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Trial registered on ANZCTR
Registration number
ACTRN12624000408583
Ethics application status
Approved
Date submitted
19/03/2024
Date registered
4/04/2024
Date last updated
28/07/2024
Date data sharing statement initially provided
4/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Avatar-based discharge education mobile application for Chinese-speaking patients with heart attacks
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Scientific title
Efficacy of a culturally adapted avatar-based discharge education mobile application to improve disease knowledge and attendance at cardiac rehabilitation in Chinese-speaking patients after acute coronary syndrome (ACS)
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Secondary ID [1]
311769
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None
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Universal Trial Number (UTN)
None
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
cardiovascular
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Condition category
Condition code
Cardiovascular
329967
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is an self-administered mobile application. This Mandarin version application was culturally adapted from the initial English version application, which is based on the Heart Foundation’s Six Steps to Cardiac Recovery'. During the adaptation process, bilingual clinicians and Chinese-speaking patients were heavily involved to ensure linguistic and cultural appropriateness, particularly, in the process of the storyboard translation and prototype development. For example, a number jokes used in the original English version were removed or replaced as they were not culturally appropriate for the Chinese.
Within the application, a Chinese-speaking avatar nurse talks and leads the patient through six modules of evidence-based essential information the Heart Foundation recommends for heart attack survivors and their families.
These six modules include:
1) understanding diagnosis/procedures,
2) knowing heart disease risk factors,
3) attending cardiac rehabilitation,
4) taking medications,
5) knowing warning signs and actions,
6) following ongoing medical review.
It will take approximately 40 minutes to complete six modules. The mode of training used in the intervention includes interactive activities and short videos.
In a single session of no more than 30 minutes, the researcher will assist participants in the intervention group to download and install the app on their personal smartphone or tablet before discharge and ensure participants are familiar with the app and its functions. Participants will have access to the app during the three months study period in addition to their usual care. Participants will have unlimited access to all the modules as many times as they like. Participants can go through the app in their own pace, which means that they do not need to complete all six modules in one attempt. Participants in the intervention groups are encouraged to contact the researcher if they experience any technical issues with the app during the study period.
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Intervention code [1]
328222
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Rehabilitation
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Comparator / control treatment
The control group will receive usual hospital care, which includes usual discharge education, medical follow-up and rehabilitation.
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Control group
Active
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Outcomes
Primary outcome [1]
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Coronary heart disease knowledge
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Assessment method [1]
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Coronary Artery Disease Education Questionnaire (short version)
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Timepoint [1]
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Baseline, one month and three months post-baseline
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Primary outcome [2]
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Knowledge, attitude and belief of acute coronary syndrome
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Assessment method [2]
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Acute Coronary Syndrome (ACS) Response Index
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Timepoint [2]
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Baseline, one-month, three-months post-baseline
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Secondary outcome [1]
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Cardiac-related hospital admission
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Assessment method [1]
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Self-report or family-report using the Follow-Up Survey Form developed by the research team
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Timepoint [1]
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One month and three months post-basedline
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Secondary outcome [2]
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Healthcare utilisation
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Assessment method [2]
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Self-reported using the Follow-Up Survey Form developed by the research team
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Timepoint [2]
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One month and three months post-baseline
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Secondary outcome [3]
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Health-related quality of life
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Assessment method [3]
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EQ-5D-5L
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Timepoint [3]
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Three months post-baseline
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Secondary outcome [4]
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Self-management behaviours
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Assessment method [4]
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Coronary Artery Disease Self-Management Scale (CSMS)
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Timepoint [4]
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Three months post-baseline
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Secondary outcome [5]
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App acceptability
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Assessment method [5]
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App User Survey developed by the research team
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Timepoint [5]
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One month post-baseline
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Secondary outcome [6]
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App feasibility
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Assessment method [6]
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Data analytics
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Timepoint [6]
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Three months post-baseline
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Secondary outcome [7]
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Barriers and facilitators of implementation
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Assessment method [7]
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Interview (individual interview and focus group)
Semi-structured interview will be used. Participants can choose to take part in a one-on-one face-to-face interview or a focus group with a maximum of 6 participants in each group.
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Timepoint [7]
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Three months post-baseline
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Secondary outcome [8]
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Cardiac-related mortality
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Assessment method [8]
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Self-report or family-report using the Follow-Up Survey Form developed by the research team
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Timepoint [8]
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One month and three months post-baseline
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Eligibility
Key inclusion criteria
Inclusion criteria:
1) >=18 years;
2) admitted to the participating hospitals with a diagnosis of ACS (unstable angina, myocardial infarction);
3) being discharged home;
4) speak Chinese (Mandarin); and
5) have a personal smartphone/tablet, which has software capable of downloading the app.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
1) critically unwell;
2) have severe co-existing medical conditions that would impede or prevent engagement in lifestyle behaviour change e.g. dementia or terminal illness
3) unable to give consent; and
4) unable to understand, speak or read basic Chinese.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
central randomisation computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
22/07/2024
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Actual
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Date of last participant enrolment
Anticipated
30/09/2024
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Actual
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Date of last data collection
Anticipated
31/01/2025
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Actual
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Sample size
Target
72
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Sydney - Faculty of Medicine and Health Bright Ideas Grant/China Studies Center Individual Research Project Support Grant
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Sydney
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
318269
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Country [1]
318269
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Western Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
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https://www.wslhd.health.nsw.gov.au/Education-Portal/Research/ethics-governance
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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18/01/2024
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Approval date [1]
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11/03/2024
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Ethics approval number [1]
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2024/ETH00110
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Summary
Brief summary
This study aims to assess the effectiveness of a culturally adapted avatar-based education app in improving coronary heart disease knowledge and uptake of cardiac rehabilitation among Chinese-speaking patients with acute coronary syndrome (ACS) admitted to hospitals. We will conduct a randomised, controlled trial to compare an avatar-based education app to usual care. Adults admitted to Westmead, Royal Prince Alfred, and St George Hospitals with a diagnosis of ACS in the current admission will be invited to participate. Participants randomised to the intervention group will be given a link to download the app to their smartphone or tablet. During the study period, participants will independently work through the app's six modules, which are based on the Heart Foundation’s Six Steps to Cardiac Recovery. We hypothesize that the application will improve Chinese-speaking ACS patients disease-related knowledge, self-management behaviours and health-related outcomes such as disease recurrence, mortality, and quality of life.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Ling Zhang
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Address
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2W70, Level 2, Building D17, The University of Sydney, NSW, 2006
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Country
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Australia
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Phone
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+61 434209383
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ling Zhang
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Address
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2W70, Level 2, Building D17, The University of Sydney, NSW, 2006
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Country
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Australia
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Phone
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+61 434209383
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Fax
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Email
133163
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[email protected]
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Contact person for scientific queries
Name
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Ling Zhang
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Address
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2W70, Level 2, Building D17, The University of Sydney, NSW, 2006
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Country
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Australia
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Phone
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+61 434209383
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
21890
Study protocol
[email protected]
21891
Informed consent form
[email protected]
21892
Ethical approval
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF