Protocol summary

Study aim
Design,production and effectiveness of educational-supportive mobile application for atherosclerotic disease risk factors primary prevention based on integrated behavior change model
Design
Clinical trial for control group with parallel and single-blind groups,Randomized using random blocks method,Third phase on 430 people, website https://www.sealedenvelope.com was used for randomization
Settings and conduct
Residents of10 health centers of Tehran are selected by cluster sampling method and with a risk score 2.5-15% are referred Tehran Heart Center Hospital by cardiologist then groups,content and application are determined using quadrupled random blocks and systematic educational design.Application on people's mobile is installed.Reminder SMS and 3 consultation calls will be done after one month and during 6 months sequentially.At the beginning and 6 months later,in both groups,researcher-made questionnaire is completed based on integrated behavior change model and cardiac risk factors structures.One-sided blinding is done for data analyzer.
Participants/Inclusion and exclusion criteria
Inclusion criteria:to have two or more risk factors,A risk score of 2.5-15% of cardiovascular disease risk assessment,Age 18 to 75.Exclusion criteria: Presence of cardiovascular diseases,Other chronic diseases and mental diseases and physical disabilities
Intervention groups
Intervention group will receive an educational-supportive package as mobile application,SMS reminder and counseling calls as three calls during 6 months for CVD risk factors control besides routine care based behavior model and control group will receive routine care at first and 6 months after intervention
Main outcome variables
Awareness,motive and behavior,Mobile application using satisfaction,BMI,Adherence to a healthy diet,Physical activity,Blood pressure,Blood sugar,Triglysirid,Total cholesterol,LDL,HDL,Stress control,Smoking.

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20200321046826N1
Registration date: 2021-11-05, 1400/08/14
Registration timing: registered_while_recruiting

