Data from: A village doctor-led mobile health intervention for cardiovascular risk reduction in rural China: cluster randomised controlled trial

Objective: To assess the effectiveness of a village doctor-led mobile
health intervention on cardiovascular risk reduction among residents in
rural China. Design: Cluster randomised controlled trial. Setting:
 127 villages from five provinces and autonomous regions in
China. Participants: 4533 participants from 127 villages: 2297 (64
villages) were randomly assigned to the intervention group and 2236 (63
villages) to the control group. Participants were aged ≥35 years, had no
established atherosclerotic cardiovascular disease (ASCVD) but a predicted
10 year risk of ≥10%, had contracted a family doctor service with the
local village doctor, and owned a smart phone. Interventions: In addition
to usual clinical care and basic public health services provided for the
control group, the intervention led by village doctors included five
components: assessing risk factors to identify individualised intervention
targets, setting gradual goals based on doctor-participant communication,
providing targeted short videos on health education, conducting health
monitoring with periodic feedback, and providing motivation to reduce risk
based on gamification. Main Outcome Measures: Mean change in
predicted 10 year risk of ASCVD from baseline to 12 months.
Results: Enrolment took place between March 2023 and May 2023.
During the 12 month follow-up (complete rate 99.4%), the 10 year risk of
ASCVD decreased from 18.0% to 11.7% in the intervention group and from
17.8% to 13.6% in the control group (absolute difference −1.88% (95%
confidence interval (CI) −2.57% to −1.19%; P<0.001). Compared with
the control group, the intervention group showed larger reductions in
lifetime ASCVD risk (−15.9% vs. −11.0%; difference −4.59%;
P<0.001), systolic blood pressure (−23.2 mmHg vs. −15.2 mmHg;
difference −7.64 mmHg; P<0.001), diastolic blood pressure (−10.9
mmHg vs. −6.9 mmHg; difference −3.59 mmHg; P<0.001), fasting blood
glucose (−0.9 mmol/L vs. −0.5 mmol/L; difference −0.30 mmol/L;
P=0.008),  proportion of daily smokers (−3.1% vs. −0.6%; odds
ratio 0.60, 95%CI 0.43 to 0.84; P=0.003), and insufficient physical
activity (−3.0% vs. 1.3%; odds ratio 0.63, 0.42 to 0.95; P=0.03). No
significant differences were observed for change in non-high density
lipoprotein cholesterol or proportion of participants with obesity.
Conclusions: The village doctor-led mobile health intervention was
effective at reducing cardiovascular risk and improving control of
behavioural and metabolic risk factors. This feasible approach could be
scaled up in rural China and other under-resourced settings to improve
health management based on the local primary healthcare system. Trial
registration: ClinicalTrials.gov NCT05645640.