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: 10406061
• 负责人: Kavita Radhakrishnan
• 金额: $ 69.13万
• 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/10406061
• 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; Educational Materials; Face; Feedback; Goals; Guidelines; Habits; Health; Health Promotion; Healthcare; Heart failure; Hospitalization; Hypertension; Immersion; 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; 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; Weight; aged; base; blood pressure reduction; cardiovascular health; cardiovascular risk factor; 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 controlled study; randomized trial; 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.

项目总结/文摘