title: The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction.
abstract: Physical activity (PA) interventions constitute a critical component of cardiovascular disease (CVD) risk reduction programs. Objective mobile health (mHealth) software applications (apps) and wearable activity monitors (WAMs) can advance both assessment and integration of PA counseling in clinical settings and support community-based PA interventions. The use of mHealth technology for CVD risk reduction is promising, but integration into routine clinical care and population health management has proven challenging. The increasing diversity of available technologies and the lack of a comprehensive guiding framework are key barriers for standardizing data collection and integration. This paper reviews the validity, utility and feasibility of implementing mHealth technology in clinical settings and proposes an organizational framework to support PA assessment, counseling and referrals to community resources for CVD risk reduction interventions. This integration framework can be adapted to different clinical population needs. It should also be refined as technologies and regulations advance under an evolving health care system landscape in the United States and globally.
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Exercise is Medicine Global Research and Collaboration Center, Emory University, Atlanta, GA, USA. Electronic address: felipelobelo@emory.edu.
authors.forename: Felipe
authors.initials: F
authors.lastname: Lobelo
authors.affiliation: Emory Clinical Cardiovascular Research Institute and Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Heval M
authors.initials: HM
authors.lastname: Kelli
authors.affiliation: Division of Hospital Medicine and Chief Research Information Officer, Emory University School of Medicine and Medical Director for Analytics, Emory Healthcare, Atlanta, GA, USA.
authors.forename: Sheri Chernetsky
authors.initials: SC
authors.lastname: Tejedor
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Pratt
authors.affiliation: Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: McConnell
authors.affiliation: Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: Department of Kinesiology, Iowa State University, Ames, IA, USA.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Welk
mesh_terms: D001292:Attitude to Computers; D020811:Biomedical Technology / Q000295:instrumentation / Q000639:trends*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016494:Computer Security; D003219:Confidentiality; D003376:Counseling / Q000639:trends*; D019033:Delivery of Health Care, Integrated / Q000639:trends*; D004059:Diffusion of Innovation; D015444:Exercise; D005544:Forecasting; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D000070497:Healthy Lifestyle; D006801:Humans; D063731:Mobile Applications / Q000639:trends*; D010342:Patient Acceptance of Health Care; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D017216:Telemedicine / Q000295:instrumentation / Q000639:trends*; D057188:Workflow
keywords: Cardiovascular disease; Clinical counseling; Mobile health; Physical activity; Population health management