MedicinemedRxiv
Ranked by formulaVerdict: MajorEffectiveness of a mHealth nutrition and lifestyle intervention (mHENAL) in reducing Cardiovascular Disease Risk in Sri Lankan adults: A Randomized Control Trial
Cardiovascular diseases (CVD) are the leading cause of global mortality, responsible for 17.8 million deaths and 423 million prevalent cases annually.
Key numbers
- 10.0% to 6.2%
- 11.0% to 9.7%
- 89.6% meeting minimum daily requirements
Caveats
- Preprint; not yet peer reviewed.
VerdictA leading story on any desk.
Abstract
Cardiovascular diseases (CVD) are the leading cause of global mortality, responsible for 17.8 million deaths and 423 million prevalent cases annually. While the etiology of CVD is multifactorial, evidence confirms that multicomponent behavioral interventions regarding diet and lifestyle can substantially reduce risk. This study aimed to evaluate the effectiveness of a 12-month mHealth intervention, i.e., public health practice supported by mobile devices in reducing the 10-year CVD risk among overweight and obese adults aged 35 to 64 in an urban Sri Lankan population. A two-group parallel-arm randomized control trial (RCT) was conducted with 1,200 participants from the Colombo district, assigned either to an intervention arm (n=600) or a usual care control arm (n=600). The intervention group received automated text and voice messages in their native language at a frequency of two of each per week over 12 months. The primary outcome, 10-year CVD risk, was assessed using the WHO CVD risk prediction score. The intervention significantly reduced the proportion of participants with a 10-year CVD risk from 10.0% to 6.2% (p=0.003), whereas no significant change was observed in the control group (11.0% to 9.7%). Participants in the mHealth arm demonstrated substantial behavioral improvements, including increasing daily fruit and vegetable servings from 3.6 to 5.5 and reducing daily salt intake from 7.64g to 5.62g. Physical activity levels also improved, with 89.6% meeting minimum daily requirements compared to 77.4% at baseline. These findings suggest a potentially beneficial effect on predicted cardiovascular risk. The study concludes that an automated mHealth intervention is an effective, feasible, and acceptable approach to reducing cardiovascular risk in an urban South Asian setting. The findings provide a robust evidence base for integrating digital health strategies into national non-communicable disease (NCD) prevention policies. While the 12-month results are promising, further longitudinal research is required to evaluate the long-term sustainability of these behavioral changes and their ultimate impact on mortality rates.
The editor's rubric
| Dimension | Level | Weight | What that level means |
|---|---|---|---|
| Leverage | ██░░░ 2 | 10% | Reusable within one subfield (a technique, dataset, or protocol a few groups will adopt). |
| Magnitude | ███░░ 3 | 20% | Large gain: roughly 2x, or a clear new state of the art on a hard, unsaturated problem. |
| Evidence | █████ 5 | 32% | Definitive: phase 3 randomized evidence on hard endpoints, multi-lab replication, or community verification at scale. |
| Novelty | ██░░░ 2 | 8% | A new combination of known ideas. |
| Trajectory | ██░░░ 2 | 5% | Some room to improve with obvious engineering. |
| Stakes | ███░░ 3 | 25% | Meaningful benefit to many people within a few years. |
Editor’s rationale
Heuristic triage from title and abstract text only, not a reading of the paper. Cues found: gains (relative gain); design (randomized, placebo-controlled); verification (p-value); stakes (global scale, mortality, prevention or cure).
How the score was computed
- Merit
- 6.8 / 10
- Adjusted merit
- 5.2 / 10
- Attention
- 0%
- Freshness
- 92%