Mobile Health Behavioral Intervention in Patients With Heart Failure and Diabetes Mellitus

Inclusion Criteria:

   - ≥ 18 years of age

   - Chronic heart failure, New York Heart Association (NYHA) class II-IV, with ongoing
   treatment with medications for heart failure for at least 1 month prior to enrollment

   - Prior diabetes mellitus diagnosis, with ongoing treatment with anti-diabetes
   medications for at least 1 month prior to enrollment

   - Adequate clinical stability in the judgment of the investigator to allow participation
   in study assessments and the intervention

   - Independent with basic activities of daily living (ADLs), including the ability to
   ambulate independently

   - No plan for revascularization (cardiac or peripheral), outpatient continuous
   intravenous inotrope administration, cardiac transplant or ventricular assist device
   implantation, or other cardiac surgery within 6 months of randomization

   - Access to a compatible smart phone (iOS or Android)

   - Signed informed consent

Exclusion Criteria:

   - Acute myocardial infarction within prior 4 weeks

   - Already actively participating in formal, facility-based cardiac rehabilitation

   - Severe stenotic valvular disease (e.g., severe aortic stenosis)

   - Implanted left ventricular assist device (LVAD)

   - Recipient of a heart transplant

   - Terminal illness other than heart failure with life expectancy < 6 months

   - Impairment from stroke, injury or other medical disorder that precludes participation
   in the intervention

   - Inability or unwillingness to comply with the study requirements