Wearable Technology Infrastructure to Enhance Capacity for Real-Time, Online Assessment and Mobility (ROAMM) of Intervening Health Events in Older Adults

可穿戴技术基础设施可增强老年人干预健康事件的实时在线评估和移动性 (ROAMM) 能力

• 批准号: 10609536
• 负责人: Todd Manini
• 金额: $ 67.63万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10609536
• 关键词: Acceleration; Accelerometer; Address; Adherence; Adopted; Adverse event; Advisory Committees; American; Apple watch; Area; Automobile Driving; Behavioral; Capsicum; Charge; Clinical; Cognition; Collaborations; Communities; Data; Data Collection; Data Science; Data Storage and Retrieval; Early Diagnosis; Ecological momentary assessment; Elderly; Ensure; Event; Fatigue; Fees; Florida; Focus Groups; Foundations; Frequencies; Geriatrics; Gerontology; Grant; Health; Heart Rate; Home; Hospitalization; Incidence; Infrastructure; Injury; Interview; Licensing; Life; Location; Longitudinal cohort study; Marketing; Measurement; Measures; Medical; Modeling; Monitor; Moods; Nature; Online Systems; Outcome; Pain; Participant; Patient Outcomes Assessments; Patients; Pattern; Persons; Phase; Phenotype; Physical Function; Physical activity; Prevention; Quality of life; Recording of previous events; Recovery; Remote management; Reporting; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Safety; Science; Secure; Services; Short-Term Memory; Symptoms; System; Technology; Testing; Time; United States National Institutes of Health; Universities; Voice; Work; advanced analytics; aged; base; cognitive testing; comorbidity; cost effectiveness; data science management; data to knowledge; data visualization; demographics; depressive symptoms; disability; executive function; experience; fall injury; fall risk; falls; focus ultra; graphical user interface; informant; longitudinal, prospective study; mobile computing; mobile sensor; novel; primary outcome; processing speed; prospective; recruit; response; secondary outcome; sensor; smart watch; technology platform; therapy design; tool; usability; walking speed; wearable device; wearable monitor; week trial

ABSTRACT Older Americans experience approximately 29 million falls and 13 million hospitalizations per year. These intervening health events (IHE - episodic falls, injuries, illnesses, and hospitalizations) are strong precipitants of disability in older adults. Because of their episodic nature, IHEs are extremely difficult to study. Continuous, long-term monitoring with remote capabilities using wearable technology is an ideal solution for capturing information surrounding an IHE and in particular, preceding it. This R21/R33 project aims to develop a sustainable research infrastructure built on the foundation of a smart watch application and server called ROAMM (Real-time Online Assessment and Mobility Monitor). It will offer long-term and continuous connectivity, bidirectional interactivity and remote programming. ROAMM will create a detailed narrative about mobility (activity patterns, walking speed, life space), patient reported outcomes/symptoms (pain, poor mood, fatigue, disability), cognition (working memory, processing speed, and executive functioning) and reports of health events (falls and hospitalizations). The infrastructure is composed of a diverse group of investigators with expertise in mobile technology/data science and applied/medical sciences who will serve in the following cores: Wearable Technology, Phenotyping, Clinical Outcomes, Data Science Management & Quality, and Recruitment, Retention & Compliance. In the R21 phase, we will create the ROAMM framework consisting of the watch application and accompanying server. We will also assess test-retest reliability, convergent validity and participant usability/acceptability. Each year, an Independent Advisory Panel and External Advisory Committee will evaluate milestone-driving activities and our Go/No-Go checkpoints for transitioning to the R33 phase. Work proposed in the R33 phase will showcase the ROAMM infrastructure by conducting a prospective, longitudinal study (range 1.25-2.5 yrs) in 200 community-dwelling persons aged 70+ yrs. This phase will test a field deployable version of ROAMM in real world settings to address the following hypotheses: 1) Pre-event patterns of low mobility, disability, fatigue, pain and depressive mood collected by ROAMM are independent predictors of incident IHE's; 2) IHE's will negatively impact the course of ROAMM measures; and 3) Additional value will be gained for explaining the change variability and recovery trajectories. An exploratory aim will evaluate safety while using ROAMM features and identify predictors of ROAMM adherence using both key-informant interviews and examine demographic and health histories to create boundaries for using ROAMM and other systems like it for long-term, continuous monitoring in research and practice. We will sustain ROAMM by targeting grant opportunities for the wearable technology surge for remote patient interaction, adopting licensing fees, and aligning our services with larger entities to become the go-to place for remote data capture. These activities will create a sustainable infrastructure to ensure research on older adults is keeping pace with the state-of-the-art “smart and connected” health with wearable technology.

抽象的 年龄较大的美国人每年经历大约2900万跌倒和1300万住院。这些 干预健康事件（IHE-情节跌倒，伤害，疾病和住院）是强大的降水剂 老年人的残疾。由于其发作性质，IHES非常困难。连续的， 使用可穿戴技术的远程功能的长期监控是捕获的理想解决方案 围绕IHE，尤其是在它之前的信息。这个R21/R33项目旨在开发一个 可持续研究基础设施建立在智能手表应用程序和服务器的基础上 ROAMM（实时在线评估和移动性监视器）。它将提供长期和连续的 连接性，双向交互性和远程编程。 Roamm将创建一个详细的叙述 流动性（活动模式，步行速度，寿命），患者报告的结局/症状（疼痛，情绪低落， 疲劳，残疾），认知（工作记忆，处理速度和执行功能）以及报告 健康事件（跌倒和住院）。基础设施由研究人员组成 具有移动技术/数据科学和应用/医学科学方面的专业知识，他们将在以下服务 核心：可穿戴技术，表型，临床结果，数据科学管理与质量以及 招聘，保留和合规。在R21阶段，我们将创建由ROAMM框架组成的 手表应用程序和参与服务器。我们还将评估测试可靠性，收敛性 并参与可用性/可接受性。每年，一个独立的咨询小组和外部咨询 委员会将评估里程碑式驾驶活动和我们的GO/No-Go检查站，用于过渡到R33 阶段。在R33阶段提出的工作将通过进行A来展示ROAMM基础架构 在70岁以上的200名社区居民中，前瞻性，纵向研究（范围1.25-2.5年）。这 阶段将在现实世界中测试ROAMM的现场可部署版本，以解决以下假设： 1）ROAMM收集的低流动性，残疾，疲劳，疼痛和抑郁情绪的事件前模式是 事件的独立预测因素； 2）IHE将对ROAMM措施的进程产生负面影响；和 3）将获得额外的价值来解释变化的可变性和恢复轨迹。探索性 AIM将在使用ROAMM功能的同时评​​估安全性，并使用两者都确定ROAMM依从性 钥匙信息访谈并检查人口统计和健康历史，以创建用于使用的边界 ROAMM和其他类似的系统，用于长期，继续进行研究和实践监控。我们将 通过针对远程患者的可穿戴技术激增的赠款机会来维持ROAMM 互动，采用许可费，并使我们的服务与较大的实体保持一致 远程数据捕获。这些活动将创建可持续的基础设施，以确保对老年人的研究 通过可穿戴技术与最先进的“智能和连接”健康保持同步。