Background: Few investigators have explored challenges and facilitators to exergaming, essential factors to exergaming adherence, among patients with heart failure. Objectives: In this qualitative study, we explored facilitators and challenges using a home-based exergame platform, the Nintendo Wii Sports, in patients with heart failure. Methods: Semistructured face-to-face interviews were conducted in 13 participants given a diagnosis of heart failure (age range, 34–69 years). Participants were asked about their experiences with exergaming. Transcribed interviews were analyzed with content analysis. Results: The following 4 facilitators were identified: (1) enjoyment and competition motivated gaming, (2) accessibility at home gave freedom and lowered participants' barriers to exercise, (3) physical benefits when decreasing sedentary lifestyle, and (4) psychosocial benefits on stress, mood, and family interactions. Challenges included (1) diminished engagement over time due to boredom playing similar games and (2) frustrations due to game difficulty and lack of improvement. Conclusion: Exergaming can increase individuals' physical activity because of easy accessibility and the fun and motivating factors the games offer. Participants initially found exergaming enjoyable and challenging. However, engagement diminished over time because of boredom from playing the same games for a period of time. Participants' preferences and capacities, participants' past experiences, and social support must be considered to avoid boredom and frustrations. Future studies are warranted to determine adherence to exergaming among patients with heart failure and, ultimately, increased overall well-being and healthcare delivery in this patient population.

Lifestyle modifications and healthy behavioural regimens are critical in preventing coronary artery disease (CAD) and other important health conditions. Little is known about the risk for CAD and health behaviour among older adults (>60 years) living in rural areas in the Philippines. Compare risk profiles and health behaviours of Filipinos at low- vs. moderate-to-high-risk for CAD and examine the association between demographic variables, risk profiles, and health behaviours. A comparative, cross-sectional study was conducted using a convenient sample of 427 Filipinos (≥60 years old). Data on sociodemographic characteristics, risk profiles, and health behaviours (e.g. diet, physical activity, smoking status, and alcohol use) were collected. Ten‐year CAD risk was estimated using the non-laboratory-based Framingham algorithm. Of the 427 participants [mean age was 69.2 ± 6.7 years, primarily women (65%), married (52.8%)], 319 (75%) were at low risk, and 108 (25%) were at moderate-to-high-risk for CAD. Filipinos at moderate to high risk were more likely to have cardiometabolic diseases (e.g. hypertension, hyperlipidaemia, diabetes, and obesity, all P's < 0.001). Health behaviours did not differ between the two groups except for the consumption of ≥5 servings of fruit, higher in the low-risk group. Data showed highly consistent and convergent evidence among older Filipinos living in rural areas at high risk for CAD and other health conditions. These findings underscore the need for culturally sensitive guidance to improve CAD outcomes for moderate to high-risk older adults living in rural areas, including education and counselling on risk and risk-reducing strategies.

Background: Digital health technologies can promote healthy aging, diagnosis, treatment, self-care, and prevention to reduce inequities. However, limited data exist on the feasibility and efficacy of these technologies for healthy lifestyle behaviors and clinical outcomes for older adults at risk for cardiovascular disease. Objectives: The purpose of this pilot study was to evaluate the feasibility of the study protocol for factors impacting process, resources, and safety and compared changes in eating patterns, physical activity, and clinical outcomes in participants randomized to Get FIT vs Get FIT+ at baseline and 12 weeks. Methods: Older adults (65.6 ± 5.8 years, 61% women, 61% married, 50% Asians, 6% Whites, 33% Hispanics, 11% Blacks) were randomized to Get FIT (n = 24) or Get Fit+ (n = 30) for 12 weeks. Get FIT included 1 in-person counseling session, a participant handbook, an activity tracker, and access to a nutrition app. Get Fit+ added weekly personalized motivational text messages. Results: All feasibility measures were excellent, with 100% consent and retention at 12 weeks. Both groups gradually increased moderate to vigorous exercise and lowered calorie intake. The Get Fit+ and Get Fit participants reported 6% and 1% weight loss, respectively. Blood pressure, lipid profiles, and HgbAa1C improved for all participants. However, improvements in high-density lipoprotein cholesterol and triglycerides were more significant in the Get FIT+ group. Conclusion: Our findings suggest that Get Fit+ can promote healthy lifestyle behaviors in older adults while lowering cardiovascular disease risk factors. A large Randomized Control Trial is needed to determine the efficacy of this intervention's personalized text-messaging feature in this population.

