Mobile App for Self Management of Comorbid Depression and Metabolic Syndrome

用于自我管理共病抑郁症和代谢综合征的移动应用程序

• 批准号: 8647523
• 负责人: AMELIA J BIRNEY
• 金额: $ 22.48万
• 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: 2014-09-23 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8647523
• 关键词: Address; Adult; Area; Behavior; Behavioral; Benchmarking; Biometry; Blood Pressure Monitors; Body Weight decreased; Calories; Carbohydrates; Cardiovascular Diseases; Chronic; Client; Clinic; Clinical; Cognitive; Cognitive Therapy; Competence; Data; Development; Devices; Diet; Dietary intake; Eating; Emotional; Failure; Goals; Guidelines; Habits; Health; Health Planning; Health behavior; Impairment; Individual; Intervention; Life Style; Marketing; Mechanics; Medical; Mental Depression; Metabolic syndrome; Metric; Monitor; Moods; Motivation; National Heart, Lung, and Blood Institute; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Patient Self-Report; Patients; Pattern; Phase; Physical activity; Positive Reinforcements; Process; Recruitment Activity; Research; Review Literature; Risk; Self Assessment; Self Care; Self Determination; Self Management; Services; Shapes; Testing; TimeLine; Update; Vendor; Walking; Washington; Weight; Wireless Technology; Work; authority; base; cardiovascular risk factor; chronic depression; clinically significant; depressive symptoms; design; digital; disability; evidence base; follow-up; glycemic control; meetings; metropolitan; mobile application; motivational enhancement therapy; population health; portion control; programs; prototype; public health relevance; randomized trial; saturated fat; social; success; theories; waist circumference

PROJECT SUMMARY Depression and metabolic syndrome (MetS) are common chronic conditions that are debilitating to individuals and costly to employers and public and private payors.1-3 Unfortunately, they are often comorbid, each making the other more severe, more difficult to manage, and more costly.4-7 This project will create MoodJaunt, a mobile app designed to fill a well-known gap8-14 in the population health management market: a lack of engaging and effective self-management programs that address both the emotional and physical wellbeing of adults managing both depression and chronic health conditions. As fully conceived, the MoodJaunt mobile app will offer an integrated approach to effect clinically significant changes in: (a) depression symptoms, (b) physical activity, (c) dietary intake, (d) weight loss, and (e) waist circumference. MoodJaunt will integrate cognitive-behavioral strategies to manage depression with a theory- based goal-attainment approach to engage patients in weight-loss activities to manage MetS. Grounded in Self Determination Theory, Motivational Interviewing, cognitive-behavioral therapy, and habit-formation research, MoodJaunt will support users' intrinsic motivations (autonomy, competence, and relatedness) to engage users in small initial health behaviors and then guide them toward clinically meaningful health habits. The Phase I functional prototype app will repurpose and adapt Jauntly, a goal-attainment platform that can be populated with goals and supportive content for a variety of self-management behaviors. Phase I content will: (a) promote behavioral activation through positive physical and social activities to manage depression and (b) build physical activity toward levels that meet NHLBI obesity clinical guidelines to begin managing MetS. We will use an Agile (iterative) development and user testing process to address three challenges: (a) creating-and optimizing engagement of-an on-boarding process that includes a user self-assessment of mood level, depression symptoms, and health-related aspirations; (b) integrating the app with a wireless accelerometer device (Fitbit(R)) to supplement self-reported physical activity data; and (c) creating a data- driven engine to tailor app-generated goals, messaging, and content, based on the user's self-assessment, program-use, and accelerometer data. The Phase II project will: (a) expand app content to address physical activity and dietary behavior goals focused on weight loss and glycemic control (reduction of calories, saturated fat, and refined carbohydrates; portion control; and weight and food-intake self-monitoring); (b) integrate with additional biometric devices to promote self-tracking of behaviors against personal results; and (c) create a client dashboard with program impact metrics. The Phase I MoodJaunt prototype will be evaluated in a 28-day randomized trial (N = 110) to assess its effect on behavioral activation, depression symptoms, and physical activity. Subjects will be recruited through the Medical/EAP Services clinic at the Washington Metropolitan Area Transit Authority.

项目概要 抑郁症和代谢综合征 (MetS) 是常见的慢性疾病，会使人衰弱 对个人和雇主以及公共和私人付款人来说代价高昂。1-3 不幸的是，它们通常是共病的， 每一个都使对方变得更加严重、更难以管理、成本更高。4-7 该项目将创造 MoodJaunt，一款旨在填补人口健康管理市场众所周知的空白8-14的移动应用程序： 缺乏有吸引力且有效的自我管理计划来解决情感和身体问题 管理抑郁症和慢性健康状况的成年人的福祉。 根据完整构想，MoodJaunt 移动应用程序将提供一种集成方法来实现具有临床意义的效果 以下方面的变化：(a) 抑郁症状、(b) 体力活动、(c) 饮食摄入量、(d) 体重减轻和 (e) 腰围 圆周。 MoodJaunt 将整合认知行为策略来管理抑郁症，其理论如下： 基于目标实现的方法让患者参与减肥活动以管理 MetS。立足于自我 决定论、动机访谈、认知行为疗法和习惯形成研究， MoodJaunt 将支持用户的内在动机（自主性、能力和相关性）来吸引用户 从小的初始健康行为，然后引导他们养成具有临床意义的健康习惯。 第一阶段的功能原型应用程序将重新调整用途并适应 Jauntly，这是一个目标实现平台，可以 充满各种自我管理行为的目标和支持内容。第一阶段内容 将：(a) 通过积极的身体和社交活动促进行为激活，以控制抑郁症和 (b) 建立符合 NHLBI 肥胖临床指南的体力活动水平，以开始管理 MetS。 我们将使用敏捷（迭代）开发和用户测试流程来解决三个挑战：(a) 创建并优化入职流程的参与度，其中包括用户的自我评估 情绪水平、抑郁症状和与健康相关的愿望； (b) 将应用程序与无线网络集成 加速计设备 (Fitbit(R))，用于补充自我报告的身体活动数据； (c) 创建一个数据- 驱动引擎根据用户的自我评估定制应用程序生成的目标、消息传递和内容， 程序使用和加速度计数据。 第二阶段项目将：(a) 扩展应用程序内容以实现身体活动和饮食行为目标 专注于减肥和血糖控制（减少卡路里、饱和脂肪和精制碳水化合物； 份量控制；以及体重和食物摄入量自我监测）； (b) 与其他生物识别设备集成 促进根据个人结果进行行为的自我跟踪； (c) 使用程序创建客户端仪表板 影响指标。 I 期 MoodJaunt 原型将在为期 28 天的随机试验（N = 110）中进行评估，以评估其效果 对行为激活、抑郁症状和体力活动的影响。受试者将通过招募 华盛顿都市区交通管理局的医疗/EAP 服务诊所。