Cardiovascular disease (CVD) and type 2 diabetes (T2D) remain leading cause of death in most
European countries, and new strategies for prevention are urgently needed.
Considerable evidence suggest that lifestyle changes can prevent or delay the onset of type 2
diabetes and cardiovascular disease. Modifiable lifestyle factors have been established as
key drivers of disease onset and progression.
Many prevention programmes are, however, time-limited and fail to provide continuous support.
They also require substantial costs and healthcare resources. Furthermore, accessibility to
primary and secondary cardiac prevention programmes is highly variable, as is long-term
adherence to lifestyle advice.
In light of this, international associations have emphasized the need for innovative,
scalable and cost-effective lifestyle interventions that could be integrated into
pre-existing healthcare structures. Digital tools have large potential for clinical utility,
but there are several important knowledge gaps. First, data on long-term efficacy is scarce.
Second, most studies to date have included only small number of individuals, and there is a
need for large randomized controlled studies. Third, cost-effectiveness remains to be
demonstrated.
The objective or this study is to evaluate a new web-based tool, developed at the University
Gothenburg, Sweden, that aims to support patient autonomy and motivation to make sustainable
lifestyle changes.
The investigators will test the hypothesis that individuals who have access to the tool get
lower incidence of major cardiovascular events (MACE) and type 2 diabetes or in case they
already have diabetes develop improved glucose control compared with control individuals.
The study is an investigator-initiated single-center study conducted over three years.
The tool is web-based and used via a computer or mobile phone. It is used at each
individual's preferred pace but participants are recommended to login at least every other
week. Every round the participants choose a themes (out of appr. 80 possible covering e.g.
food, exercise, stress, self-reflection aspects), which takes appr. 15-30 minutes to
complete. Participants then reflect on the content and how it could be implemented in daily
life. When returning for next round participants are asked to reflect on any changes done
since last time. There is no interaction between individual participants.