# An innovative mobile health intervention to improve self-care in patients with heart failure

> **NIH NIH R21** · UNIVERSITY OF ILLINOIS AT CHICAGO · 2020 · $207,064

## Abstract

Abstract
More than 6.5 million people have heart failure (HF) in the United States and 960,000 new cases are reported
annually. HF is associated with high mortality and hospitalization rates, high costs, and poor health-related
quality of life (HRQL). Despite major improvements in outcomes with medical and surgical therapy, admission
rates following a HF-related hospitalization remain high with 25% of patients readmitted to the hospital within
30-days and up to 50% readmitted within 6 months. Previous research shows that adherence to routine HF
self-care behaviors reduces the risk of all-cause mortality and hospitalization, and improves HRQL. However,
self-care has generally been found to be poor among HF patients, particularly minority
populations. Nonadherence to HF symptom monitoring and medication use is remarkably high even among
recently discharged patients hospitalized for an HF exacerbation. Recent advances in consumer-based mobile
health (mHealth) technologies, such as smartphones, mobile health apps, wearable sensors, and other
connected health devices, offer scalable and affordable solutions for promoting better HF self-care and
expanding delivery of care services to communities that are difficult to reach. Leveraging our team's
interdisciplinary expertise in this emerging area, we developed an innovative, patient-centered intervention
(iCardia4HF) that promotes adherence to HF self-care through the use of commercial mHealth tools.
iCardia4HF consists of: (1) a patient-centered mHealth app (developed in partnership with the Heart Failure
Society of America) that interfaces with multiple connected health devices and comprises a number of self-
monitoring, patient education, and adherence reminder tools for improving self-care; and (2) individually
tailored text-messages (TMs) targeting health beliefs, self-care efficacy, and HF-knowledge. We propose a
pilot randomized controlled trial (RCT) with 92 HF patients randomized 1:1 to iCardia4HF or an attention
control group receiving the same connected health devices as the intervention group for 12 weeks, but without
the mobile app and TMs. Specific aims are to: 1) assess the feasibility and acceptance of iCardia4HF; 2)
examine the preliminary efficacy of iCardia4HF on objectively assessed measures of HF self-care using real-
time data from the connected health devices and app, as well as self-reported Self-Care and HRQL; track the
number of hospitalizations and emergency room (ER) visits over 12 weeks; and 3) examine the mediating
effect of intervention target variables (health beliefs, self-care efficacy, and HF-knowledge) and impact of
independent patient factors on HF self-care. This study represents an important step in identifying an
affordable and scalable mHealth intervention that has the potential to bring about a new paradigm in self-care
management of HF. Data collected from this study will help us further refine the intervention, and provide the
scientific basis for a future R01-...

## Key facts

- **NIH application ID:** 9986898
- **Project number:** 5R21NR018281-02
- **Recipient organization:** UNIVERSITY OF ILLINOIS AT CHICAGO
- **Principal Investigator:** Spyros Kitsiou
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $207,064
- **Award type:** 5
- **Project period:** 2019-08-01 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9986898

## Citation

> US National Institutes of Health, RePORTER application 9986898, An innovative mobile health intervention to improve self-care in patients with heart failure (5R21NR018281-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9986898. Licensed CC0.

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