Influencing Basic Behavioral Mechanisms of Action while targeting Daily Walking in Those at Risk for Cardiovascular Disease: Science of Behavior Change Factorial Experiment of Behavioral Change

以日常步行为目标，影响有心血管疾病风险的人的基本行为机制：行为改变的科学 行为改变的析因实验

• 批准号: 10673605
• 负责人: Karina W. Davidson
• 金额: $ 73.79万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10673605
• 关键词: Accelerometer; Address; Adherence; Adult; American; Basic Science; Behavior; Behavioral; Behavioral Mechanisms; Cardiovascular Diseases; Cells; Communities; Counseling; Elderly; Eligibility Determination; Experimental Designs; Feedback; Future; Goals; Guidelines; Health behavior; Individual; Intervention; Knowledge; Mediating; Mediation; Mediator; Medicine; Methods; Modality; Modeling; Monitor; Morbidity - disease rate; Outcome; Participant; Persons; Physical activity; Play; Populations at Risk; Program Sustainability; Public Health; Publishing; Randomized; Randomized, Controlled Trials; Recommendation; Research; Research Activity; Research Personnel; Risk; Risk Factors; Role; Science; Scientist; Self Efficacy; Surveys; Techniques; Testing; Text; Text Messaging; Time; Walking; actigraphy; aged; arm; behavior change; behavior influence; cardiovascular disorder prevention; cardiovascular disorder risk; cost; design; eligible participant; exercise intervention; experimental study; improved; innovation; moderate-to-vigorous physical activity; mortality; prevent; recruit; remote delivery; sedentary; sedentary lifestyle; systematic review; theories; therapy development

We use the basic science of behavior change1,2 experimental medicine approach to efficiently test the effects of four distinct behavior change techniques (BCTs). These BCTs are selected to engage one of the key behavioral mechanisms of action (MoAs)--self-efficacy--for improving daily walking by at least 1000 steps in those who are very sedentary and at elevated cardiovascular disease risk.3,4 We propose a randomized 25 factorial experiment to do so. Whereas we have hundreds of behavior change interventions aimed at physical activity initiation, most test multi-BCT interventions, averaging six BCTs in each randomized controlled trial.6 Systematic reviews of these trials concluded that self-efficacy was in many cases the key proposed mechanism of action that improved initiation.7-11 They also concluded that self-efficacy was significantly improved by these multi-BCT interventions, as was physical activity.7,12 However, when they attempt to conclude that one BCT uniquely engaged or changed self-efficacy, and that the change in self-efficacy in turn increased the physical activity, they cannot do so.13 They cannot, because currently published physical activity interventions--with one single exception--always have multiple BCTs involved. These interventions don't quantitatively assess whether the BCT was used by the participant. These interventions don't assess the key MoA and behavior repeatedly across time, so that a full mediation model can be appropriately tested and analyzed. And, they don't estimate statistical power for conducting such a mediation model test, and so are likely under-powered to detect mediation. The Science of Behavior Change experimental method proposes that researchers identify the putative MoA, engage this MoA through experimentation and/or intervention, and then assess the degree to which MoA engagement produces behavior change. We used this approach to design an experiment in which eligible sedentary adults will be randomized to one of 16 cells for five months of intervention. Innovations of this project include: 1) identifying the individual effects of each of four BCTs on the hypothesized MoA, with a full factorial design; 2) using sequential mediation analysis to address longitudinal mediators; 3) including sufficient participants (N=480) to have adequate statistical power; and 4) quantitatively assessing whether the BCT was used. Sedentary behavior among participants at risk for CVD is highly prevalent, and is associated with increased risk for morbidity and mortality. Identifying which unique behavior change techniques engage self-efficacy and improve walking, and which ones don't, may allow future interventions to be more efficient and scientifically informed to precisely target this important public health problem.

我们使用行为的基本科学改变1,2实验医学方法来有效测试效果 在四种不同的行为变化技术（BCT）中。这些BCT被选为接合之一 行为机制（MOAS） - 自我效能感 - 以每天提高至少1000步的步行 那些非常久坐且处于心血管疾病风险升高的人。3,4我们提出了一个随机25 阶乘实验这样做。而我们有数百种针对身体的行为改变干预措施 活动开始，大多数测试多BCT干预措施，在每个随机对照试验中平均六个BCT。66 这些试验的系统评价得出的结论是，自我效能是在许多情况下提出的关键 7-11他们还得出结论，自我效能显着 这些多BCT干预措施以及体育锻炼也得到了改善。7,12但是，当它们试图尝试 得出结论，一个BCT独特地参与或改变了自我效能感，而自我效能的变化反过来 增加了体育锻炼，他们不能这样做。13他们不能 干预措施 - 一个单个例外 - 始终涉及多个BCT。这些干预措施没有 定量评估参与者是否使用了BCT。这些干预措施无法评估钥匙 MOA和行为跨时间反复，以便可以适当测试完整的调解模型，并且 分析。而且，他们没有估计进行此类中介模型测试的统计能力，因此 检测调解的可能不足。 行为改变的科学实验方法提出，研究人员确定了推定的MOA， 通过实验和/或干预参与此MOA，然后评估MOA的程度 参与会导致行为改变。我们使用这种方法设计了合格的实验 久坐的成年人将在五个月的干预中随机分为16个细胞之一。该项目的创新 包括：1）确定四个BCT中每种BCT对假设MOA的单个效果，并具有完整的阶乘 设计; 2）使用顺序中介分析来解决纵向介体； 3）包括足够的 参与者（n = 480）具有足够的统计能力； 4）定量评估BCT是否为 用过的。 有CVD风险的参与者的久坐行为非常普遍，并且与增加有关 发病率和死亡率的风险。确定哪种独特的行为改变技术具有自我效能感和 改善步行，哪些没有，可能会使将来的干预措施更有效，更科学 被告知要精确针对这个重要的公共卫生问题。