By Pedja Klasnja
Bad habits are hard to change. New Year’s resolutions quickly crumble. Dieters can slip back into old eating habits once they achieve their weight goal. And survivors of severe cardio trauma often return to the unhealthy behaviors that led to their heart attacks in the first place. Finding ways to counter that last behavior is the goal of UMSI Assistant Professor Pedrag “Pedja” Klasnja, who has received a $1.9 million grant from the National Institutes of Health to develop and test a new mobile health application to support heart-disease patients in adopting — and sustaining — healthy habits.
Typically, after a heart attack, patients are referred to a rehabilitation program, which includes treadmill exercise and healthy eating classes. The bulk of their rehab program focuses on physical activity, the area on which Klasnja’s study will focus.
Research shows over 50% of patients stop their post-op therapy exercise program after their rehab program ends. But within two years of not exercising, patients are back at their original level of risk. The trouble is that three to four months after the cardiac incident, heart attack patients generally feel better; they go back to work, their families don’t see them as sick, and it is easy for them to resume prior eating and behavior patterns.
Klasnja and his fellow researchers are investigating ways in which mobile technology can help prevent this recidivism and testing various interventions to see which will be the most effective. His interdisciplinary team consists of two U-M statistics professors, a cardiologist and a University of Arizona psychologist.
They will develop and evaluate a personalized, adaptive mobile health application to encourage cardiac rehabilitation patients to maintain physical activity in the year following their experience of severe cardiac trauma.
Via a smartphone or wearable device, the patient would receive reminders about the need for physical activity. The patient would have tools that allow them to reflect on their situation and find ways to be active in a sustainable way, such as parking one’s car farther from a destination in order to get in more walking.
The app will be individualized and researchers will look at criteria such as what times of day are best to contact each patient. “We don’t want the patient to be annoyed when we ping them,” Klasnja says.
“Ultimately, we are studying how to effect behavior change, how to get patients to shift from one health objective to another. I am interested in designing effective interventions, in improving our theories of behavior and understanding of factors that affect human behavior.”
Study participants will be recruited through U-M’s Cardiac Rehab program and patients will need physician approval to participate. The study begins by encouraging patients to walk more, ideally reaching 10,000 steps a day. The app can be modified to cover a broader range of activity, such as getting in 75 minutes of weekly physical activity.
“Understanding the psycho-social mechanisms at work to maintain healthy behaviors is a goal of this study,” he says. He hopes his findings will have a larger impact in understanding and working with other health challenges, such as weight reduction. “What we do can have a very direct effect on people’s health. And we can do it at scale — that can touch a lot of people.”