Heart Steps: Adaptive mHealth intervention for physical-activity maintenance

描述(由申请人提供)：许多心脏病的风险因素是行为因素，如缺乏体育锻炼、吸烟、高饱和脂肪和反式脂肪饮食。心脏康复和其他二级预防计划有效地帮助心脏病患者进行降低风险所需的初始生活方式改变，但患者在计划结束后往往无法保持这些改变。在这笔赠款中，研究人员建议开发一种新的mHealth应用程序，以支持心脏康复后维持体力活动。通过利用个人与人之间的频繁互动 调查人员将设计和评估一款自适应的个性化应用程序，该应用程序(1)让患者记住他们的健康目标，增加他们注意到参与体力活动的机会的可能性；(2)根据患者当前的环境，为患者如何立即活跃提供可行的想法；以及(3)帮助患者计划和反思他们的体力活动，以培养强大和可持续的体力活动习惯。此外，该应用程序将随着时间的推移调整其功能以适应ECH患者，以便将用户负担降至最低，同时优化其鼓励体力活动和保持参与干预的能力。以用户为中心的设计过程将被用来调查长期使用的mHealth技术的设计要求，该系统将在一项为期一年的研究中进行评估，60名冠心病患者完成了第二阶段的心脏康复。研究数据将被分析，以了解随着时间的推移，不同组件的使用如何影响患者的体力活动水平、感知的负担和对系统的投入。该项目的创新之处在于，将拟议的干预措施建立在自我调节的双进程模型中，开发新的算法，使应用程序随时间推移的工作方式能够进行适应和个性化，并使用微随机化研究设计，能够对一年中应用程序的使用如何影响患者的体力活动、用户负担和参与度进行因果解释。该项目的成功将为心脏病患者在日常生活中保持身体活动提供持续可用的支持，并深入了解长期使用的行为改变mHealth技术的技术和设计要求。

DESCRIPTION (provided by applicant): Many of the risk factors for heart disease are behavioral, such as physical inactivity, smoking, and diets high in saturated and trans-fats. Cardiac rehabilitation and other secondary prevention programs are effective at helping cardiac patients make the initial lifestyle changes needed to reduce their risks, but patients often fail t maintain those changes after the program ends. In this grant, the investigators propose to develop a novel mHealth application for supporting maintenance of physical activity after cardiac rehabilitation. By taking advantage of the frequent interactions that individuals have with their mobile phones throughout the day, the investigators will design and evaluate an adaptive, personalized application that (1) keeps patients reminded of their health goals, increasing the likelihood that they will notice opportunities to engage in physical activity; (2) provides actionable ideas for how patients can be active right now, given their current context; and (3) helps patients plan and reflect on their physical activity to enable creation of robust and sustainable physical-activity habits. In addition, the application will adapt its functioning for ech patient over time in order to minimize user burden while optimizing its ability to encourage physical activity and maintain engagement with the intervention. A user-centered design process will be used to investigate design requirements of mHealth technologies for long-term use, and the system will be evaluated in a year-long study with 60 patients with coronary artery disease who completed phase II cardiac rehabilitation. Study data will be analyzed to understand how the use of different components affect, over time, patients' physical activity levels, perceived burden, and engagement with the system. The project's innovations lie in grounding the proposed intervention in dual-process models of self-regulation, developing new algorithms to enable adaptation and personalization of how the application works over time, and using a micro-randomization study design to enable causal accounts of how the application use affects patients' physical activity, user burden, and engagement over the course of a year. The success of the project will provide cardiac patients with continuously available support for staying physically active in the midst of daily life, and deep understanding of technical and design requirements for behavior-change mHealth technologies for long-term use.