Background: Self-care helps maintain health, prevents complications and improves the quality of life of patients living with heart failure (HF). Self-care is critical to HF management but has received limited attention in Nepal. Identification of the sociodemographic and clinical characteristics associated with self-care is crucial to tailoring appropriate self-care programs to improve health outcomes including patients' quality of life. Aims: The aims of this study were to describe self-care including the factors influencing self-care and the relationship between self-care and health-related quality of life in patients living with HF in Kathmandu, Nepal. Methods: We used a cross-sectional observational study design to measure self-care maintenance, self-care management, and self-care confidence using the Nepali Self-Care of Heart Failure Index. To analyze data, we used descriptive statistics, bivariate associations and regression modeling. Results: We recruited 221 patients with HF: mean age 57.5 AE 15.76 years, 62% male. The results in this sample indicated poor self-care maintenance (38.5 AE 11.56), management (45.7 AE 15.14), and confidence (40.9 AE 16.31). Patients with higher education were associated with higher self-care maintenance and management. Living alone and a better New York Heart Association functional classification for HF were related to higher selfcare confidence. Higher social support was associated with better self-care. Self-care confidence was an independent predictor of self-care maintenance, management and health-related quality of life on adjusted analyses. Conclusion: Self-care was limited among patients living with HF in Nepal yet was associated with better quality of life. The study identified various sociodemographic and clinical factors related to self-care, which could be crucial while developing self-care interventions.

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Background Although mobile health (mHealth) technologies are burgeoning in the research arena, there is a lack of mHealth interventions focused on improving self-management of individuals with cardiometabolic risk factors (CMRFs). Objective The purpose of this article was to critically and systematically review the efficacy of mHealth interventions for self-management of CMRF while evaluating quality, limitations, and issues with disparities using the technology acceptance model as a guiding framework. Methods PubMed, CINAHL, EMBASE, and Lilacs were searched to identify research articles published between January 2008 and November 2018. Articles were included if they were published in English, included adults, were conducted in the United States, and used mHealth to promote self-care or self-management of CMRFs. A total of 28 articles were included in this review. Results Studies incorporating mHealth have been linked to positive outcomes in self-management of diabetes, physical activity, diet, and weight loss. Most mHealth interventions included modalities such as text messaging, mobile applications, and wearable technologies. There was a lack of studies that are (1) in resource-poor settings, (2) theoretically driven, (3) community-engaged research, (4) measuring digital/health literacy, (5) measuring and evaluating engagement, (6) measuring outcomes related to disease self-management, and (7) focused on vulnerable populations, especially immigrants. Conclusion There is still a lack of mHealth interventions created specifically for immigrant populations, especially within the Latino community—the largest growing minority group in the United States. In an effort to meet this challenge, more culturally tailored mHealth interventions are needed.