The Effectiveness of a Personalised Digital Health Intervention (Naluri) on Self-Care Behaviours and Quality of Life Outcomes among Cardiac Patients at the Malaysian National Heart Institute: A Randomized Controlled Trial

INTERVENTION: Each participant will be approached individually and face‐to‐face by the researcher for consent and to complete a baseline assessment which includes the Adherence to Healthy Lifestyle Questionnaire, Hospital Anxiety and Depression Scale (HADS) and Heart Quality of Life (HeartQOL). Information on basic demographic information will be obtained and height, weight, blood pressure, HbA1c and cholesterol levels will also be measured. Participants in the intervention group will be requested to download a digital health intervention called Naluri on their smartphone. Participants will be approached individually. Participants are required to engage with the app for 16 weeks. The Naluri app consists of real‐time chat with a dedicated health coach and expert coaches such as dietitian, fitness coach, medical advisor, pharmacist and executive coach. There are over 70 daily modules which participants can complete one daily. This series of proprietary daily modules cover topics like mental readiness, diet, exercise, stress management and self‐care. There is a food journal feature that allows patients to log their daily food intake and the coaches will comment and suggest healthier alternatives. The thought journal feature encourages participants to log any helpful or unhelpful thoughts and behaviors related to those thoughts. The participants are then guided by the health coach to understand what were the underlying beliefs and emotions behind those unhelpful actions and to learn skills to eventually prevent recurrence of those behaviours. Participants are encouraged to engage the app at least 5‐10 minutes, once a day by using any of the available features of the app ‐ modules, food journal, thought journal, chat channels, progress planner. Participants are expected to complete at least the first 14 modules which looks into the baseline of participant's current diet and exercise behaviours. Subsequent modules will be recommended by the coaches. Each module takes CONDITION: Cardiovascular ‐ Coronary heart disease Coronary Heart Disease; ; Coronary Heart Disease PRIMARY OUTCOME: Change in diet as measured using the Adherence to Healthy Lifestyle questionnaire[Baseline and at 16 weeks after randomization] Change in physical activities as measured using the Adherence to Healthy Lifestyle questionnaire[Baseline and at 16 weeks after randomization] SECONDARY OUTCOME: Composite secondary outcomes consisting of height, weight, blood pressure, HbA1c and cholesterol levels. These will be measured respectively using stadiometers, weighing scales, electronic sphygmomanometers and serum assay.[Baseline and at 16 weeks after randomization] Mean score of the Hospital Anxiety and Depression Scale (HADS)[Baseline and at 16 weeks after randomization ] Quality of life as measured by HeartQOL[Baseline and 16 weeks after randomization] INCLUSION CRITERIA: • Consent to participate in research • Have been discharged from the hospital not more than four weeks after diagnosis • Smart mobile telephone users • Literate in either English or Malay.