{
  "abstract": "Introduction Active self-management by patients following acute coronary syndrome (ACS) can reduce recurrent events. Patient education for transitioning from hospital to home promotes effective self-management but can be limited in the acute setting due to time and resource pressures. Patients from ethnic minority and immigrant backgrounds face additional language, cultural and health literacy barriers to receiving patient education. Self-administered virtual patient education presents an innovative solution to these challenges. This study aims to evaluate a co-adapted, virtual avatar nurse-guided, discharge education application (app) for Chinese-speaking patients following ACS.Methods and analysis This multicentre, assessor-blinded, randomised controlled trial will recruit 98 Chinese-speaking inpatients following ACS with evaluation at 1 and 3 months postdischarge. Control participants in the control group will receive the usual ward-based patient discharge education. Intervention participants will additionally receive the education app installed on their devices before hospital discharge with unlimited access during the study period. Cultural relevance and linguistic accuracy for this Chinese version of an existing app were ensured through co-adaptation with Chinese-speaking consumers; the primary outcome will be coronary heart disease (CHD) knowledge, and secondary outcomes will include knowledge, attitudes and beliefs regarding heart attack symptoms and responses, CHD self-management behaviours, utilisation of healthcare services and quality of life. A process evaluation will be conducted alongside the trial to assess the acceptability and feasibility of the app. Between-group comparisons will be made using 95% CIs, accounting for baseline differences using linear mixed effects or mixed effects logistic regression models.Ethics and dissemination The Western Sydney Local Health District Human Research Ethics Committee has approved this study protocol (26 February 2024, amendment number 2) (2024/STE00147), with site-specific authorisations obtained from each participating hospital. The results will be disseminated through peer-reviewed journal articles and presentations at scientific conferences.Trial registration number ACTRN12624000408583.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia"
      ],
      "name": "Ling Zhang"
    },
    {
      "affiliations": [
        "Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Wendan Shi"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Emma Zhao"
    },
    {
      "affiliations": [
        "Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia",
        "Cardiology Department, ANZAC Research Institute, Concord Repatriation General Hospital, Concord, New South Wales, Australia"
      ],
      "name": "Karice K Hyun"
    },
    {
      "affiliations": [
        "Cardiac Rehabilitation Services, Westmead Hospital, Westmead, New South Wales, Australia"
      ],
      "name": "Robert Zecchin"
    },
    {
      "affiliations": [
        "Cardiology Department, St George Hospital, Kogarah, New South Wales, Australia"
      ],
      "name": "Yan Gao"
    },
    {
      "affiliations": [
        "Cardiology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"
      ],
      "name": "Ludimila Brunorio"
    },
    {
      "affiliations": [
        "School of Public Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Fiona Stanaway"
    },
    {
      "affiliations": [
        "Physiotherapy, Westmead Hospital, Westmead, New South Wales, Australia"
      ],
      "name": "Tiffany Ellis"
    },
    {
      "affiliations": [
        "Bond University Institute for Evidence-Based Healthcare, Robina, Queensland, Australia"
      ],
      "name": "Julie Redfern"
    },
    {
      "affiliations": [
        "School Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia"
      ],
      "name": "Robyn Clark"
    },
    {
      "affiliations": [
        "Flinders University, Adelaide, South Australia, Australia"
      ],
      "name": "Huiyun Du"
    },
    {
      "affiliations": [
        "Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Robyn Gallagher"
    }
  ],
  "title": "Effectiveness of a co-adapted virtual discharge education app on disease knowledge and health behaviours in patients following heart attack: a multicentre, randomised controlled trial protocol in Sydney, Australia",
  "uid": "ac52de75-6e1e-58d0-9969-1894ade9f2b5"
}