A sensor-controlled digital game-based approach to improve self-care behaviors among adults diagnosed with hypertension in a Native American community

一种基于传感器控制的数字游戏方法，用于改善美洲原住民社区中被诊断患有高血压的成年人的自我保健行为

• 批准号: 10612481
• 负责人: Kavita Radhakrishnan
• 金额: $ 68.81万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10612481
• 关键词: 18 year old; Accelerometer; Active Learning; Address; Adult; Behavior; Behavioral; Cardiac; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cellular Phone; Clinic; Communities; Complement; Control Groups; County; Data; Diagnosis; Diastolic blood pressure; Disparity; Education; Educational Materials; Electronics; Face; Feedback; Goals; Guidelines; Habits; Health; Health Promotion; Healthcare; Heart failure; Hospitalization; Hypertension; Incentives; Incidence; Individual; Intervention; Interview; Kidney Diseases; Knowledge; Learning; Life Style; Life Style Modification; Lumbee tribe; Measures; Modeling; Monitor; Morbidity - disease rate; Motivation; Native Americans; North Carolina; Obesity; Oklahoma; Outcome; Participant; Physical activity; Physical assessment; Play; Population; Quality of life; Randomized; Randomized Controlled Clinical Trials; Randomized, Controlled Trials; Recommendation; Research Design; Rewards; Risk Factors; Sampling; Self Care; Self Efficacy; Standardization; Stroke; Technology; Testing; Texas; Time; Training; Tribes; Weight; Writing; aged; blood pressure reduction; cardiovascular health; cardiovascular risk factor; care burden; community based participatory research; community building; digital; digital health; digital intervention; effectiveness testing; efficacy testing; evidence base; exercise intervention; group intervention; health disparity; hypertension control; improved; insight; member; mortality; mortality risk; portability; primary outcome; prospective; randomized trial; randomized, controlled study; recruit; response; secondary outcome; sensor; skills; social; tool; tribal community

PROJECT SUMMARY/ABSTRACT Cardiovascular disease is the leading cause of death among Native Americans (NAs). The Lumbee tribal community in Robeson county in North Carolina suffer from severe disparities related to cardiovascular disease incidence and mortality. Hypertension (HTN) strongly elevates the morbidity and mortality risks related to cardiovascular disease. Lifestyle modifications promoted by U.S. HTN guidelines includes modifiable self- care behaviors such as regular physical activity which is associated with lower blood pressure, reduced cardiovascular risk, and beneficial cardiac structural remodeling. Therefore, motivating physical activity behaviors would be key to cardiovascular health promotion efforts among the NA Lumbee tribal community. One promising approach is the use of sensor-controlled digital games (SCDGs), which offer affordable, portable, and scalable tools to facilitate engagement in HTN self-care behaviors while being enjoyable and easy to use. The SCDG intervention integrates HTN participants’ behavioral data from an activity tracker sensor to activate game progress, rewards, and feedback. The primary goal of this study is to test a culturally adapted SCDG intervention (N-SCDG) for improving daily physical activity self-care behaviors among Lumbee tribal adults with HTN and examine approaches for sustaining the impact of the N-SCDG at the community level. For Aim 1, we will use community based participatory approach to culturally adapt a SCDG intervention that we have already developed for mobile smartphones to motivate sustained physical activity self-care behaviors among NA adults with HTN. For Aim 2, using a randomized controlled clinical trial, we will compare the N-SCDG intervention versus a sensor-only control for the primary outcome of engagement in the HTN self- care behavior of physical activity and the secondary outcomes of HTN self-care knowledge, self-care behaviors, self-efficacy, systolic and diastolic blood pressure, cardiac hospitalization, and quality of life at baseline and at 3 and 6 months. For our sample, we will recruit adults aged 18 years or older from tribal affiliated cardiac clinics in Robeson county. We will randomize 220 participants to either the N-SCDG intervention group, in which participants will receive sensors that track physical activity and will play the N- SCDG on a mobile smartphone, or a control group that will receive sensors, an app that tracks physical activity, and standardized written HTN educational materials. For Aim 3, we will evaluate the sustainability of N-SCDG intervention in the Lumbee tribal community through qualitative interviews with study participants and community leaders and train Lumbee community members to sustain and disseminate the N-SCDG intervention for building community capacity for HTN management. This project will generate insight and guidance for scalable and easy-to-use digital gaming solutions to motivate HTN self-care behaviors and improve health outcomes among NA individuals with HTN.

项目概要/摘要 心血管疾病是美洲原住民 (NA) 的主要原因。 北卡罗来纳州罗伯森县的社区在心血管方面存在严重差异 高血压（HTN）会大大增加相关的发病率和死亡风险。 美国 HTN 指南提倡的生活方式改变包括可改变的自我改变。 护理行为，例如与降低血压、减少血压相关的定期体力活动 心血管风险和有益的心脏结构重塑因此，激励身体活动。 行为将是 NA Lumbee 部落社区心血管健康促进工作的关键。 一种有前途的方法是使用传感器控制的数字游戏 (SCDG)，它提供价格实惠、 便携式、可扩展的工具，可促进 HTN 自我护理行为的参与，同时让您感到愉快和轻松 SCDG 干预集成了来自活动跟踪器的 HTN 参与者的行为数据。 传感器来激活游戏进度、奖励和反馈 这项研究的主要目标是测试文化。 适应的 SCDG 干预 (N-SCDG) 用于改善 Lumbee 的日常身体活动自我护理行为 患有 HTN 的部落成年人，并研究维持 N-SCDG 对社区影响的方法 对于目标 1，我们将使用基于社区的参与方法来适应 SCDG 干预措施。 我们已经为移动智能手机开发了该功能，以激发持续的身体活动自我保健 对于目标 2，我们将使用随机对照临床试验来比较患有 HTN 的 NA 成年人的行为。 N-SCDG 干预与仅传感器控制的 HTN 自我参与的主要结果 身体活动的护理行为和 HTN 的次要结果 自我护理知识、自我护理 行为、自我效能、收缩压和舒张压、心脏病住院治疗以及生活质量 基线以及 3 个月和 6 个月时，我们将从部落招募 18 岁或以上的成年人。 我们将 220 名参与者随机分配至 N-SCDG。 干预组，参与者将收到跟踪身体活动的传感器，并玩 N- 移动智能手机上的 SCDG，或将接收传感器的对照组，这是一个跟踪身体状况的应用程序 对于目标 3，我们将评估标准化活动和书面 HTN 教育材料。 N-SCDG 通过对研究参与者进行定性访谈对 Lumbee 部落社区进行干预， 社区领袖并培训 Lumbee 社区成员以维持和传播 N-SCDG 该项目将产生洞察力和影响力，以建设社区的 HTN 管理能力。 可扩展且易于使用的数字游戏解决方案的指南，以激励 HTN 自我保健行为和 改善 NA 高血压患者的健康状况。