Dr. Ying Wu’s research team, iCARE, at the Capital Medical University School of Nursing, Beijing, China, developed an Intelligent Cardiovascular Application for Risk Elimination (iCARE) for patients with coronary heart disease (CHD). The iCARE has two end-users, patients and care providers, and also includes a cloud platform. The iCARE system has acceptable usability when it was used by patients to manage their CVD in real-time and was perceived as being satisfactory, useful, and easy to use. The iCARE system was effective in facilitating unhealthy lifestyle changes and medication adherence at 6-month and 12-month follow-up among patients with CHD.
The iCARE project was supported by the National Natural Science Foundation of China. The purpose of the iCARE project is to create an Individualized, Intelligent, Integrated Cardiovascular Application for Risk Elimination management and evaluate its effectiveness on health behavior changes and risk factor modifications. To create the system, by following the intervention mapping (IM) approach, the iCARE research team used scientific methods and developed a decision support system (the iCARE system), which includes five steps:
- Developing a behavior change theory for patients with CHD, named as the “Contemplation-Action-Maintenance, CAM” model in guiding the project;
- Developing a set of knowledge bases, rules, interventions, that are necessary for fostering health behavior changes. Based on the computer tailoring method, a set of “IF-THEN” rules were developed to trigger interventions in correspondence with each moderator in different phases of the behavior change process in accordance with the CAM model, by taking patient’s specific conditions, preferences, CVD risk factors, and treatment benefits into account;
- Developing the iCARE system by working with a technology team;
- Testing the usability and acceptability of the iCARE system among patients with CHD. The usability testing of iCARE system includes two stages: task analysis and a usability evaluation;
- Evaluating the effectiveness of the iCARE on health behavior changes and risk factor elimination through a large-scale, multi-center parallel-group, open-label, randomized controlled clinical trial from 2019 to 2025 in Beijing, China.
The development process, the results of the usability test, and the effectiveness evaluation of the iCARE system can be found in the recording Global Perspectives in Cardiovascular Nursing (2021) under Best Practices and Local Applications of Clinical Work.
For more information regarding the iCARE project, please read the following articles published by our team.
- Yue, P., Wu, Y.*, Zhang Y. Chen Yl, Li J, Xu YH, Liu YS. Contemplation-action-maintenance model of behaviour change for persons with coronary heart disease: A qualitative study. Journal of Clinical Nursing. 2021 May;30(9-10):1464-1478. DOI: 10.1111/jocn.15699
- Yuling Chen, Fangqin Wu, Ying Wu (corresponding author), et al. Development of theory- and evidence-based, individualized, and intelligent interventions to promote the adoption and maintenance of healthy diet and physical activity in patients with coronary heart disease. BMC Public Health, 2019;19:1311.
- Yuling Cheng#, Meihua Ji#, Ying Wu*, Qingyu Wang, Ying Deng, Yong Liu, Fangqin Wu, Mingxuan Liu, Yiqiang Guo, Ziyuan Fu, Xiaoying Zheng. An Intelligent Individualized Cardiovascular App for Risk Elimination (iCARE) for Individuals with Coronary Heart Disease: Development and Usability Testing Analysis. JMIR mHealth and uHealth. 2021;9(12):e26439 URL: https://mhealth.jmir.org/2021/12/e26439，DOI: 10.2196/26439
- Yuling Cheng#, Meihua Ji#, Ying Wu*, Qingyu Wang, Yiqiang Guo, Tiane Guo, Zijia Jiang, Mingxuan Liu, Ziyuan Fu. Individualized mobile health interventions for cardiovascular event prevention in patients with coronary heart disease: study protocol for the iCARE randomized controlled trial. BMC Cardiovascular Disorders, 2021 December.