The Healthy Heart Study: Using online and mobile risk

calculators to improve cardiovascular disease prevention

The Healthy Heart Study

Screening and Test Evaluation Program (STEP)

Sydney School of Public Health

Carissa Bonner, PhD Candidate

Supervisors: Kirsten McCaffery, Jesse Jansen, Les Irwig, Ben Newell

Collaborators: Shannon McKinn, Jenny Doust, Paul Glasziou, Armando Teixeira-Pinto, Haryana Dhillon

Funding: National Health & Medical Research Council, Heart Foundation

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The problem

› CVD prevention guidelines advocate the use of absolute risk 1

› Clinicians report difficulties communicating absolute risk 2

› Probabilistic information is poorly understood by patients and clinicians 3

› Early research suggests that heart age may be more effective 4

1. Ferket BS, et al. Systematic review of guidelines on cardiovascular risk assessment which recommendations should clinicians follow for a cardiovascular health check? Arch Intern Med 2010;170:27

2. Bonner C, et al. General Practitioners' use of different assessment strategies in cardiovascular disease prevention: a qualitative study. Med J Aust 2013; 99:485

3. Visschers V, et al. Probability information in risk communication: A review of the research literature. Risk Analysis 2009;29:267

4. Soureti A, et al. Evaluation of a cardiovascular disease risk assessment tool for the promotion of healthier lifestyles. Eur J Cardiovascular Prev Rehab 2010;17:519

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The approach

› Study 1: Qualitative think aloud study of online calculators

› Study 2: Experiment to test components of online calculator

› Study 3: Experiment to test components of app calculator

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www.heartagecalculator.com

Study 1: Results of think aloud study

Study 1: Results of think aloud study

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www.knowyournumbers.co.nz

EXPECTATIONS

EXPERIENCE

EVALUATION

ACTIONIncreased knowledge

Changed risk perceptionReject results

See GP for assessmentConsider lifestyle change

Apply to others

General knowledgeSpecific knowledge

Expected info = positive reaction

Unexpected info = negative reaction

Low credibility High credibility

MatchRe

-eva

luat

eMismatch

Study 1: Results of think aloud study

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Study 2: Development of online experiment

Your risk of a cardiovascular event in the next 5 years is 11%. If you stopped smoking and had lower levels of cholesterol and blood pressure, your risk would be 3%.

Your heart age is 74, 24 years older than you. If you stopped smoking and had lower levels of cholesterol and blood pressure, your heart age would be 50, the same as your current age.

Example: 50 year old male smoker with raised blood pressure and cholesterol

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Study 3: Development of app experiment

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Collaboration

› What do we need? We would like to talk to experts in:

- The use of mobile apps for recruitment and as interventions

- The development of interactive graphics

- Online health information seeking

› What can we offer? Our team has expertise in:- Psychology: risk communication, decision making, behaviour change,

health literacy and numeracy

- Public health: screening, clinical practice guidelines, older adults

- Mixed methods: qualitative, experimental, intervention RCT, epidemiology

carissa.bonner@sydney.edu.au