The effect of education using the interactive avatar application on self-care and the ability to identify and respond to the symptoms of heart attack in patients with acute coronary syndrome: a randomized clinical trial

BMC Health Serv Res. 2025 Apr 21;25(1):572. doi: 10.1186/s12913-025-12756-z.

Abstract

Background: This study aimed to assess the effectiveness of an interactive avatar application in enhancing self-care behaviors and improving recognition and response to heart attack symptoms among patients with Acute Coronary Syndrome (ACS).

Methods: A non-blinded, two-arm, randomized controlled trial was conducted with 78 ACS patients randomly allocated to either an intervention group or a control group. The control group received conventional education, while the intervention group received conventional education supplemented with training via an interactive avatar application. The application provided guidance on self-care practices, recognition of heart attack symptoms, and appropriate responses. Data were collected at baseline, 1 month, and 3 months post-discharge using demographic questionnaires, the Self-Care of Coronary Heart Disease Inventory, and the ACS Response Index. Statistical analyses included chi-square tests, independent samples t-tests, and Mann-Whitney U tests.

Results: At the 3-month follow-up, participants in the intervention group exhibited significantly higher scores on both the Self-Care of Coronary Heart Disease Inventory and ACS Response Index compared to the control group (P < 0.05). Furthermore, during the 3-month follow-up period, all patients in the intervention group (100%) ceased activity and took sublingual nitroglycerin upon experiencing heart attack symptoms, compared to 80% in the control group.

Conclusions: The interactive avatar application proved effective in improving knowledge, attitudes, beliefs, and self-care behaviors among ACS patients. This innovative educational tool holds promise for enhancing patient outcomes in ACS management.

Trial registration: This study was registered at the Iranian Registration Clinical Trial Center (Code: IRCT20220920056001N1, Date: 2023-01-03).

Keywords: Acute coronary syndrome; Avatar education application; Heart attack; Mobile health intervention; Patient education; Self-care.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Coronary Syndrome* / diagnosis
  • Acute Coronary Syndrome* / therapy
  • Aged
  • Avatar
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction* / diagnosis
  • Myocardial Infarction* / therapy
  • Patient Education as Topic* / methods
  • Self Care* / methods
  • Surveys and Questionnaires