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Tai Chi Exercise and Wearable Feedback Technology to Promote Physical Activity in ACS Survivors

太极拳运动和可穿戴反馈技术促进 ACS 幸存者的身体活动

基本信息

批准号：
10696084
负责人：
Elena Salmoirago-Blotcher
金额：
$ 56.83万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-05 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10696084
关键词：
Accelerometer Adherence Aerobic Exercise Affect American Heart Association Anxiety Awareness Behavioral Blood Pressure Body Weight Cardiac rehabilitation Cardiometabolic Disease Cardiovascular system Chronic Chronic Disease Cognition Cognitive Communities Coronary heart disease Data Development Devices Dimensions Educational Materials Emotional Energy Metabolism Enrollment Equilibrium Event Exercise Feasibility Studies Feedback Focus Groups Fostering Future Glucose Goals Guidelines Health Home Individual Intervention Interview Light Lipids Measures Mental Depression Meta-Analysis Morbidity - disease rate Motivation Musculoskeletal Pain Patient-Focused Outcomes Patients Physical Exercise Physical activity Physical assessment Population Preparation Prognosis Provider Pulmonary Heart Disease Qualitative Methods Quality of life Randomized Randomized, Controlled Trials Recommendation Rehabilitation therapy Risk Factors Safety Secondary Prevention Self Efficacy Site Social support Strenuous Exercise Stress Structure Survivors System Tai Ji Techniques Technology Time Training Weight Work acceptability and feasibility acute coronary syndrome behavior change behavioral construct cardiometabolic risk cardiometabolism cardiovascular health cardiovascular risk factor data collection site evidence base exercise capacity exercise intervention exercise program exercise training experience fasting plasma glucose fitbit heart disease risk high risk high risk population improved instructor interest intrinsic motivation mind/body mindfulness moderate-to-vigorous physical activity monitoring device mortality multi-component intervention novel participant retention patient engagement patient population peer support physical inactivity pragmatic trial programs public health priorities recruit remote delivery remote group sedentary skills stress management treatment as usual uptake virtual wearable device

项目摘要

Project Summary/Abstract Physical activity (PA) is a cornerstone of secondary prevention after an acute coronary syndrome (ACS) with associated improvements in cardiovascular risk, morbidity, and mortality. Unfortunately, over 80% of these cardiovascular patients remain sedentary after an event. Participation in cardiac rehabilitation programs is poor, and long-term adherence to PA remains problematic. There is a critical need for the development of novel exercise programs to improve PA in this high-risk patient population. Tai Chi (TC) is a multi-dimensional intervention that integrates low-moderate intensity physical exercise with meditative components that have been shown to improve important self-regulatory skills and cognitive- behavioral determinants of behavior change, such as self-efficacy, motivation, and emotional health. Because it is delivered in a class format, TC also fosters social support. Preliminary evidence suggests that TC may positively impact PA and selected cardiovascular risk factors. TC is an attractive exercise option for ACS survivors, who are often sedentary or deconditioned. There is also growing evidence supporting the use of wearable technology (e.g., Fitbit) as an effective behavioral strategy to promote PA. Wearable devices can utilize evidence-based techniques such as individualized goal setting and feedback in increasing motivation and self-efficacy for exercise. In patients with cardiometabolic disease, the addition of wearable technology to structured exercise has been promising to increase moderate-vigorous PA and improve cardiovascular risk. This application leverages our prior work with TC to promote PA among sedentary ACS survivors, experience with remote delivery of group-based TC, and experience combining mind-body exercise with wearables (Fitbit). We propose a multi-site feasibility study as a necessary step in preparation for a future, fully-powered trial investigating the efficacy of a multi-modal intervention (TC+Wearable) that combines virtual, group TC classes with an individual wearable device to support overall PA, and thus impact downstream cardiometabolic risk. The specific aims are: 1) To assess feasibility of a multi-site randomized controlled trial of TC+Wearable plus enhanced usual care (with cardiovascular risk factor education materials) vs. enhanced usual care alone among inactive ACS survivors. Feasibility measures will include recruitment and retention; intervention acceptability, adherence, and fidelity; and coordination/management of multi-site data collection. Patient- centered outcomes will include accelerometry-assessed PA and sedentary time, cognitive-behavioral constructs (self-efficacy, intrinsic motivation, awareness, anxiety/depression, stress), and cardiometabolic measures (exercise capacity, weight, lipids, blood pressure, glucose). 2) To obtain qualitative feedback from multiple stakeholders to inform future study conduct. We will engage patients, providers, and TC instructors in interviews/focus groups on acceptability of TC+Wearable (content, facilitators/barriers, integration of TC and device); technical aspects of remote delivery; and openness for future provider and TC instructor engagement.

项目总结/文摘