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.

项目摘要/摘要 心血管疾病是美国原住民（NAS）死亡的主要原因。 Lumbee部落 北卡罗来纳州罗伯逊县的社区患有与心血管有关的严重差异 疾病事件和死亡率。高血压（HTN）强烈提高发病率和死亡率风险 患心血管疾病。美国HTN指南提起的生活方式修改包括可修改的自我 护理行为，例如与降低血压相关的常规体育锻炼，降低 心血管风险和有益的心脏结构重塑。因此，激励体育锻炼 行为将是Na Lumbee部落社区中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），可提供负担得起的， 可便携式和可扩展的工具，以促进在愉快的同时参与HTN自我保健行为和 便于使用。 SCDG干预措施整合了来自活动跟踪器的HTN参与者的行为数据 传感器激活游戏的进度，奖励和反馈。这项研究的主要目标是在文化上测试 改编的SCDG干预措施（N-SCDG），用于改善LUMBEE之间的每日体育锻炼自我护理行为 具有HTN的部落成年人和检查方法以维持N-SCDG对社区的影响 等级。对于AIM 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成熟的持续体育锻炼自我保健 NA成年人HTN的行为。对于AIM 2，使用随机对照临床试验，我们将比较 N-SCDG干预与仅传感器控制HTN自我参与的主要结果 体育活动的护理行为和HTN自我保健知识的次要结果，自我保健 行为，自我效能感，收缩压和舒张压，心脏住院和生活质量 基线和3和6个月。对于我们的样本，我们将招募从部落以上的18岁以上的成年人 罗伯逊县的关联心脏诊所。我们将将220名参与者随机为N-SCDG 干预小组，参与者将收到跟踪体育活动的传感器，并将播放N- 移动智能手机上的SCDG或将接收传感器的对照组，该应用程序跟踪物理 活动和标准化的书面HTN教育材料。对于AIM 3，我们将评估 N-SCDG通过与研究参与者的定性访谈和 社区领导者和培训Lumbee社区成员以维持和传播N-SCDG HTN管理的建筑社区能力的干预。该项目将产生洞察力，并 有关动机的可扩展且易于使用的数字游戏解决方案的指南HTN自我保健行为和 改善HTN的NA患者的健康结果。