Last update: 2021-11-05, 1400/08/14
Update count: 0
Registration date
2021-11-05, 1400/08/14
Registrant information
Name
afsaneh aein
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 21 6612 7769
Email address
aein.a@tak.iums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2021-09-23, 1400/07/01
Expected recruitment end date
2022-04-18, 1401/01/29
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Design, implementation, and evaluation of mobile application based on integrated behavior change model for primary prevention of atherosclerotic coronary artery disease risk factors.
Public title
Evaluation of the effectiveness of education with a mobile application on the prevention of atherosclerotic coronary artery diseases risk factors
Purpose
Prevention
Inclusion/Exclusion criteria
Inclusion criteria:
Have two or more risk factors for coronary artery atherosclerosis include an unhealthy diet, physical inactivity, high blood pressure, high blood fats, high blood sugar, obesity, smoking. Obtain a risk score of 2.5-15% based on cardiovascular disease risk assessment. 75 - 18 years old Have a desire to participate in the study Have a smartphone or tablet Have the ability to work with mobile applications Intention to stay at the place of study for the next one year
Exclusion criteria:
History of cardiovascular diseases Physical disability Existence of other chronic diseases Mental Disease
Age
From 18 years old to 75 years old
Gender
Both
Phase
3
Groups that have been masked
  • Outcome assessor
  • Data analyser
Sample size
Target sample size: 430
Randomization (investigator's opinion)
Randomized
Randomization description
Permuted block randomization method will be used in this study to randomize the samples. Blocking is used to balance the number of samples assigned to each of the study groups. This feature helps researchers in cases where the need for intermediate analysis during the sampling process in this method, the number of people assigned to each group is almost equal. In this method, blocks are formed based on the considered variables and within each block, half of the people are involved and half are considered as controls. The main goal of this method is to balance the number of participants in each group. The size of all blocks is equal and we will have 108 blocks of 4 in this two-group experiment (including 2 participants in the intervention group and 2 participants in the control group). Random allocation sequence and list of blocks will be obtained by the statistical consultant with the help of software. The website https://www.sealedenvelope.com is a useful site for generating random sequences for block randomization. This site is designed in such a way that there is no limit to the number of groups for random allocation. The 4-volume block method is used to create a random allocation sequence. According to the total number of samples required for the study, which is 430 patients (215 patients in the intervention group (A) and 215 patients in the control group (B), 108 quadruple blocks including two groups A and B were randomly selected through design software. It can be like ..... (ABAB), (BBAB), (AABB), (ABBA), (BAAB). Based on the sample size, 430 envelopes (215 envelopes containing paper containing A) and (215 envelopes containing paper Contains B) Based on the list of randomly prepared quadruple blocks, a trained person outside the research team is responsible for randomly assigning participants, after each participant enters, according to the 108 quadruple blocks prepared in the first stage. Each patient will be randomly assigned to group A (intervention) or B (control group) and the sampling process will be performed consecutively until the end of sampling. For example, according to the block (ABAB), after obtaining the informed consent of each person after entering the study, he/she enters the intervention, control, intervention, and control groups, respectively. The rain block will continue. Then, to hide the random allocation, non-transparent envelopes with random sequences (Sequentially numbered, sealed opaque envelopes) will be used. It will be written and placed in envelopes in order. The production of the allocation sequence and the preparation of the envelopes based on it will be done by a person not involved in the research. It is noteworthy that in the process of performing random allocation, the specialist has created a random sequence statistic, the cardiologist will examine the participants in terms of inclusion and exclusion criteria and will include them in the study and the researcher allocate participants' intervention and control group. Then, in order to hide the random allocation, non-transparent envelopes with random sequence (Sequentially numbered, sealed opaque envelopes) will be used. It will be written and placed in envelopes in order. The production of the allocation sequence and the preparation of the envelopes based on it will be done by a person not involved in the research. It is noteworthy that in the process of performing random allocation, the specialist has created a random sequence statistic, the cardiologist will examine the participants in terms of inclusion and exclusion criteria and will include them in the study and the researcher will send the participants to the group. Will allocate intervention and control measures.
Blinding (investigator's opinion)
Single blinded
Blinding description
This study is a single-blind controlled trial that includes the control group (not receiving the intervention) and the first intervention group (receiving training with mobile software). In this way, the outcome can be measured objectively. Due to the nature of the study and the fact that the researcher performs the educational intervention and also the participants are aware of the type of training they receive (routine clinic training or mobile training program) it is not possible to blind the participants and the researcher. In this intervention, to prevent possible bias in the results of the study, all samples will be screened by a cardiologist who is not aware of how the samples are placed in the intervention and control groups. The score-2 will be determined at the beginning of the study and individuals with a risk score of 2.5 to 15% will be included in the study. Also, in this study, the data analyzer is blinded and will not be aware of how individuals are assigned to groups and the method used for training. Then, to hide the random allocation, non-transparent envelopes with random sequences (Sequentially numbered, sealed opaque envelopes) will be used. It will be written and placed in envelopes in order. The production of the allocation sequence and the preparation of the envelopes based on it will be done by a person not involved in the research. It is noteworthy that in the process of performing random allocation, the specialist has created a random sequence statistic, the cardiologist will examine the participants in terms of inclusion and exclusion criteria and will include them in the study and the researcher allocate participants' intervention and control group.
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
National Ethics System in Biological Research
Street address
Floor 13, Block A, Ministry of Health & Medical Education Headquarters, Between Zarafashan & South Falamak, Qods Town, Tehran, Iran. Website Statistics
City
Tehran
Province
Tehran
Postal code
۱۴۴۹۶۱۴۵۳۵
Approval date
2018-10-28, 1397/08/06
Ethics committee reference number
IR.IUMS.REC.1397.932

Health conditions studied

1

Description of health condition studied
Atherosclerotic coronary artery disease
ICD-10 code
I25.0
ICD-10 code description
Atherosclerotic cardiovascular disease

Primary outcomes

1

Description
Knowledge score about risk factors for coronary artery atherosclerotic disease
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Researcher-made questionnaire on knowledge of risk factors for atherosclerotic coronary heart disease

2

Description
Risk perception score on risk factors for atherosclerotic coronary heart disease
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Researcher-made risk perception questionnaire about risk factors for atherosclerotic coronary heart disease

3

Description
Attitude score on risk factors for atherosclerotic coronary artery disease
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Researcher-made attitude questionnaire about risk factors for atherosclerotic coronary heart disease

4

Description
Perceived self-efficacy score on risk factors for atherosclerotic coronary heart disease
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Researcher-made perceived self-efficacy questionnaire on risk factors for coronary atherosclerotic disease

5

Description
Perceived social support score on risk factors for coronary artery atherosclerotic disease
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Researcher-made social support questionnaire on the risk factors for coronary atherosclerotic disease

6

Description
Score of preventive behavior on risk factors for atherosclerotic coronary artery disease
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Researcher-made preventive behavior questionnaire on risk factors for atherosclerotic coronary heart disease

7

Description
Satisfaction with the use of mobile application
Timepoint
Six months after the intervention
Method of measurement
User Experience Questionnaire(UEQ) - Persian Version

Secondary outcomes

1

Description
Blood pressure
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Mercury sphygmomanometers

2

Description
Triglyceride
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Spectrophotometry

