For a study, researchers sought to develop a relational agent, which was an interactive intervention based on smartphones and was accessible regardless of the user’s level of digital or health literacy, to support people living in rural areas of Western Pennsylvania who had Atrial fibrillation (AF) in their efforts to self-manage their chronic disease. The “Mobile health intervention for rural atrial fibrillation” was a single-center, parallel-arm randomized clinical trial for adults with AF funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health to enroll 264 participants. The trial would be conducted in rural areas. Every single member would receive a smartphone equipped with a data plan: The intervention consists of a relational agent that was worn for 4 months, coupled with an AliveCor Kardia for the monitoring of heart rate and rhythm that was provided by a smartphone, and the control consisted of a smartphone-based application that was pre-installed and provided health-related information (WebMD). In addition, individuals who would not normally be likely to participate in clinical research due to their rural location were invited to participate in the study through remote recruiting and engagement methods. The level of adherence to oral anticoagulation was the primary focus of the study, and it was evaluated based on the proportion of days covered after 1 year. The secondary outcomes are the secondary outcomes of the quality of life, both in general and in terms of AF specifically, and the consumption of medical services. A baseline visit, an intervention phase that lasts for 4 months, and follow-up visits at 8 and 12 months were all part of the study. In the context of mobile health, this trial investigated whether or not a relational agent accessible through a smartphone could successfully improve clinical and patient-reported outcomes in people living in rural areas.

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