A Tailored Physical Activity Smartphone App for Patients with Alcohol Dependence

为酒精依赖患者量身定制的体育活动智能手机应用程序

• 批准号: 9267078
• 负责人: Ana M Abrantes
• 金额: $ 21.23万
• 依托单位: BUTLER HOSPITAL (PROVIDENCE, RI)
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2018-08-19
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9267078
• 关键词: Acute; Adherence; Adopted; Adverse event; Affect; Alcohol dependence; Alcohols; Area; Attention; Behavioral; Cause of Death; Cellular Phone; Day Care; Development; Exercise; Expectancy; Feedback; Focus Groups; Future; Goals; Health; Individual; Intervention; Interview; Knowledge; Measures; Mediating; Mental Health; Metadata; Methods; Monitor; Motivation; Outcome; Patient Self-Report; Patients; Persons; Phase; Physical activity; Populations at Risk; Professional counselor; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recovery; Relapse; Rewards; Role; Self Determination; Self Efficacy; Series; Suggestion; Supervision; Technology; Testing; Time; addiction; alcohol abuse therapy; alcohol relapse; alcohol use disorder; anxiety symptoms; base; behavior change; behavior influence; brief advice; cost; craving; depressive symptoms; design; disorder later incidence prevention; drinking; exercise intervention; experience; fitness; follow up assessment; follow-up; improved; moderate-to-vigorous physical activity; negative affect; negative mood; novel; physical conditioning; pilot trial; programs; prototype; psychologic; public health relevance; reduced alcohol use; relapse risk; satisfaction; sedentary lifestyle; sobriety; social cognitive theory; software development; theories; usability

 DESCRIPTION (provided by applicant): Alcohol Use Disorders (AUDs) are highly prevalent and a costly public health problem. Given the compelling evidence for the benefits of increased physical activity for physical health and psychological functioning as well as promising findings regarding alcohol relapse prevention, efforts to help patients with AUDs adopt and sustain increased levels of physical activity (PA) are likely to result in significant public health impact Yet, not only are patients with AUDs engaging in low levels of physical activity, relatively little attention has been given to the development of multilevel physical activity interventions in this unhealthy, at-risk population. Building on the advantages for scalability and dissemination afforded by the use of technology, we propose to develop a smartphone-based physical activity application (app), which we call Fit&Sober, tailored for patients with AUDs. Most existing PA apps suffer from a lack of theory-based concepts known to influence behavior change. However, PA apps that incorporate key behavioral principles relevant to physical activity promotion have demonstrated promising results of increases in physical activity, though none have been examined or tailored for individuals with AUDs. Grounded in Self-Determination Theory and Social Cognitive Theory, we will develop the Fit&Sober app for patients with AUDs by designing features that will help patients develop intrinsic, value-driven goals (e.g., exercisig for benefits related to sobriety) with a particular focus on increasing the saliency of immediate rewards associated with PA (e.g., decreased alcohol urges/craving and improved affect). Early recovery from AUDs, when negative affect is a risk for relapse and urges to drink are common, may be an opportune time to help patients develop internalized, self-determined motivation through experientially making connections between exercise and acute improvements in affect and cravings. The design of this study takes place in 2 phases -- the R21 phase will be focused on the development of the Fit&Sober app, while the R33 phase will be devoted to evaluating the preliminary efficacy of the app in a small RCT. The R21 phase (Years 1 & 2) will consist of 3 stages: 1) development of the Fit&Sober prototype; 2) series of usability studies with patients with AUDs and focus group with addiction treatment counselors; and 3) a 12-week open pilot trial (n=20) to test the feasibility and acceptability of the Fit&Sober app. The R33 Phase (Years 3-5) will involve randomizing 160 patients currently receiving treatment for alcohol addiction at a partial hospitalization program to either: 1) one brief advice (BA) session to increase PA plus the Fit&Sober app OR 2) one BA session. Follow-up assessments will be conducted at 3, 6, & 12-months to determine both the short- and long-term adherence to physical activity and app usage. We expect that this project will lead to the development of a novel, PA app tailored to patients with AUDs, providing them with a valuable adjunct to traditional treatment that can be delivered in any setting and at any time, thereby improving their overall health and well-being.