This study aimed to determine the effect of a multi-component mHealth intervention on patient activation and examine its predictors among older adults at risk of cardiovascular disease (CVD). This pilot randomized controlled trial compared two groups: Get FIT (control), who received healthy lifestyle counselling from a licensed health coach, a mHealth app (MyFitnessPal) with push alerts, and an activity tracker, and Get FIT + (intervention), who received the same interventions and had personalized text messages with 3- and 6-month follow-up periods. Patient activation was measured using the 13-item Patient Activation Measure; higher scores indicated better activation. Linear mixed-effects models were used to investigate between-group changes in outcomes across time. The participants’ (n = 54) mean age was 65.4 ± 6.0 years; 61% were female; and 61% were married. Baseline characteristics were comparable between groups. Significant improvements in mean patient activation scores were observed in the Get FIT + group at 3 months [mean 3.53 points, 95% confidence interval (CI) 0.11, 6.96; P = 0.043] and 6 months (mean 4.37 points, 95% CI 0.91, 7.83; P = 0.014), whereas improvements in the Get FIT group were non-significant. Adjusting for age, gender, education, employment, marital status, social support, smartphone confidence, and self-perceived health, we found that only social support was associated with higher patient activation overall (B = 5.14, 95% CI 1.00, 9.27; P = 0.015). The findings indicate that personalized text messaging can improve the self-care of older adults at risk of CVD. Findings also emphasize the importance of social support in the success of mHealth interventions for older adults. The study is registered in ClinicalTrials.gov (NCT03720327).

Background: Health education is a vital component of preventative care; however, rural Filipino adults often face structural, linguistic, and access barriers to obtaining reliable health information. Designing equitable and culturally relevant health education programs requires understanding which sources are most significant and how context affects them. Objective: To identify preferred sources of health education among adults in rural Philippine communities and investigate the contextual factors that influence these preferences. Methods: A cross-sectional mixed-methods study included 1203 adults from disadvantaged Luzon and Visayas barangays. Participants completed a self-administered survey on the importance of neighborhood health fairs, native-language instructional tools, and social media. Descriptive statistics (mean ± standard deviation) were used to aggregate importance ratings, and exploratory comparisons were made using paired and independent-samples t-tests. A subsample of 60 semi-structured interviews was analyzed using thematic analysis to interpret qualitative data. Results: Community health fairs were identified as the primary source of health education, with a mean rating of 8.5 ± 1.6, followed by native-language educational materials, which received a mean rating of 5.5 ± 2.4. In contrast, social media was rated the lowest, with a mean of 3.5 ± 2.3. Preference patterns were consistent across regions and sociodemographic groups, with only slight variation in rating magnitudes. Qualitative analysis revealed four themes influencing source preferences: accessibility and proximity, cultural and linguistic relevance, confidence in local health providers, and structural obstacles to digital access. Conclusions: In rural Philippine communities, intimacy, confidence, and cultural congruence influence health education preferences more than online platforms do. Strengthening community-based, locally integrated health education strategies may enhance the reach and contextual relevance of preventive health communication in underserved settings.

Background: Chronic pain is a leading contributor to disability worldwide, yet population-based data from rural and medically underserved settings remain limited. Evidence describing the biopsychosocial correlates of chronic pain in rural Filipino communities is particularly scarce. Methods: We conducted a secondary analysis of cross-sectional data from the I-HELP-FILIPINO community cohort, collected between January and June 2017. Participants included 909 adults aged 18–93 years who voluntarily attended barangay clinic days in rural Philippine communities. Pain severity was assessed with standardized self-report tools. Sociodemographic, psychosocial, sleep, and functional health factors were examined using bivariate analysis and hierarchical linear regression. Results are shown with 95% confidence intervals. Results: Chronic pain was very common, affecting 83.8% of participants, with 5.6% experiencing severe pain. In multivariable models, psychosocial distress, sleep issues, and reduced physical functioning were significantly linked to increased pain severity, while demographic factors contributed minimally to the variance. Most of the explained variance in pain outcomes was accounted for by psychosocial and clinical variables. Conclusions: In this rural Filipino cohort, chronic pain was strongly associated with modifiable psychosocial, sleep, and functional health factors. Focusing on community-based and culturally tailored interventions can inspire hope and empower healthcare professionals and policymakers to tackle these issues more effectively.