Evaluating Connected Health Approaches to Improving the Health of Veterans

评估改善退伍军人健康的互联健康方法

• 批准号: 9189574
• 负责人: Mitesh S. Patel
• 金额: --
• 依托单位: PHILADELPHIA VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-10-01 至 2020-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9189574
• 关键词: Address; Address; Baseline Surveys; Baseline Surveys; Behavior; Behavior; Behavior monitoring; Behavior monitoring; Cardiovascular Diseases; Cardiovascular Diseases; Caring; Characteristics; Characteristics; Clinical Trials; Clinical Trials Design; Clinical Trials Design; Country; Country; Data; Data; Devices; Devices; Diabetes Mellitus; Diabetes Mellitus; Diet; Diet; Emotions; Emotions; Goals; Goals; Health; Health; Health Services Research; Health Services Research; Health Technology; Health Technology; Health behavior; Health behavior; Healthcare; Healthcare; Healthcare Systems; Healthcare Systems; Hospitalization; Hospitalization; Human; Human; Hypertension; Hypertension; Incentives; Incentives; Individual; Individual; Information Technology; Information Technology; Intervention; Intervention; Interview; Interview; Investigator-Initiated Research; Investigator-Initiated Research; Investments; Investments; K-Series Research Career Programs; K-Series Research Career Programs; Lead; Lead; Medical center; Medical center; Mentorship; Mentorship; Methods; Methods; Modeling; Modeling; Monitor; Monitor; Morbidity - disease rate; Morbidity - disease rate; Multi-Institutional Clinical Trial; Obesity; Obesity; Outcome; Outcome; Overweight; Overweight; Patient Monitoring; Patient Monitoring; Performance; Performance; Persons; Persons; Philadelphia; Philadelphia; Physical activity; Physical activity; Premature Mortality; Premature Mortality; Probability; Probability; Randomized Clinical Trials; Randomized Clinical Trials; Regrets; Regrets; Research; Research; Research Design; Research Personnel; Research Personnel; Research Project Grants; Research Project Grants; Research Proposals; Research Proposals; Risk Factors; Risk Factors; Service delivery model; Site; Site; Smoking; Smoking; Social support; Social support; Structure; Structure; Surveys; Surveys; Technology; Technology; Testing; Testing; Training; Training; Veterans; Veterans; Weight; Weight; Work; Work; base; base; behavior change; behavior change; behavioral economics; behavioral economics; cardiovascular disorder risk; cardiovascular disorder risk; career; career; career development; design; design; driving behavior; experience; experience; financial incentive; financial incentive; follow-up; follow-up; health administration; health administration; health care delivery; improved; improved; innovation; innovation; insight; insight; mHealth; mHealth; medication compliance; medication compliance; mobile computing; mobile computing; mortality; mortality; new technology; new technology; novel strategies; novel strategies; physical inactivity; population health; population health; programs; programs; randomized trial; randomized trial; research and development; skills; skills; social; social; sociodemographics; telehealth; telehealth; usability; usability

Background Cardiovascular disease is the leading cause of hospitalization, morbidity, and mortality among veterans. Many of the contributing risk factors are health behaviors that occur outside of the health care system and within their everyday lives of veterans such as physical activity, obesity, smoking, and medication adherence. Connected health is a model for using mobile technologies to remotely monitor health outcomes and deploy interventions to change behavior. While connected health devices may help to facilitate the monitoring of behaviors within veterans' everyday lives, they alone may not drive behavior change toward improved health. Insights from behavioral economics can help to design engagements strategies around connected health devices that leverage the fact the individuals tend to be more present-biased, put undue weight on small probabilities, and are heavily influenced by emotions such as regret and loss aversion. The Veterans Health Administration (VHA) is a leader in pioneering connected health technologies to improve the care and health of veterans as exemplified by the VA Center for Connected Health. However, little is known about veterans' experiences and outcomes with these technologies. Without the appropriate design, veterans' use of connected health devices may be subject to multiple challenges and potentially unintended consequences. Given VHA's significant investment in these technologies, the potentially significant impact on veterans nationally, and the alignment with the VHA's Blueprint for Excellence, it is imperative that these approaches are rigorously tested Objectives To address these issues, I will aim to focus on following research objectives: 1) Understand veterans' perspectives of needs, barriers, and opportunities with connected health devices; 2) Evaluate veteran's experiences with Way to Health, a technology platform already being used at the CMCVAMC in Philadelphia to integrate connected health devices and enable automated deployment of behavioral economic interventions; 3) Use Way to Health to test social and financial incentive-based connected health approaches to increase physical activity among veterans to inform an investigator-initiated research proposal. Methods My first study will use a mixed-methods approach to identify veterans' experiences with mobile and connected health technologies, conduct a 4-week pilot using Way to Health, a connected device, and social incentive intervention to increase physical activity, and conduct semi-structured interviews to evaluate trial experiences. These findings will inform my second study, a 20-week randomized clinical trial testing combinations of social and financial incentives to increase physical activity. This work will inform an investigator initiated research proposal for a larger, multisite clinical trial. Insights from this work will be applicable to other health behaviors such as those related to smoking, obesity, and medication adherence. Anticipated Impact on Veterans' Health Approaches that effectively combine insights from behavioral economics with connected health devices and lead to improvements in behaviors within the everyday lives of veterans can have a significant impact on the health of veterans. Insights from this work could be leveraged to address other cardiovascular disease risk factors such as hypertension, diabetes, obesity, and smoking, which could lead to additional improvements in the health of veterans on a national scale.

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