Tailoring Online Continence Promotion for Women

项目摘要 子宫内膜异位症是常见的，昂贵的，而且在女性中治疗得非常不足。排尿和排便 尿失禁经常同时发生，并影响超过一半绝经后妇女， 每年的医疗费用超过300亿美元。生活方式的改变是第一步- 线治疗，但大多数妇女不知道这些战略，因为他们不寻求 在乎将这些解决方案的信息带给医疗机构以外的女性， 授权他们做出这些行为改变有可能改善症状， 影响生活质量，并降低数百万妇女的医疗费用。我们的团队开发 并测试了一个小团体行为：健康的肠道，健康的膀胱（Mind Over Matter：Healthy Bowels，Healthy Bladder）。 改变干预措施，改善50岁及以上女性的尿失禁和肠失禁。 该计划是创新的，其纳入战略，以改善膀胱和肠道 然而，它的范围是有限的，因为它是提供给社区中的小团体 设置.我们之前的研究表明，不到20%的女性尿失禁， 参加类似的计划，而超过60%的人会参加在线培训， 推广计划。因此，我们的团队获得了试点资金，以适应在线 平台，并展示了巨大的影响力相比，在人的程序（> 4000 3个月内的用户数与12个月内的<300个用户数）。然而，大多数参与者 只参加了一次培训，没有采取任何行为改变。其他学科也使用过 定制，一个过程，通过这个过程，来自特定用户的输入被处理， 个性化的输出，以加强与电子健康促进的参与。裁缝有 尽管NIDDK认识到个体化， 尿失禁的治疗作为一个重要的研究重点。我们提出了一个随机的 对照试验测试剪裁的影响（与计划的活性对照组相比， 数字提醒）参与在线广告和采用健康行为， 提高了生产效率。我们假设那些有定制体验的人会使用该计划 更有可能做出行为改变。在最后的目标，我们探索机制， 通过这种剪裁影响行为改变。我们的团队正在努力改善 从跨学科的角度（心理学、人因工程学、健康 沟通理论和泌尿妇科学），并提出了一项研究，有可能显着 推进我们对如何个性化失禁行为治疗的理解。

PROJECT SUMMARY Incontinence is common, costly, and vastly undertreated in women. Urinary and bowel incontinence often co-occur and impact more than half of women after menopause, with healthcare costs in excess of $30 billion per year. Lifestyle changes are recommended as first- line treatment but most women are not aware of these strategies because they do not seek care. Bringing information about these solutions to women outside the healthcare setting and empowering them to make these behavior changes has the potential to improve symptoms, impact quality of life, and decrease healthcare costs for millions of women. Our team developed and tested Mind Over Matter: Healthy Bowels, Healthy Bladder (MOM), a small-group behavior change intervention that improves urinary and bowel incontinence in women age 50 and older. This program is innovative in its inclusion of strategies to improve both bladder and bowel incontinence; its reach, however, is limited because it is delivered to small groups in community settings. Our prior research showed that less than 20% of women with incontinence would participate in a program like MOM, while over 60% would participate in an online continence promotion program. Our team therefore obtained pilot funding to adapt MOM to an online platform and demonstrated tremendous reach compared to the in-person program (>4,000 users in 3 months versus <300 users in 12 months). However, the majority of participants visited the program only once and did not adopt behavior changes. Other disciplines have used tailoring, a process through which inputs from a specific user are processed to generate individualized outputs, to enhance engagement with electronic health promotion. Tailoring has not been widely studied in continence promotion despite NIDDK recognizing individualization of treatment for urinary incontinence as a significant research priority. We propose a randomized controlled trial testing the impact of tailoring (versus an active control group with scheduled digital reminders) on engagement with online MOM and adoption of health behaviors that improve continence. We hypothesize that those with a tailored experience will use the program more and be more likely to make behavior changes. In the final aim, we explore mechanisms through which tailoring impacts behavior change. Our team approaches improving continence promotion from a transdisciplinary perspective (psychology, human factors engineering, health communication theory, and urogynecology) and proposes a study with potential to significantly advance our understanding of how to personalize behavioral treatment for incontinence.