The effect of a WeChat-based gamification intervention on the self-management ability of patients with coronary heart disease: pilot randomized controlled trial (Preprint)

BACKGROUND A healthy lifestyle is an essential component of the successful treatment of coronary heart disease. Despite manifest evidence for the many health benefits of lifestyle changes, it is difficult for patients to achieve sustained changes in health behaviors. There is evidence that mHealth-based gamified interventions can promote health behavior change in patients, but studies in China are scarce. OBJECTIVE The study aimed to evaluate the effect of an 8-week WeChat-based gamified intervention on self-management ability compared with a waiting control group in Chinese CHD patients. METHODS A single-blind randomized controlled trial of CHD patients in Beijing, from November 2022 to February 2023. The primary outcome was coronary self-management behavior, measured using the Coronary Self-Management Behavior Scale. After recruitment at the Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, 86 patients were randomly assigned to the intervention and control groups. The intervention group received an 8-week WeChat-based gamification intervention, and the control group received the usual care. A total of 2 assessments were conducted, 1 at the beginning of the intervention (T1, N=86) and 1 at the end of the 8-week intervention (T2, N=74). RESULTS Eligible patients (N=86) were randomized to the intervention (n=43) or the control (n=43) group. 74 patients eventually completed the clinical pilot study, including 38 in the trial and 36 in the control groups. Participants were predominantly male (47/74, 63.5%), and retiree (28/74, 37.8%), with a mean age of 63.2 ± 9.7 years. A significant treatment effect in favor of the intervention was observed for the primary outcome at 8 weeks (P=.03). The intervention group reported significantly greater knowledge level and self-efficacy (P＜.001 and P=.03, respectively). CONCLUSIONS Patients’ self-management ability, disease knowledge, and self-efficacy can be improved by a WeChat-based gamified intervention that focuses on self-management. Such an intervention provides a viable means of self-management for patients with coronary heart disease and a reference for self-management of other chronic diseases. CLINICALTRIAL the name of registry: The effect of a WeChat-based gamification intervention on the self-management ability of patients with coronary heart disease: study protocol of a randomized controlled trial registration number:ChiCTR2200067108 URL of the registry:https://www.chictr.org.cn/showproj.html?proj=178392