โก Quick Summary
The implementation of the CHAMP digital health intervention aims to enhance self-monitoring of hypertension through a patient-facing chatbot and AI-augmented clinical decision support. This initiative seeks to optimize deployment strategies across primary care centers, potentially improving chronic disease management for millions.
๐ Key Details
- ๐ Target Population: 31% of the global adult population affected by hypertension
- ๐ค Technology: AI-based chatbot and clinical decision support system
- ๐ Study Duration: Ongoing implementation studies
- ๐ Methodology: Rapid evidence review, mixed methods study, and strategy development
๐ Key Takeaways
- ๐ก CHAMP is designed to support chronic disease self-management.
- ๐ Three interlinked studies will evaluate implementation strategies and effectiveness.
- ๐ฃ๏ธ Stakeholder Engagement: Interviews with healthcare providers and patients are integral to the study.
- ๐ Evidence-based strategies will be developed to facilitate CHAMP’s implementation.
- ๐ Potential for scale-up across primary care centers in Singapore.
- ๐ Ethics Approval: Secured for initial studies, with ongoing patient interviews pending.
- ๐ Registration: The evidence review protocol is registered on PROSPERO (CRD42024613653).
๐ Background
Hypertension is a significant global health concern, affecting approximately 31% of adults worldwide. The rise of digital health interventions, particularly those utilizing artificial intelligence, presents a promising avenue for enhancing self-management of chronic conditions. The CHAMP initiative aims to leverage these technologies to empower patients in managing their hypertension effectively.
๐๏ธ Study
The CHAMP project encompasses three interlinked studies aimed at optimizing the intervention’s deployment in primary care settings. The first study involves a rapid evidence review to identify factors influencing the implementation of mobile health and chatbot interventions. The second study employs mixed methods to assess the current state of CHAMP’s deployment and identify barriers and facilitators. Finally, the third study focuses on developing actionable implementation strategies based on insights gained from the previous studies.
๐ Results
As of now, the evidence review protocol has been registered, and the team has completed the initial phases of screening. Ethics approval has been obtained for the formative study, and semistructured interviews with healthcare providers and leadership have commenced. The team is currently awaiting approval to begin patient interviews, which will further inform the implementation process.
๐ Impact and Implications
The successful implementation of CHAMP could significantly enhance the management of hypertension in primary care settings, potentially alleviating pressure on healthcare systems. By integrating digital health solutions, we can improve patient engagement and self-management, ultimately leading to better health outcomes and a more efficient healthcare delivery model.
๐ฎ Conclusion
The CHAMP initiative represents a significant step forward in the realm of digital health interventions for chronic disease management. By focusing on implementation strategies and stakeholder engagement, this project has the potential to transform how hypertension is managed in primary care settings. Continued research and adaptation will be crucial in realizing the full benefits of this innovative approach.
๐ฌ Your comments
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Implementation of a Digital Health Intervention (CHAMP) for Self-Monitoring of Hypertension: Protocol for 3 Interlinked Implementation Studies.
Abstract
BACKGROUND: Hypertension affects 31% of the global adult population. Artificial intelligence-based chatbots may support self-management of hypertension and other chronic disorders. Chronic Disease Management Program (CHAMP) is a digital health intervention designed to support chronic disease self-management, comprising a patient-facing chatbot and an artificial intelligence-augmented clinical decision support system linked to electronic medical records.
OBJECTIVE: This project aims to optimize the deployment of CHAMP across primary care centers by developing implementation strategies and pilot-testing their appropriateness and effectiveness.
METHODS: We report 3 interlinked studies. Study 1 is a rapid evidence review to evaluate the factors influencing the implementation of mobile health and chatbot interventions in health care settings and the strategies and processes involved. We will follow the Cochrane Rapid Reviews Methods Group methodology and use the Consolidated Framework for Implementation Research and the unified theory of acceptance and use of technology frameworks to analyze the data. Study 2 is a formative, mixed methods study to inform the state of CHAMP deployment to date, the organizational structure of primary care centers, and the barriers and facilitators influencing the implementation and scale-up of CHAMP in primary care centers. We will interview members of the CHAMP development and initial implementation team, health care providers (HCPs), primary care centers’ leadership, and patient users and nonusers of CHAMP; conduct 1-day on-site visits to primary care centers; and assess the readiness to change among HCPs using validated questionnaires. Study 3 involves the development of implementation strategies for the implementation of CHAMP in primary care centers. We will develop a process map informed by the findings of studies 1 and 2 to outline the patient journey; map the barriers and facilitators influencing the implementation of CHAMP; and develop a set of implementation strategies to effectively implement CHAMP using the Expert Recommendations for Implementing Change taxonomy to define the implementation strategies and the action, actor, context, target, and time framework to define the strategy implementation processes. In parallel, we will use evidence-based behavioral science to test variations of the chatbot’s messages to increase patient engagement.
RESULTS: To date, the evidence review protocol (study 1) has been registered on PROSPERO. We have completed title and abstract screening and are in the full-text screening phase. For study 2, we obtained ethics approval and conducted the semistructured interviews with HCPs, primary care centers’ leadership, and members of the CHAMP development and initial implementation team. We are awaiting institutional review board approval to start the interviews with patients.
CONCLUSIONS: The study results will inform the further implementation and scale-up of CHAMP across primary care centers in Singapore. Successful implementation of digital health interventions to support self-management of chronic disorders may improve health care delivery without further straining health care systems.
TRIAL REGISTRATION: PROSPERO CRD42024613653; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024613653.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/72942.
Author: [‘Martinengo L’, ‘Ha NHL’, ‘Tay E’, ‘Tong SC’, ‘Sevdalis N’]
Journal: JMIR Res Protoc
Citation: Martinengo L, et al. Implementation of a Digital Health Intervention (CHAMP) for Self-Monitoring of Hypertension: Protocol for 3 Interlinked Implementation Studies. Implementation of a Digital Health Intervention (CHAMP) for Self-Monitoring of Hypertension: Protocol for 3 Interlinked Implementation Studies. 2025; 14:e72942. doi: 10.2196/72942