Theresa Beckie, PhD, MN, BScN, RN, FAHA, FAAN, FAAAS, professor and research faculty at the USF Health College of Nursing, has been awarded an RO1 grant for more than $3.5 million from the National Institute of Nursing Research at the National Institutes of Health (NIH). The funding will support a trial of HerBeat, a secondary prevention intervention involving a smartphone and smartwatch that helps women with coronary heart disease improve their heart-healthy behaviors..
The project grows out of a question Beckie pursued for nearly three decades. At Tampa General Hospital, she was interviewing a patient for a research study when his wife mentioned that she survived three heart attacks without recognizing what they were. Beckie had been studying heart disease in both men and women, but that encounter turned her focus to women.
The gap she saw is still there. Center-based cardiac rehabilitation (CBCR) is the gold standard after a heart attack or heart surgery, yet women are referred less often than men, enroll less often, and are less likely to finish. Beckie’s research shows as few as 10% of referred women enroll in these programs, and up to 72% of those who start never finish. Additionally, when a supervised program ends, many women are left without a clear way to continue healthy habits at home.
Beckie has worked on this problem for years. In 2004, she received an NIH grant to run a five-year study of women-only cardiac rehabilitation. It paired supervised exercise with education designed for women and a team that included psychologists to address depression, anxiety and stress. The study was a success, but the model was costly to replicate and reached only women with the insurance to attend. It became the starting point for HerBeat, a way to carry the lessons of that program into women’s everyday lives.
HerBeat delivers support where women already are. Throughout the day, participants receive motivational messages grounded in behavior change theory, along with brief check-ins that help tailor the support to what is happening in their lives. Women choose their own goals across five areas of heart health: physical activity, healthy eating, stress management, medication adherence and, when relevant, quitting smoking. A smartwatch and smartphone track progress as well as certain health metrics like daily step counts, and a health coach reviews each participant’s activity on a web-based dashboard and calls weekly to help her problem-solve.
Beckie emphasizes that HerBeat is not a substitute for cardiac rehabilitation. It is designed to cover the behaviors that matter most to heart health and to reach women who may never set foot in a rehab center.
In the randomized controlled trial, HerBeat will be compared with an educational approach built around the American Heart Association workbook An Active Partnership for Your Health, a resource commonly used in cardiac rehabilitation to teach patients about heart-healthy living. The question is whether a personalized, technology-supported approach can do more for women than education alone.
HerBeat is the product of collaboration. She completed USF’s I-Corps program and secured early funding from the National Science Foundation and the USF Foundation to build and pilot test a prototype. With funding, she assembled a team with experts from the USF Muma College of Business, the USF College of Engineering, and the Bellini College of Artificial Intelligence, Cybersecurity, and Computing.
Graduate students in computer engineering and business did much of the technical work, and one business doctoral student wrote his dissertation on the app’s development. Women consulted during pilot testing also shaped the design, from the colors and fonts to the images.
The early days were hands-on. The team gathered to work out how the app would function, with ideas for the prototype drawn out on posterboards. Beckie never threw them away. They remain in her office, a reminder of where the project began.
“Behavior change is hard,” Beckie says. “But so is living with heart disease.” With this new funding, she and her team will test whether HerBeat can make that change more achievable for the women who need it most.
With the funding secured to test HerBeat with trial participants, Beckie is now able to begin building the team to execute the study which will begin in early 2027.