 描述（由申请人提供）：酒精使用障碍 (AUD) 非常普遍，是一个代价高昂的公共卫生问题。鉴于有令人信服的证据证明增加体力活动对身体健康和心理功能的好处，以及预防酒精复吸的有希望的发现，帮助 AUD 患者采取和维持增加体力活动 (PA) 水平的努力可能会产生重大的公共健康影响。 然而，AUD 患者不仅从事低水平的体力活动，而且相对较少 针对这一不健康的高危人群制定多层次的身体活动干预措施已受到关注。基于技术使用带来的可扩展性和传播优势，我们建议开发一款基于智能手机的身体活动应用程序 (app)，我们称之为 Fit&Sober，专为 AUD 患者量身定制。大多数现有的 PA 应用程序缺乏已知会影响行为改变的基于理论的概念。然而，包含与促进身体活动相关的关键行为原则的 PA 应用程序已经显示出增加身体活动的良好结果，尽管尚未针对 AUD 个人进行检查或定制。基于自我决定理论和社会认知理论，我们将为 AUD 患者开发 Fit&Sober 应用程序，通过设计功能帮助患者制定内在的、价值驱动的目标（例如，锻炼以获得与清醒相关的益处），特别注重提高与 PA 相关的即时奖励的显着性（例如，减少酒精冲动/渴望和改善情感）。当负面情绪有复发风险且饮酒冲动很常见时，AUD 的早期恢复可能是帮助患者通过体验性地在运动与情感和渴望的急剧改善之间建立联系来帮助患者发展内在的、自我决定的动机的好时机。这项研究的设计分为两个阶段——R21阶段将重点关注Fit&Sober应用程序的开发，而R33阶段将致力于在小型RCT中评估该应用程序的初步功效。 R21 阶段（第 1 年和第 2 年）将包括 3 个阶段：1）开发 Fit&Sober 原型； 2）针对 AUD 患者和成瘾治疗顾问焦点小组的一系列可用性研究； 3) 为期 12 周的公开试点试验（n=20），以测试 Fit&Sober 应用程序的可行性和可接受性。 R33 阶段（第 3-5 年）将包括对目前正在接受酒精成瘾治疗的 160 名患者进行随机分组。 部分住院治疗计划：1) 一次简短的建议 (BA) 会议，以增加 PA 加上 Fit&Sober 应用程序或 2) 一节 BA 课程。后续评估将在 3、6 和 12 个月进行，以确定短期和长期坚持体育活动和应用程序的情况。我们预计该项目将开发一款专为 AUD 患者量身定制的新型 PA 应用程序，为他们提供传统治疗的宝贵辅助手段，可以在任何环境下、任何时间提供，从而改善他们的整体健康和福祉。

项目成果

Exploring Factors Associated With Mobile Phone Behaviors and Attitudes Toward Technology Among Adults With Alcohol Use Disorder and Implications for mHealth Interventions: Exploratory Study.

• DOI: 10.2196/32768
• 发表时间: 2022-08-15
• 期刊: JMIR formative research
• 影响因子: 2.2

A Smartphone Physical Activity App for Patients in Alcohol Treatment: Single-Arm Feasibility Trial.

• DOI: 10.2196/35926
• 发表时间: 2022-10-19
• 期刊: JMIR FORMATIVE RESEARCH
• 影响因子: 2.2
• 作者: Abrantes, Ana M.;Meshesha, Lidia Z.;Blevins, Claire E.;Battle, Cynthia L.;Lindsay, Clifford;Marsh, Eliza;Feltus, Sage;Buman, Matthew;Agu, Emmanuel;Stein, Michael
• 通讯作者: Stein, Michael