3

Description
Low density lipoprotein (LDL)
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Spectrophotometry

4

Description
High Density Lipoprotein (HDL)
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Spectrophotometry

5

Description
Cholesterol
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Spectrophotometry

6

Description
Fasting blood sugar
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Spectrophotometry

7

Description
Body Mass Index (BMI)
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Calibrated weights, meters to measure height

8

Description
Weight
Timepoint
Before the intervention and six months after the intervention
Method of measurement
Digital scales

9

Description
healthy eating habits
Timepoint
Before the intervention and six months after the intervention
Method of measurement
National Survey Questionnaire on non-communicable diseases risk factors-WHO STEPS Instrument

10

Description
physical activity
Timepoint
Before the intervention and six months after the intervention
Method of measurement
International Physical Activity Questionnaire - Short Form (IPAQ)

11

Description
smoking
Timepoint
Before the intervention and six months after the intervention
Method of measurement
National Survey Questionnaire on non-communicable diseases risk factors-WHO STEPS Instrument

12

Description
Mental health
Timepoint
Before the intervention and six months after the intervention
Method of measurement
European Society of Cardiology (ESC) psychosocial screening instrument

Intervention groups

1

Description
Intervention group: The intervention includes three phases: pre-test, content education, and post-test. Pre-tests in both intervention and control groups are sent to their mobile phones as an online questionnaire. During a meeting, the members of the intervention group are introduced to the objectives of the study, and the expectations of the study team are raised from them. The application is installed on their mobile phones and how to work with it will be explained in the first face-to-face visit to Tehran Heart Center Hospital. The educational content in the intervention group will be activated immediately after completing the pre-test form. For 6 months at any time and place have access to educational content based on the needs assessment and recommendations of classes AI, IIA, IB guidelines of primary prevention of heart disease. From the first month, weekly behavioral reminder messages will be sent. One month later, 3 months later, and 5 months later, telephone counseling and follow-up will be provided. At the end of 6 months, access to educational content will be automatically disabled. And the link to receive the post-test by the researcher is sent immediately, 6 months after the educational intervention to both intervention and control groups.
Category
Prevention

2

Description
Control group: will receive the usual treatment. Common office treatments include clinical and laboratory evaluation, answering the patient's questions, prescribing the previous drug or changing the medication, and explaining how to use it according to the patient's condition and the specialist physician and education in the office.
Category
Prevention

Recruitment centers

1

Recruitment center
Name of recruitment center
Tehran Heart Center Hospital
Full name of responsible person
Dr.Ali Vasheghani Farahani
Street address
Tehran - North kargar avenue - Corner of Jalal Al-Ahmad Highway - Tehran Heart Center - Tehran Heart Center Hospital
City
Tehran
Province
Tehran
Postal code
1411713138
Phone
+98 21 8802 9600
Email
avasheghani@tums.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Primary Prevention of Cardiovascular Diseases Research Center, Tehran University of Medical Sciences
Full name of responsible person
Dr.Ali Vasheghani Farahani
Street address
North Kargar-Ave, Jalal-e-Al-e-Ahmad Hwy,Tehran Heart Center Hospital
City
تهران
Province
Tehran
Postal code
14117 13138
Phone
+98 21 8802 9600
Email
avasheghani@tums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Primary Prevention of Cardiovascular Diseases Research Center, Tehran University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Afsaneh Aein
Position
Student
Latest degree
Ph.D.
Other areas of specialty/work
Health Promotion
Street address
Shahid Hemmat Highway Between Sheikh Fazl Allah Nouri and Shahid Chamran Iran University of Medical Sciences
City
Tehran
Province
Tehran
Postal code
1449614535
Phone
+2166947769
Email
AFSANEH.AEIN@GMAIL.COM

Person responsible for scientific inquiries

Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Dr Mahnaz Solhi
Position
Professor
Latest degree
Ph.D.
Other areas of specialty/work
Health Promotion
Street address
Shahid Hemmat Highway between Sheikh Faz Allah Nouri and Shahid Chamran Iran University of Medical Sciences
City
Tehran
Province
Tehran
Postal code
1449614535
Phone
+2186704758
Fax
Email
solhi.m@iums.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Afsaneh Aein
Position
Student
Latest degree
Ph.D.
Other areas of specialty/work
Health Promotion
Street address
Shahid Hemmat Highway between Sheikh Fazl A .. Nouri and Shahid Chamran Iran University of Medical Sciences
City
تهران
Province
Tehran
Postal code
1449614535
Phone
+2166127769
Email
afsaneh.aein@gmail.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
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