Mobile Intervention to Enhance Physical Activity in the Chronically Ill

移动干预增强慢性病患者的身体活动

• 批准号: 8706543
• 负责人: AMELIA J BIRNEY
• 金额: $ 22.37万
• 依托单位: OREGON CENTER FOR APPLIED SCIENCE, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8706543
• 关键词: Address; Adult; American; American Medical Association; Asthma; Behavioral; Chronic; Chronic Disease; Chronically Ill; Clinical Trials; Cognitive Therapy; Computers; Consensus; Data; Degenerative polyarthritis; Devices; Diabetes Mellitus; Disease; Disease Management; Effectiveness; Employee; Evaluation; Exercise; Fatigue; Feedback; Focus Groups; Funding; Goals; Habits; Health; Health Planning; Heart failure; Hypertension; Individual; Internet; Intervention; Link; Lung; Lung diseases; Mails; Medical; Medicine; Meta-Analysis; Monitor; Online Systems; Outcome; Pain; Patient Self-Report; Patients; Phase; Physical activity; Physicians; Population; Prevalence; Primary Care Physician; Provider; Public Health; Recommendation; Reporting; Sports Medicine; Tablets; Testing; Text; Therapeutic Intervention; Time; TimeLine; Underserved Population; United States; United States National Institutes of Health; Update; Visit; Vulnerable Populations; Wireless Technology; college; design; disorder prevention; efficacy trial; evidence base; improved; mobile application; neglect; patient population; preference; programs; prototype; public health relevance; remediation; screening; sedentary; social; usability

PROJECT SUMMARY This project aims to fill the urgent need for a safe and engaging intervention that promotes physical activity in a population of patients with chronic diseases (e.g., diabetes, asthma, osteoarthritis, and chronic heart failure). Compelling evidence suggests that physical activity is an effective therapeutic intervention for numerous chronic diseases. However, in spite of the wide consensus that physical activity should be an integral treatment component for many chronic diseases, most patients remain inactive1 due to a variety of barriers and obstacles they regularly encounter. We therefore propose to innovatively adapt an efficacious exercise-promoting intervention that targets sedentary employees2 to a population with specific needs and constraints that result from chronic disease and deliver this intervention as a mobile application that can be accessed via smartphone, tablet, or computer. We propose a program design that follows recommendations derived from a recent NIH-funded meta- analytic review of interventions to promote physical activity in patients with chronic diseases, which emphasizes the importance of behavioral activation as opposed to cognitive-behavioral intervention features.3 Our comprehensive mobile application is therefore composed of (a) an initial screening; (b) baseline physical activity (PA) levels recorded via wireless accelerometer device; (c) an assessment that elicits information regarding preferences for and barriers to PA; (d) goal setting; (e) daily e-mail or text messages stating the goal for the day, the type of exercise, and a link to a video demonstrating the exercise; (f) a brief check-in to determine whether the user is currently encountering a barrier (pain, fatigue, etc.) and tailored remediation for the barrier through social media functionality and expert advice; (g) prompts to execute the daily exercise; (h) integration of a wireless accelerometer device (e.g., Fitbit(R)) to supplement self-reported exercise data and to drive tailored feedback and goal setting; (i) check-in regarding activity completion (e.g., "have you completed the exercise?," "did you enjoy this exercise?," "do you feel better after this exercise?"); (j) immediate, personalized feedback on how executed physical activities contribute to goal progress; and (k) feedback reports for the primary care physician. Together these design features will promote and support a sustainable habit of regular PA in this vulnerable population. In a 30-day pre-post study, we will test preliminary efficacy and feasibility of this prototype intervention in a population of 38 adult patients with chronic osteoarthritis. The Phase I prototype program will be limited to demonstrating feasibility with individuals with osteoarthritis to control the overall scope of the Phase I project. We hypothesize that this intervention will engage this population and increase subjects' PA level from pre- to post-assessment. If this pilot efficacy trial yields satisfactory results, the Phase 2 project will expand the scope of the program to include all patients with additional chronic diseases (e.g., osteoarthritis, hypertension, diabetes, pulmonary disease).

项目摘要 该项目旨在满足对安全且引人入胜的干预措施的迫切需求，以促进体育锻炼 在慢性疾病的患者中（例如糖尿病，哮喘，骨关节炎和慢性心脏 失败）。令人信服的证据表明，体育活动是一种有效的治疗干预措施 许多慢性疾病。但是，尽管有广泛的共识，即体育锻炼应该是 许多慢性疾病的整体治疗成分，大多数患者由于多种 他们经常遇到的障碍和障碍。 因此，我们建议创新适应针对的有效锻炼干预措施 久坐的雇员2至人口，有特定需求和由慢性疾病和约束的人口 将这种干预作为移动应用程序提供，该应用程序可以通过智能手机，平板电脑或计算机访问。 我们提出了一个计划设计，该计划遵循从NIH资助的最新资助的元数据中得出的建议 对干预措施的分析综述，以促进慢性疾病患者的体育锻炼，这 强调行为激活而不是认知行为干预特征的重要性。3 因此，我们的全面移动应用程序由（a）初始筛选组成； （b）基线物理 通过无线加速度计记录的活动（PA）级别； （c）一种引起信息的评估 关于对PA的偏好和障碍； （d）目标设定； （e）每日电子邮件或短信说明目标 在一天中，锻炼的类型以及与练习的视频链接； （f）简短的办理登机手续 确定用户当前是否遇到障碍（疼痛，疲劳等）和量身定制的补救措施 通过社交媒体功能和专家建议的障碍； （g）提示执行日常锻炼； （h） 无线加速度计设备（例如Fitbit（R））集成以补充自我报告的锻炼数据和 推动量身定制的反馈和目标设定； （i）关于完成活动的登机手续（例如，“有你 完成了练习吗？ 有关执行体育活动如何促进目标进步的直接，个性化的反馈； （k） 初级保健医师的反馈报告。这些设计功能将共同促进和支持 在这个脆弱人群中，普通PA的可持续习惯。 在一项为期30天的前研究中，我们将测试该原型干预措施的初步功效和可行性 38例慢性骨关节炎患者的人群。 I期原型程序将仅限于 证明与骨关节炎的个体可行性控制I期的整体范围 项目。我们假设这种干预将吸引该人群，并将受试者的PA水平提高 后至评估。如果该试验效能试验产生令人满意的结果，则第2阶段项目将扩大 该计划的范围包括所有患有其他慢性疾病的患者（例如，骨关节炎， 高血压，糖尿病，肺部疾病）。