chi instructors, c. Translating text messages from English into simplified and traditional Chinese, d. Conducting a community review via survey to collect consumer feedback, e. Finalising Chinese message based on consumer feedback, and f. Programming and pilot testing the delivery of text messages. Participants will attend the one-off Shared Medical Appointment (SMA) group session and one-on-one session, which takes approximately up to 2 to 3 hours in total. The group session lasts 90 minutes. Participants will have 60 minutes with a cardiologist for consultation and 30 minutes with allied health practitioners (a dietitian and a physiotherapist) for general education in a group setting. In addition, participants will have additional one-on-one consultations with the nurse and allied health practitioners outside of the SMA group session. Each session lasts a maximum of 30 minutes. All sessions will be held after regular business hours on weekdays at 6pm (UTC+11) via zoom meetings. The sessions will be delivered in Mandarin (with Cantonese translation if necessary). All healthcare providers are familiar with the study design and be trained with the use of zoom meetings and the SMA approach. Participants will attend online live Tai Chi class two times per week for 24 weeks. The class will be held on Tuesday and Thursday at 8am (UTC+11) via zoom meetings. Each class lasts 60 minutes. The contents include walking, standing posture, cloud hands and 6-form Chen-style Tai Chi. Class attendance will be recorded by the Tai Chi instructor in each class and reasons for missed sessions will be tracked by phone. Participants will be required to practice in an adequately spacious and safe place (at least 2 square meters) and guided by an experienced Tai Chi instructor with more than 15-year experience and two teaching assistants. Participants will receive instruction in self-monitoring during the practice. Close supervision will also be applied by the Tai Chi instructor and two teaching assistants. Participants are allowed to progress at their own pace, and have a rest when necessary, during the class. Participants are encouraged to practice at least three days outside of group class at home and record home practice in a participant diary. Home practice may take around 10 minutes to one hour daily depending on preference. Participants are encouraged to have a carer or helper nearby when doing Tai Chi practice at home. A WeChat group would be set up for participants in the intervention group to increase social support to participants and ensure timely feedback from the Tai Chi instructor and the teaching assistants to support participants’ home practice.
Sponsors
Western Sydney University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Aged 18 years old or above. • Are an Australian citizen or permanent resident. • Are of Chinese ancestry, speak Mandarin or Cantonese at home, and can read Chinese (traditional or simplified). • Experienced at least one of the following conditions or events: o myocardial infarction, o heart failure, or o coronary artery disease with recent revascularisation with coronary artery bypass graft (CABG), or coronary angioplasty/stenting. • Being discharged home for at least 12 weeks. • Are willing and able to give written informed consent. • Have a mobile phone and the capacity to receive and understand text messages. • Have access to the internet.
Exclusion criteria
Participants will be excluded if they: • have being diagnosed cognitive impairment or terminal illness by a medical doctor, • are regular Tai Chi practitioner or have practiced Tai Chi within 3 months, • are enrolled in another active research project, or • new (within the last 8 weeks) symptoms of breathlessness, chest discomfort, palpitation, syncope, or presyncope, documented change in resting ECG, uncontrolled resting hypertension (systolic BP > 180mmHg and/or diastolic BP > 110mmHg); • have any orthopaedic limitations that would significantly limit exercise participation.
Outcome results
None listed