@Article{info:doi/10.2196/60676,
author="Lockwood, Kimberly G
and Kulkarni, Priya R
and Branch, OraLee H
and Graham, Sarah A",
title="Cardiac Self-Efficacy Improvement in a Digital Heart Health Program: Secondary Analysis From a Feasibility and Acceptability Pilot Study",
journal="JMIR Form Res",
year="2025",
month="Apr",
day="24",
volume="9",
pages="e60676",
keywords="digital health; self-efficacy; behavior change; prevention; cardiovascular health; digital heart health; lifestyle; heart health; health coaching; mobile phone",
abstract="Background: Lifestyle modification programs play a critical role in preventing and managing cardiovascular disease (CVD). A key aim of many programs is improving patients' self-efficacy. In-person lifestyle modification programs can enhance self-efficacy in managing CVD risk, also known as cardiac self-efficacy (CSE). However, such programs are typically staffing and resource intensive. Digital lifestyle modification programs may offer a scalable and accessible way to improve CSE, but this has not been shown in prior research. Objective: This study examined changes in CSE among individuals using a digital lifestyle modification program for cardiovascular health. Evaluation of improvement in CSE was a secondary goal of a feasibility and acceptability pilot study of a digital program for Heart Health. Methods: Participants were individuals with elevated risk for CVD who enrolled in a 90-day pilot study that involved mobile app--based, artificial intelligence--powered health coaching and educational lessons focused on behaviors that promote cardiovascular health. Participants completed the 9-item CSE Scale at baseline and in month 2. Changes in confidence in participants' ability to manage their cardiovascular health were assessed. Results: The sample included 273 (n=207, 61.2{\%} female; mean age 59.3, SD 10.1 years) participants who submitted a complete CSE Scale at baseline and in month 2. The total CSE Scale score increased by 12.9{\%} (P<.001) from baseline to month 2. Additionally, there were significant increases in mean score on each of the 9 individual CSE Scale items (all P<.001), with the largest increases in confidence ``in knowing when to call or visit the doctor for your heart disease'' (17{\%} increase; P<.001), ``in knowing how much physical activity is good for you'' (16.3{\%} increase; P<.001), and ``that you can get regular aerobic exercise'' (19{\%} increase; P<.001). Conclusions: The present analyses indicate that participants in a digital lifestyle modification program for cardiovascular health showed significant improvements in CSE within 2 months. This work adds to the growing literature examining ways to improve health-related self-efficacy and scalable access to programs for prevention and management of CVD. ",
issn="2561-326X",
doi="10.2196/60676",
url="https://formative.jmir.org/2025/1/e60676",
url="https://doi.org/10.2196/60676"
}