There are limited data on the fluid balance characteristics and fluid replenishment behaviors of high-performance adolescent athletes. The heterogeneity of hydration status and practices of adolescent athletes warrant efficient approaches to individualizing hydration strategies. This study aimed to evaluate and characterize the hydration status and fluid balance characteristics of high-performance adolescent athletes and examine the differences in fluid consumption behaviors during training. In total, 105 high-performance adolescent athletes (male: 66, female: 39; age 14.1 ± 1.0 y) across 11 sports had their hydration status assessed on three separate occasions—upon rising and before a low and a high-intensity training session (pre-training). The results showed that 20–44% of athletes were identified as hypohydrated, with 21–44% and 15–34% of athletes commencing low- and high-intensity training in a hypohydrated state, respectively. Linear mixed model (LMM) analyses revealed that athletes who were hypohydrated consumed more fluid (F (1.183.85)) = 5.91, (p = 0.016). Additional K-means cluster analyses performed highlighted three clusters: “Heavy sweaters with sufficient compensatory hydration habits,” “Heavy sweaters with insufficient compensatory hydration habits” and “Light sweaters with sufficient compensatory hydration habits”. Our results highlight that high-performance adolescent athletes with ad libitum drinking have compensatory mechanisms to replenish fluids lost from training. The approach to distinguish athletes by hydration characteristics could assist practitioners in prioritizing future hydration intervention protocols.

Background: Cardiovascular diseases (CVDs) are a leading cause of death and disability worldwide. For people living with CVD, clinical guidelines recommend ongoing self-care such as symptom monitoring, medication adherence, and lifestyle modifications. However, many people struggle to engage in this due to the complexity of disease management, limited understanding, and a lack of cultural support. Conversational agents (CAs) offer a solution by providing artificial intelligence–driven, voice-based support that enables human-like communication. While many CAs and digital interventions are good for people with CVDs, they are for mainstream populations and overlook culturally and linguistically diverse communities. Objective: This study outlines the protocol for pilot testing the feasibility and usability of Diaspora Engaged Self-Care Intervention and Heart (DESI-Heart) program, to support self-care management among Indian diaspora populations with CVDs in Australia over an 8-week intervention period. The formative development of DESI-Heart is also described. Methods: We integrated the Double Diamond Model and the ecological validity model to develop our DESI-Heart program. First, we co-designed the program with end users, who identified 4 key goals for engagement with self-care through culturally and linguistically appropriate approaches. Based on these priorities and ideas, we developed specific goals, including (1) medication reminders, (2) daily exercise guidance, (3) diet buddy, and (4) guided meditation. Participants will access the DESI-Heart program through a web-based CA, available on smartphones, laptops, or PCs. Based on their preferred timing, individuals will receive links to access specific components of the program corresponding to each goal. These links will be sent to participants via SMS or email, depending on their preference. A single-arm prepost pilot trial (N=28) will be conducted to evaluate the feasibility and usability of the DESI-Heart program among Indian adults living in Australia with CVDs. The primary outcome will assess feasibility indicators, including recruitment, engagement, and usability, while secondary outcomes will examine changes in self-care behaviors and quality of life. Results: The DESI-Heart program received ethics approval in July 2024. Recruitment for the pilot trial is scheduled to begin in June 2025 and conclude by September 2025, with participant follow-up expected to be completed by the end of December 2025. All 28 participants have been recruited, and data analysis will be conducted once follow-up is finalized. Conclusions: We have co-designed and developed the DESI-Heart program, a culturally and linguistically appropriate self-care intervention aimed at supporting Indian adults with CVD living in Australia. The next step is to conduct a pilot study to assess the feasibility and usability of DESI-Heart, which will inform the design of a larger evaluation trial. DESI-Heart has the potential to complement existing health services by helping individuals with CVD manage their condition within the community, while acknowledging their cultural backgrounds and language preferences. International Registered Report Identifier (IRRID): PRR1-10.2196/78923

