Edinburgh Napier University

  Background and aim: Low participation in cardiac rehabilitation (CR) means alternative strategies are urgently required to ensure secondary prevention of cardiovascular disease (CVD). Digital games promote behaviour change in other diseases, however, they have not been tested in CVD. The aim was to develop an innovative evidence-based digital game to engage patients in secondary prevention of CVD.

Methods: An iterative design process involving key stakeholders (patients, app developers, cardiologists, nurse researchers, CR nurses, physiotherapist, dietitian, and Heart Foundation representative). The two-month process included (i) Literature search and review of available apps; (ii) concept and design review by consumers; (iii) coding of evidence-based guidelines to inform real-world challenges. Through this process, the MyHeartMate app was developed.

Results: The literature review identified that mobile apps have potential to improve CVD risk factors. Only two studies were found that incorporated gamification strategies (e.g leaderboards, rewards for goal achievement) in their mobile app, although no studies were found which evaluated a digital game. Similarly, no digital games were found in iOS or Android top-100 CVD apps. Ninety real-world challenges were created from evidence-based guidelines for consumer completion. Consumer feedback determined aesthetics of the app. The eventual MyHeartMate app is an interactive digital game in which the health of the heart (Figure) is influenced by real-world actions undertaken by the participant.
Conclusion: A robust design process informed the development of an innovative evidence-based digital game platform for secondary prevention of CVD. This may provide an additional strategy to engage patients who do not participate in CR.