RELAX: A mobile application suite targeting obesity and stress

描述(申请人提供)：肥胖和压力是高度并存的，都会增加心血管疾病(CVD)的风险。压力与无节制饮食、垃圾食品消费以及农产品和全谷物的低消费有关。压力和压力诱导的饮食不仅与肥胖有关，而且在生活方式干预中也会预测最糟糕的结果。除了饮食和体力活动外，干预措施还应针对压力和压力诱导的进食，以最大限度地减轻肥胖成年人的体重和降低心血管疾病风险；然而，这有助于强化干预。可以利用技术来减少干预负担，同时通过收集和编辑患者数据来为临床医生决策提供信息并直接提供干预，从而解决更复杂的患者问题 战略。这项建议的目的是开发和测试RELAX应用套件(AS)的可行性和概念验证，这是一种针对肥胖者的生活方式干预的移动、云和网络伴侣。RELAX-AS包括RELAX-APP和RELAX-WEB。Relax-APP是一款面向患者的移动应用程序，将链接到Microsoft Health Vault，这是一个基于云的平台，允许在线安全访问健康数据。Relax-APP将包括自我监控(饮食、锻炼、压力、压力诱导的饮食)；通过易于解释的视觉显示和关于目标行为之间的数量、时间、背景和关系的反馈报告进行自动反馈；以及当压力评级提高时提示的自我引导压力管理功能。Relax-Web是一个基于Web的应用程序，供临床医生以易于理解的视觉显示和 反馈报告，以提高他们的咨询效率。我们的目标是使用RELAX-AS创建一种干预交付模式，通过使用传统生活方式干预的一半来减轻体重和压力。我们建议进行为期3年的研究，包括3个阶段：需求收集/开发、可用性测试/前期试验和试验。需求收集/开发工作将侧重于在用户和临床医生中迭代开发可视显示、反馈消息和移动交付的压力缓解策略。在可用性测试/试点前阶段，我们将检查RELAX的可用性，就像在目标人群成员和临床医生中使用缩短的四周试点前干预一样。在试验阶段，我们将肥胖成年人随机分为3种情况：放松-AS，通用饮食/运动应用系统，或不使用技术。所有的情况都将接受短暂的减肥咨询。可行性结果将是APP功能的使用、可接受性、依从性、临床医生的时间、负担、保留、时间和成本。探索性结果包括体重、压力和压力诱导的进食的变化。这项工作将为我们准备一项双臂疗效试验，比较放松--就像短暂的生活方式干预一样，与仅对体重、压力和压力饮食进行短暂的生活方式干预相比较。

DESCRIPTION (provided by applicant): Obesity and stress are highly comorbid and both increase risk for cardiovascular disease (CVD). Stress is associated with disinhibited eating, junk food consumption and low consumption of produce and whole grains. Both stress and stress-induced eating are not only associated with obesity but also predict worst outcomes in lifestyle interventions. In addition to diet and physical activity, both stress and stress-induced eating should be targeted in interventions obese adults to maximize weight loss and CVD risk reduction; however, this makes for an intensive intervention. Technology could be leveraged to reduce intervention burden while still addressing more complicated patient issues by collecting and compiling patient data to inform clinician decision making and directly delivering intervention strategies. The purpose of this proposal is to develop and test the feasibility and proof-of-concept of RELAX Application Suite (AS), a mobile-, and cloud- and web-based companion to a lifestyle intervention for obese individuals. RELAX-AS includes RELAX-app and RELAX-web. RELAX-app is a patient-facing mobile application that will be linked to Microsoft Health Vault, a cloud-based platform that allows for secure access of health data online. RELAX-app will include self-monitoring (diet, exercise, stress, stress-induced eating); automated feedback via easy-to-interpret visual displays and feedback reports on the amount, timing, context, and relationship between target behaviors; and self-guided stress management features that are prompted when stress ratings are elevated. RELAX-web is a web-based application for clinicians to access the patient's information in the form of easily digestible visual displays and feedback reports to increase the efficiency of their counseling. Our goal is to use RELAX-AS to create an intervention delivery model that reduces both weight and stress with half the visits of traditional lifestyle interventions. We propose a 3-year study that includes 3 phases: Requirements Gathering/Development, Usability Testing/Pre-Pilot, and Pilot. Requirements Gathering/Development work will focus on the iterative development of visual displays, feedback messages, and mobile-delivered stress reduction strategies among users and clinicians. In the Usability Testing/Pre-pilot phase we will examine usability of RELAX-AS in both members of the target population and clinicians using an abbreviated 4-week pre-pilot intervention. In the Pilot phase, we will randomize obese adults to 3 conditions: RELAX-AS, a generic diet/exercise application system, or no technology. All conditions will receive brief weight loss counseling. Feasibility outcomes will be usage of app features, acceptability, adherence, clinician time, burden, retention, time and cost. Exploratory outcomes include changes in weight, stress, and stress-induced eating. This work will prepare us for a 2-arm efficacy trial comparing RELAX-AS with a brief lifestyle intervention to a brief lifestyle intervention alone on weight, stress, and stress eating.