BACKGROUND Cardiovascular diseases (CVDs) are a leading cause of death and disability worldwide. For people living with CVD, clinical guidelines recommend ongoing self-care such as symptom monitoring, medication adherence, and lifestyle modifications. However, many people struggle to engage in this due to the complexity of disease management, limited understanding, and a lack of cultural support. Conversational agents (CAs) offer a solution by providing artificial intelligence–driven, voice-based support that enables human-like communication. While many CAs and digital interventions are good for people with CVDs, they are for mainstream populations and overlook culturally and linguistically diverse communities. OBJECTIVE This study outlines the protocol for pilot testing the feasibility and usability of Diaspora Engaged Self-Care Intervention and Heart (DESI-Heart) program, to support self-care management among Indian diaspora populations with CVDs in Australia over an 8-week intervention period. The formative development of DESI-Heart is also described. METHODS We integrated the Double Diamond Model and the ecological validity model to develop our DESI-Heart program. First, we co-designed the program with end users, who identified 4 key goals for engagement with self-care through culturally and linguistically appropriate approaches. Based on these priorities and ideas, we developed specific goals, including (1) medication reminders, (2) daily exercise guidance, (3) diet buddy, and (4) guided meditation. Participants will access the DESI-Heart program through a web-based CA, available on smartphones, laptops, or PCs. Based on their preferred timing, individuals will receive links to access specific components of the program corresponding to each goal. These links will be sent to participants via SMS or email, depending on their preference. A single-arm prepost pilot trial (N=28) will be conducted to evaluate the feasibility and usability of the DESI-Heart program among Indian adults living in Australia with CVDs. The primary outcome will assess feasibility indicators, including recruitment, engagement, and usability, while secondary outcomes will examine changes in self-care behaviors and quality of life. RESULTS The DESI-Heart program received ethics approval in July 2024. Recruitment for the pilot trial is scheduled to begin in June 2025 and conclude by September 2025, with participant follow-up expected to be completed by the end of December 2025. All 28 participants have been recruited, and data analysis will be conducted once follow-up is finalized. CONCLUSIONS We have co-designed and developed the DESI-Heart program, a culturally and linguistically appropriate self-care intervention aimed at supporting Indian adults with CVD living in Australia. The next step is to conduct a pilot study to assess the feasibility and usability of DESI-Heart, which will inform the design of a larger evaluation trial. DESI-Heart has the potential to complement existing health services by helping individuals with CVD manage their condition within the community, while acknowledging their cultural backgrounds and language preferences. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/78923

BACKGROUND Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide, including in Australia. Effective self-care is critical for managing CVDs, yet many individuals face barriers such as complex treatment regimens, limited health literacy, and insufficient culturally appropriate support. Conversational agents (CAs) offer AI-driven, voice-based assistance to promote self-care, but most are designed for mainstream populations and do not address the specific needs of culturally diverse communities. To address this gap, we co-designed DESI-Heart, a culturally tailored conversational agent aimed at supporting self-care among Indian Australians with CVDs OBJECTIVE To evaluate the feasibility and usability of DESI-Heart, an 8-week CA-delivered self-care program for Indian Australians living with CVDs. METHODS Co-designed with the target population, the 8-week DESI-Heart program comprised four culturally and linguistically tailored modules: (1) medication reminders, (2) daily exercise guidance, (3) diet buddy, and (4) guided meditation. A single-arm pre-post pilot trial design (n=28) was used to assess the feasibility and usability of the DESI-Heart program. After completing the pretest assessments, participants accessed DESI-Heart through a web-based CA, available on smartphones or laptops. According to their preferred schedules, participants received links to the relevant modules, delivered at four time points each week over an 8-week period. Upon completion of the program, participants were invited to complete a follow-up session, which included post-test assessments and qualitative feedback on their experience using DESI-Heart. RESULTS The DESI-Heart program demonstrated feasibility. Recruitment targets were achieved, although the recruitment period exceeded by 12 weeks. Retention was high (89%, 25/28), and attrition (10.7%, 3/28) remained below the predefined feasibility threshold. Program completion rates indicated good engagement, with participants completing 74.48% (132.6/160 sessions) of prescribed sessions. Usability was rated highly (Bot Usability Score mean = 88.23), supported by sustained platform engagement. Preliminary pre-post analyses showed statistically significant changes in medication adherence, self-care maintenance and monitoring, physical and psychological quality of life (QoL), and overall QoL. CONCLUSIONS The co-designed DESI-Heart program demonstrated feasibility as a culturally appropriate, digitally delivered self-care intervention for Indian Australians with CVD. Satisfactory recruitment, high participant retention, low attrition, strong program completion, and high usability collectively support progression to a larger-scale evaluation trial. CLINICALTRIAL NA INTERNATIONAL REGISTERED REPORT RR2-10.2196/78923