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A Clinical Intervention to Promote Behaviour Change in those with Cardiovascular Disease

PIVOT joined the research team to improve the UX and efficacy of this critical, patient-centred intervention.


After suffering a heart attack, many patients go off their treatment plans—attending cardiac rehab and taking medication—causing 1 in 10 to die from a second incident within just one year. That’s why a team of doctors at Hamilton Health Sciences (HHS) started a research project to mail out reminders that would engage patients with vital information to prevent another heart attack. Initially, the project involved a dense, 10-page text-heavy document meant to be mailed out to patients every month as a reminder of the importance of cardiac rehab and medication. This was both cumbersome to mail out and did not achieve the uptake results the research team was hoping for. PIVOT then joined the team to improve the UX and efficacy of this critical, patient-centred intervention.


After conducting in-depth user interviews with both patients and providers, we made content recommendations to the team and redesigned the document as a series of informational booklets which included interactive worksheets and infographics to help patients with their goal setting and lead them towards better behaviour change. Special care was taken to design the booklets as mailers and to incorporate the appropriate look and feel, pace and intention—right down to the illustration styles, typography, and word choices.

Prior to working with us, the HHS team had not considered pacing of the content so that their patients could receive small chunks of information over time. By conducting interviews and creating personas, PIVOT learned from the users, and used design thinking to building a series of user-friendly booklets that highlight relevant information to patients over time. The five distinct mailers became compelling and usable touchpoints that helped people change behaviour and better manage their cardiac rehabilitation.


Five touchpoints were sent out to 500 patients over the course of a year following their heart attack. This pilot project tested whether the designed information improved patient uptake and adherence to their post-myocardial infarction treatment plan (medication + cardiac rehab).

The HHS team spearheading the project published a paper after the randomized control trial outlining the project, process, findings, and outcomes.

Read it in the BMJ here.