Mobile App for Self Management of Comorbid Depression and Metabolic Syndrome

项目摘要 抑郁症和代谢综合征（MetS）是常见的慢性疾病， 1 -3不幸的是，它们往往是共病的， 每一个都使另一个更严重，更难以管理，成本更高。 MoodJaunt是一款移动的应用程序，旨在填补人口健康管理市场的一个众所周知的空白8 -14： 缺乏参与和有效的自我管理计划，解决情绪和身体 成年人的健康管理抑郁症和慢性健康状况。 根据充分的设想，MoodJaunt移动的应用程序将提供一种综合方法， 改变：（a）抑郁症状，（B）体力活动，（c）饮食摄入，（d）体重减轻，（e）腰围 周长MoodJaunt将整合认知行为策略，以管理抑郁症的理论- 基于目标实现的方法，使患者参与减肥活动，以管理代谢综合征。扎根于自我 决心理论、动机访谈、认知行为疗法和习惯形成研究， MoodJaunt将支持用户的内在动机（自主性，能力和相关性）来吸引用户 在小的初始健康行为，然后引导他们走向临床有意义的健康习惯。 第一阶段的功能原型应用程序将重新调整和适应Jauntly，这是一个目标实现平台，可以 为各种自我管理行为提供目标和支持内容。第一阶段内容 将：（a）通过积极的身体和社会活动促进行为激活，以管理抑郁症， (b)建立符合NHLBI肥胖临床指南的身体活动水平，以开始管理代谢综合征。 我们将使用敏捷（迭代）开发和用户测试过程来解决三个挑战： 创建并优化包括以下内容的用户自我评估的入职过程的参与 情绪水平、抑郁症状和健康相关愿望;（B）将应用程序与无线通信系统集成， 加速度计设备（Fitbit（R））以补充自我报告的身体活动数据;以及（c）创建数据- 驱动引擎，根据用户的自我评估，定制应用程序生成的目标、消息传递和内容， 程序使用和加速度计数据。 第二阶段项目将：（a）扩展应用程序内容，以解决身体活动和饮食行为目标 专注于减肥和血糖控制（减少卡路里，饱和脂肪和精制碳水化合物; 分量控制;以及体重和食物摄入量自我监测）;（B）与附加的生物测定装置集成， 促进根据个人结果自我跟踪行为;以及（c）创建一个客户仪表板， 影响指标。 第一阶段MoodJaunt原型将在一项为期28天的随机试验（N = 110）中进行评估，以评估其 对行为激活、抑郁症状和体力活动的影响。受试者将通过以下方式招募 医疗/EAP服务诊所在华盛顿大都会区交通管理局。

PROJECT SUMMARY Depression and metabolic syndrome (MetS) are common chronic conditions that are debilitating to individuals and costly to employers and public and private payors.1-3 Unfortunately, they are often comorbid, each making the other more severe, more difficult to manage, and more costly.4-7 This project will create MoodJaunt, a mobile app designed to fill a well-known gap8-14 in the population health management market: a lack of engaging and effective self-management programs that address both the emotional and physical wellbeing of adults managing both depression and chronic health conditions. As fully conceived, the MoodJaunt mobile app will offer an integrated approach to effect clinically significant changes in: (a) depression symptoms, (b) physical activity, (c) dietary intake, (d) weight loss, and (e) waist circumference. MoodJaunt will integrate cognitive-behavioral strategies to manage depression with a theory- based goal-attainment approach to engage patients in weight-loss activities to manage MetS. Grounded in Self Determination Theory, Motivational Interviewing, cognitive-behavioral therapy, and habit-formation research, MoodJaunt will support users' intrinsic motivations (autonomy, competence, and relatedness) to engage users in small initial health behaviors and then guide them toward clinically meaningful health habits. The Phase I functional prototype app will repurpose and adapt Jauntly, a goal-attainment platform that can be populated with goals and supportive content for a variety of self-management behaviors. Phase I content will: (a) promote behavioral activation through positive physical and social activities to manage depression and (b) build physical activity toward levels that meet NHLBI obesity clinical guidelines to begin managing MetS. We will use an Agile (iterative) development and user testing process to address three challenges: (a) creating-and optimizing engagement of-an on-boarding process that includes a user self-assessment of mood level, depression symptoms, and health-related aspirations; (b) integrating the app with a wireless accelerometer device (Fitbit(R)) to supplement self-reported physical activity data; and (c) creating a data- driven engine to tailor app-generated goals, messaging, and content, based on the user's self-assessment, program-use, and accelerometer data. The Phase II project will: (a) expand app content to address physical activity and dietary behavior goals focused on weight loss and glycemic control (reduction of calories, saturated fat, and refined carbohydrates; portion control; and weight and food-intake self-monitoring); (b) integrate with additional biometric devices to promote self-tracking of behaviors against personal results; and (c) create a client dashboard with program impact metrics. The Phase I MoodJaunt prototype will be evaluated in a 28-day randomized trial (N = 110) to assess its effect on behavioral activation, depression symptoms, and physical activity. Subjects will be recruited through the Medical/EAP Services clinic at the Washington Metropolitan Area Transit Authority.