Mobile App for Self Management of Comorbid Depression and Metabolic Syndrome

项目总结 抑郁症和代谢综合征(METS)是一种常见的慢性疾病，会使人虚弱到 1-3不幸的是，它们往往是并存的， 每一项都会使对方变得更加严重、更难管理、成本更高。4-7此项目将创建 一款旨在填补人口健康管理市场上著名缺口8-14的移动应用程序MoodJa姨：a 缺乏吸引人的、有效的自我管理计划，以解决情感和身体上的问题 同时患有抑郁症和慢性健康状况的成年人的幸福感。 根据充分的设想，MoodJa姨移动应用程序将提供一种集成的方法来影响临床意义 改变：(A)抑郁症状、(B)体力活动、(C)饮食摄入量、(D)体重减轻和(E)腰围 周长。MoodJaine将把管理抑郁症的认知行为策略与一种理论相结合-- 以达到目标为基础的方法，让患者参与减肥活动，以管理METS。植根于自我 决定论、动机访谈、认知行为疗法和习惯养成研究， MoodJa姨将支持用户的内在动机(自主性、能力和关联性)来吸引用户 在最初的小健康行为中，引导他们养成有临床意义的健康习惯。 第一阶段功能原型应用程序将重新调整用途和适应Jaunly，这是一个实现目标的平台，可以 为各种自我管理行为设定目标和支持性内容。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，以管理抑郁和 (B)将体力活动增加到符合NHLBI肥胖临床指南的水平，以便开始管理MET。 我们将使用敏捷(迭代)开发和用户测试流程来应对三个挑战： 创建-并优化-自注册流程，其中包括用户对 情绪水平、抑郁症状和与健康相关的愿望；(B)将应用程序与无线 用于补充自我报告的体力活动数据的加速度计设备(Fitbit(R))；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APP内容，以满足体力活动和饮食行为目标 重点关注减肥和血糖控制(减少卡路里、饱和脂肪和精制碳水化合物； 份量控制；以及体重和食物摄入量自我监测)；(B)与更多的生物识别设备相结合，以 促进针对个人结果的行为自我跟踪；以及(C)使用程序创建客户端仪表板 影响指标。 将在为期28天的随机试验(N=110)中对第一阶段的MoodJaine原型进行评估，以评估其 对行为激活、抑郁症状和体力活动的影响。受试者将通过以下途径招募 华盛顿大都会地区运输管理局的医疗/EAP服务诊所。

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.