Secondary Prevention Risk Interventions via Telemedicine and Tailored Patient Education (SPRITE): A randomized trial to improve post myocardial infarction management.

Abstract

Objective

We evaluated the impact of a low intensity web-based and intensive nurse-administered intervention to reduce systolic blood pressure (SBP) among patients with prior MI.

Methods

Secondary Prevention Risk Interventions via Telemedicine and Tailored Patient Education (SPRITE) was a three-arm trial. Patients were randomized to 1) post-MI education-only; 2) nurse-administered telephone program; or 3) web-based interactive tool. The study was conducted 2009-2013.

Results

Participants (n = 415) had a mean age of 61 years (standard deviation [SD], 11). Relative to the education-only group, the 12-month differential improvement in SBP was - 3.97 and - 3.27 mmHg for nurse-administered telephone and web-based groups, respectively. Neither were statistically significant. Post hoc exploratory subgroup analyses found participants who received a higher dose (>12 encounters) in the nurse-administered telephone intervention (n = 60; 46%) had an 8.8 mmHg (95% CI, 0.69, 16.89; p = 0.03) differential SBP improvement versus low dose (<11 encounters; n = 71; 54%). For the web-based intervention, those who had higher dose (n = 73; 53%; >1 web encounter) experienced a 2.3 mmHg (95% CI, -10.74, 6.14; p = 0.59) differential SBP improvement versus low dose (n = 65; 47%).

Conclusions

The main effects were not statistically significant.

Practical implications

Completing the full dose of the intervention may be essential to experience the intervention effect.

Clinical trial registration

The unique identifier is NCT00901277 (http://www.

Clinicaltrials

gov/ct2/show/NCT00901277?term=NCT00901277&rank=1).

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1016/j.pec.2022.05.011

Publication Info

Zullig, Leah L, Eric D Peterson, Bimal R Shah, Steven C Grambow, Eugene Z Oddone, Felicia McCant, Jennifer Hoff Lindquist, Hayden B Bosworth, et al. (2022). Secondary Prevention Risk Interventions via Telemedicine and Tailored Patient Education (SPRITE): A randomized trial to improve post myocardial infarction management. Patient education and counseling, 105(9). pp. 2962–2968. 10.1016/j.pec.2022.05.011 Retrieved from https://hdl.handle.net/10161/29374.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Zullig

Leah L Zullig

Professor in Population Health Sciences

Leah L. Zullig, PhD, MPH is a health services researcher and an implementation scientist. She is a Professor in the Duke Department of Population Health Sciences and an investigator with the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham Veterans Affairs Health Care System. Dr. Zullig leads INTERACT, the Implementation Science Research Collaborative, and is co-leader of Duke Cancer Institute's cancer prevention and control program.

Dr. Zullig’s overarching research interests address three domains: improving cancer care delivery and quality; promoting cancer survivorship and chronic disease management; and improving medication adherence. Throughout these three area of foci Dr. Zullig uses an implementation science lens with the goal of providing equitable care for all by implementing evidence-based practices in a variety of health care environments. She has authored over 200 peer-reviewed publications. 

Dr. Zullig completed her BS in Health Promotion, her MPH in Public Health Administration, and her PhD in Health Policy.

Areas of expertise: Implementation Science, Health Measurement, Health Policy, Health Behavior, Telehealth, and Health Services Research

Grambow

Steven C. Grambow

Associate Professor of Biostatistics & Bioinformatics

Transforming research education through innovation, mentorship, and collaboration.

Steven C. Grambow, PhD is Associate Professor and Associate Chair of Education in the Department of Biostatistics and Bioinformatics at Duke University School of Medicine. He serves as Director of the Clinical Research Training Program (CRTP), Duke’s flagship degree-granting program for clinical and translational research education, and as Co-Director of the Workforce Development Pillar of the Duke Clinical and Translational Science Institute (CTSI). Dr. Grambow provides strategic oversight for multiple educational and workforce development initiatives that span the full continuum of learners, from students to faculty.

With over two decades of experience in graduate and professional education, Dr. Grambow has taught statistical methods and research design to more than 1,000 physician-scientists, clinical fellows, and faculty at Duke and the NIH. He has led the CRTP’s core statistics course for over 21 years and has directed or co-directed national and international certificate programs across multiple institutions. His expertise spans classroom, hybrid, and online environments, and he has served as a leader in designing programs that respond to evolving workforce and research needs.

A central focus of Dr. Grambow’s work is building pathways into clinical and translational research careers. He has cultivated longstanding partnerships with academic and community institutions, including North Carolina Central University and Durham Technical Community College, to create educational models that prepare learners for impactful roles in research. His efforts emphasize strong mentorship, practical experience, and tailored program design to meet learners where they are and help them advance.

Dr. Grambow is also at the forefront of educational innovation, leading initiatives that explore the integration of artificial intelligence into biostatistical training and academic workflows. His current work includes faculty development in AI literacy, emerging pedagogical models that support active learning and reflective practice, and new frameworks for clinical research education that emphasize adaptability and cross-disciplinary collaboration.

As a collaborative statistical scientist, Dr. Grambow has contributed to a wide range of clinical research studies, including observational studies, randomized trials, and epidemiologic investigations. His research collaborations have addressed public health and clinical challenges such as amyotrophic lateral sclerosis (ALS), post-traumatic stress disorder (PTSD), Prader-Willi syndrome (PWS), prostate cancer, cardiovascular risk reduction, and substance use recovery.

Dr. Grambow’s leadership has been recognized through institutional and national awards, including teaching honors from the American Statistical Association and Duke University. He brings a unique combination of academic rigor, educational strategy, and programmatic leadership to his roles, helping to shape the future of clinical research training through thoughtful innovation and sustained collaboration.


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