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Prog Cardiovasc Dis. 2016 May-Jun;58(6):584-94. doi: 10.1016/j.pcad.2016.02.007. Epub 2016 Feb 26.

The Wild Wild West: A Framework to Integrate mHealth Software Applications and Wearables to Support Physical Activity Assessment, Counseling and Interventions for Cardiovascular Disease Risk Reduction.

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Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Exercise is Medicine Global Research and Collaboration Center, Emory University, Atlanta, GA, USA. Electronic address:
Emory Clinical Cardiovascular Research Institute and Emory University School of Medicine, Atlanta, GA, USA.
Division of Hospital Medicine and Chief Research Information Officer, Emory University School of Medicine and Medical Director for Analytics, Emory Healthcare, Atlanta, GA, USA.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Ciccarone Center for the Prevention of Heart Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Kinesiology, Iowa State University, Ames, IA, USA.


Physical activity (PA) interventions constitute a critical component of cardiovascular disease (CVD) risk reduction programs. Objective mobile health (mHealth) software applications (apps) and wearable activity monitors (WAMs) can advance both assessment and integration of PA counseling in clinical settings and support community-based PA interventions. The use of mHealth technology for CVD risk reduction is promising, but integration into routine clinical care and population health management has proven challenging. The increasing diversity of available technologies and the lack of a comprehensive guiding framework are key barriers for standardizing data collection and integration. This paper reviews the validity, utility and feasibility of implementing mHealth technology in clinical settings and proposes an organizational framework to support PA assessment, counseling and referrals to community resources for CVD risk reduction interventions. This integration framework can be adapted to different clinical population needs. It should also be refined as technologies and regulations advance under an evolving health care system landscape in the United States and globally.


Cardiovascular disease; Clinical counseling; Mobile health; Physical activity; Population health management

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