Behavior Change

1. Behavior Change in heart failure patients AdetaniaPramanik Durga Kudtarkar Shubhshankar M. Sankachelvi

2. SRD Significance sodium restricted diet • 25% of heart failure (HF) related patients were readmitted • Limiting sodium intake is one of the ways of readmission prevention for HF patients. • However, it is difficult for patients to understand how to manage and change their daily sodium intake

3. Background Heart Failure • Most common cause HF: coronary artery disease (narrowing the blood vessels that supply the heart) • Conditions that contribute to HF: obesity, diabetes, smoking, hypercholesterolemia, hypertension,… • Is a progressive, chronic disease

4. Background • Functional classification(NYHA): • Four stages of HF(ACC / AHA): • Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities. • Stage A: high risk for HF but no functional or structural heart disorder • Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion. • Stage B: a structural heart disorder but no symptoms at any stage • Class III: marked limitation of any activity; the patient is comfortable only at rest. • Stage C: an underlying structural heart problem, but managed with medical treatment • Stage C: an underlying structural heart problem, but managed with medical • Class IV: any physical activity brings on discomfort and symptoms occur at rest. • Stage D: hospital-based support, a heart transplant or palliative care.

5. Risk Factors Cannot be changed Can be treated

6. Treatment Plan

7. Nutritional Diet • Sodium intake < 3,000 mg/day • Lesser HF symptoms • What does 1500, 2300 or 3000 mg/day mean? • Low salt doesn’t mean low sodium

8. SRD sodium restricted diet • Understanding sodium content of food • Lack of food selection • Food preparation habits • Fast foods and convenience products • Understanding the symptoms of HF • Literacy • Co-morbidities • Depression: worse self-care & poorer prognosis

9. SRD sodium restricted diet

10. The Problem • How can we assist HF patients in understanding their appropriate daily • sodium intake and motivate them to • bring about a • behavior change?

11. Solution 1 informative hospital food + interactive packaging

12. Solution 1 informative hospital food

13. Solution 1 interactive packaging

14. Related Work • How to Nudge In Situ: Designing Lambent Devices to deliver Information Salience in Supermarkets • http://mapawatt.com/2009/10/07/list-of-energy-monitoring-tools/ • http://daeyoon-scale-industrial-co.tradenote.net/images/users/000/195/393/products_images/567029.jpg

15. Solution 2 Trust Labels, not taste buds = Difficult to follow everyday

16. Solution 2 Apps to monitor sodium intake Milk, fluid, 1% fat, without added vitamin A and vitamin D on-line global nutrition information www.nal.usda.gov/fnic/foodcomp/search/

17. Solution 2 App architecture design Mobile device Scan QR code Intuitive output Input: QR code or text Client server communication Data retrieval Web server USDA Database

18. Solution 3 Dietary Recall systems Track daily sodium consumption and provide feedback. Frequently consumed items Questionnaire Timing Quantity

19. Solution 4 Food recommendations

20. Thanks