Abstract 4369438: Digital Health Intervention Boosts Health-Conscious Behaviors in Veterans with PAD Despite Technological Challenges

Abstract

Aim: To identify the key strengths and weaknesses of Smart MOVE, a 12-week virtual home-based exercise program combining exercise coaching and counseling on healthy behaviors with mobile health for veterans with symptomatic PAD, through qualitative exploration of participant experiences, focusing on the benefits and challenges of mobile technologies. Methods: Qualitative interviews were conducted with veterans who completed Smart MOVE. Interviews focused on veterans' experiences with mobile health tools—including a watch and a phone-based app that enabled two-way messaging with coaches, provided educational content, and included an electronic diary—interactions with health coaches, and overall impressions. Transcripts were coded with an a priori codebook and later revised based on emerging salient topics. Results: We interviewed 11 veterans between 2022 and 2023. Participants reported improved health-conscious behaviors, motivation to exercise, routine-setting, and a sense of accomplishment. However, they expressed frustration over limitations on sharing health vitals (e.g., heart rate, blood pressure, etc.) with other providers and a sense of failure when established goals were unmet. The health coach was consistently praised for providing personalized support and motivation. Technological components elicited mixed responses. The app and watch increased accountability and motivation by allowing participants direct access to their health vitals and step counts, but were difficult to navigate, reducing usage. Despite challenges, participants reported overall positive experiences and a strong willingness to recommend the program. Conclusion: Smart MOVE can enhance health outcomes for veterans with PAD, but technology and goal achievement challenges must be addressed. Comprehensive training sessions may improve user experience and satisfaction with the technology. Future efforts should leverage patient testimonials for recruitment, conduct long-term follow-up studies on health-conscious behavior, and expand health coaches’ roles through structured support mechanisms.