Mobile Intervention to Enhance Physical Activity in the Chronically Ill

移动干预增强慢性病患者的身体活动

• 批准号: 8706543
• 负责人: AMELIA J BIRNEY
• 金额: $ 22.37万
• 依托单位: OREGON CENTER FOR APPLIED SCIENCE, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-15 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8706543
• 关键词: Address; Adult; American; American Medical Association; Asthma; Behavioral; Chronic; Chronic Disease; Chronically Ill; Clinical Trials; Cognitive Therapy; Computers; Consensus; Data; Degenerative polyarthritis; Devices; Diabetes Mellitus; Disease; Disease Management; Effectiveness; Employee; Evaluation; Exercise; Fatigue; Feedback; Focus Groups; Funding; Goals; Habits; Health; Health Planning; Heart failure; Hypertension; Individual; Internet; Intervention; Link; Lung; Lung diseases; Mails; Medical; Medicine; Meta-Analysis; Monitor; Online Systems; Outcome; Pain; Patient Self-Report; Patients; Phase; Physical activity; Physicians; Population; Prevalence; Primary Care Physician; Provider; Public Health; Recommendation; Reporting; Sports Medicine; Tablets; Testing; Text; Therapeutic Intervention; Time; TimeLine; Underserved Population; United States; United States National Institutes of Health; Update; Visit; Vulnerable Populations; Wireless Technology; college; design; disorder prevention; efficacy trial; evidence base; improved; mobile application; neglect; patient population; preference; programs; prototype; public health relevance; remediation; screening; sedentary; social; usability

PROJECT SUMMARY This project aims to fill the urgent need for a safe and engaging intervention that promotes physical activity in a population of patients with chronic diseases (e.g., diabetes, asthma, osteoarthritis, and chronic heart failure). Compelling evidence suggests that physical activity is an effective therapeutic intervention for numerous chronic diseases. However, in spite of the wide consensus that physical activity should be an integral treatment component for many chronic diseases, most patients remain inactive1 due to a variety of barriers and obstacles they regularly encounter. We therefore propose to innovatively adapt an efficacious exercise-promoting intervention that targets sedentary employees2 to a population with specific needs and constraints that result from chronic disease and deliver this intervention as a mobile application that can be accessed via smartphone, tablet, or computer. We propose a program design that follows recommendations derived from a recent NIH-funded meta- analytic review of interventions to promote physical activity in patients with chronic diseases, which emphasizes the importance of behavioral activation as opposed to cognitive-behavioral intervention features.3 Our comprehensive mobile application is therefore composed of (a) an initial screening; (b) baseline physical activity (PA) levels recorded via wireless accelerometer device; (c) an assessment that elicits information regarding preferences for and barriers to PA; (d) goal setting; (e) daily e-mail or text messages stating the goal for the day, the type of exercise, and a link to a video demonstrating the exercise; (f) a brief check-in to determine whether the user is currently encountering a barrier (pain, fatigue, etc.) and tailored remediation for the barrier through social media functionality and expert advice; (g) prompts to execute the daily exercise; (h) integration of a wireless accelerometer device (e.g., Fitbit(R)) to supplement self-reported exercise data and to drive tailored feedback and goal setting; (i) check-in regarding activity completion (e.g., "have you completed the exercise?," "did you enjoy this exercise?," "do you feel better after this exercise?"); (j) immediate, personalized feedback on how executed physical activities contribute to goal progress; and (k) feedback reports for the primary care physician. Together these design features will promote and support a sustainable habit of regular PA in this vulnerable population. In a 30-day pre-post study, we will test preliminary efficacy and feasibility of this prototype intervention in a population of 38 adult patients with chronic osteoarthritis. The Phase I prototype program will be limited to demonstrating feasibility with individuals with osteoarthritis to control the overall scope of the Phase I project. We hypothesize that this intervention will engage this population and increase subjects' PA level from pre- to post-assessment. If this pilot efficacy trial yields satisfactory results, the Phase 2 project will expand the scope of the program to include all patients with additional chronic diseases (e.g., osteoarthritis, hypertension, diabetes, pulmonary disease).

项目概要 该项目旨在满足对促进身体活动的安全且有吸引力的干预措施的迫切需求 在患有慢性疾病（例如糖尿病、哮喘、骨关节炎和慢性心脏病）的患者群体中 失败）。令人信服的证据表明，体力活动是一种有效的治疗干预措施 多种慢性疾病。然而，尽管人们普遍认为体力活动应该是一种 许多慢性疾病的整体治疗组成部分，大多数患者由于各种原因而保持不活动1 他们经常遇到的障碍和障碍。 因此，我们建议创新性地采用一种有效的运动促进干预措施，目标是 久坐不动的员工2以及因慢性疾病和疾病而有特殊需求和限制的人群 以可通过智能手机、平板电脑或计算机访问的移动应用程序的形式提供这种干预措施。 我们提出了一个程序设计，该设计遵循最近 NIH 资助的元数据的建议。 对促进慢性病患者身体活动的干预措施进行分析审查，其中 强调行为激活相对于认知行为干预特征的重要性。3 因此，我们全面的移动应用程序由以下部分组成：(a) 初步筛选； (b) 基线身体素质 通过无线加速计设备记录的活动 (PA) 水平； (c) 获取信息的评估 关于 PA 的偏好和障碍； (d) 目标设定； (e) 每日电子邮件或短信说明目标 当天的锻炼类型以及演示锻炼的视频链接； (f) 短暂登记 确定用户当前是否遇到障碍（疼痛、疲劳等）并针对其量身定制补救措施 通过社交媒体功能和专家建议消除障碍； (g) 提示执行日常练习； （八） 集成无线加速计设备（例如 Fitbit(R)）以补充自我报告的锻炼数据和 推动量身定制的反馈和目标设定； (i) 签到活动完成情况（例如，“您 完成了练习吗？”，“你喜欢这个练习吗？”，“这个练习之后你感觉好点了吗？”）；（j） 关于所执行的身体活动如何有助于目标进展的即时、个性化反馈；和 (k) 初级保健医生的反馈报告。这些设计特征将共同促进和支持 在这个弱势群体中定期进行 PA 的可持续习惯。 在为期 30 天的前后研究中，我们将测试这种原型干预措施的初步功效和可行性。 38 名患有慢性骨关节炎的成年患者。第一阶段原型计划将仅限于 证明骨关节炎患者控制第一阶段总体范围的可行性 项目。我们假设这种干预措施将吸引该人群并提高受试者的 PA 水平 评估前至评估后。如果该试点疗效试验取得满意结果，二期项目将扩大 该计划的范围包括所有患有其他慢性疾病的患者（例如骨关节炎、 高血压、糖尿病、肺部疾病）。