Avatar-based discharge education mobile application for Chinese-speaking patients with heart attacks

INTERVENTION: 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 Si XSteps 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 si Xmodules of evidence‐based essential information the Heart Foundation recommends for heart attack survivors and their families. These si Xmodules 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 si Xmodules. 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 m CONDITION: Cardiovascular ‐ Coronary heart disease cardiovascular; ; cardiovascular PRIMARY OUTCOME: Coronary heart disease knowledge[Coronary Artery Disease Education Questionnaire (short version) Baseline, one month and three months post‐baseline] Knowledge, attitude and belief of acute coronary syndrome[Acute Coronary Syndrome (ACS) Response Index Baseline, one‐month, three‐months post‐baseline] 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. SECONDARY OUTCOME: App acceptability[App User Survey developed by the research team One month post‐baseline] App feasibility[Data analytics Three months post‐baseline] Barriers and facilitators of implementation[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. Three months post‐baseline] Cardiac‐related hospital admission[Self‐report or family‐report using the Follow‐Up Survey Form developed by the research team One month and three months post‐basedline] Cardiac‐related mortality[Self‐report or family‐report using the Follow‐Up Survey Form developed by the research team One month and three months post‐baseline] Health‐related quality of life[EQ‐5D‐5L Three months post‐baseline] Healthcare utilisation[Self‐reported using the Follow‐Up Survey Form developed by the research team One month and three months post‐baseline] Self‐management behaviours[Coronary Artery Disease Self‐Management Scale (CSMS) Three months post‐baseline]