The HOPE App: An Immersive Telehealth Solution for Older Adults with Diabetes

HOPE 应用程序：针对患有糖尿病的老年人的沉浸式远程医疗解决方案

• 批准号: 10703505
• 负责人: Suzanne Mitchell
• 金额: $ 99.94万
• 依托单位: SEE YOURSELF HEALTH, LLC
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10703505
• 关键词: Active Learning; Adherence; Adult; Affect; Aging; Attention; Behavior; Blood Glucose; Businesses; COVID-19; COVID-19 pandemic; COVID-19 patient; Caring; Chronic Disease; Clinical; Clinical Trials; Cognitive; Communication; Complex; Computer software; Coronavirus; Diabetes Mellitus; Disease Management; Education; Educational Technology; Effectiveness; Elderly; Enrollment; Ensure; Epidemic; Face; Fostering; Funding; Goals; Health; Health Benefit; Health Care Costs; Health Services; Health Technology; Health behavior; Health behavior and outcomes; Health behavior change; Health system; Healthcare; Hospitalization; Impaired cognition; Internet; Intervention; Learning; Length of Stay; Life Style; Marketing; Medication Management; Mental Depression; Minority Women; Modeling; New York; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Participant; Patient Outcomes Assessments; Patients; Persons; Phase; Physical Function; Physically Challenged; Play; Prediabetes syndrome; Predictive Analytics; Reporting; Research; Running; SARS-CoV-2 exposure; Self Care; Self Management; Small Business Innovation Research Grant; Social Network; Social isolation; Social support; Special Supplemental Nutrition Program for Women, Infants, and Children; Stress; Surveys; Technology; Telecommunications; Testing; Time; United States National Institutes of Health; Validation; Video Games; Visit; Woman; brain health; cloud based; cognitive function; commercialization; comorbidity; coping; cost; cost effective; depressive symptoms; design; diabetes control; diabetes distress; diabetes management; diabetes self-management; dietary; digital; digital health; educational atmosphere; evidence base; experience; feasibility testing; fitness; handheld mobile device; health application; health care availability; health management; health plan; health service use; healthy lifestyle; high risk; human old age (65+); improved; mobile application; mortality risk; new technology; pandemic disease; patient engagement; patient population; patient retention; peer support; physical conditioning; population health; programs; prototype; skills; social; telehealth; tool; usability; user centered design; virtual platform; virtual reality; virtual world

Type 2 diabetes (T2DM) is an epidemic. An estimated 34 million people in the US have T2DM and 84 million have pre-diabetes - nearly half of whom are adults 65+ yo, putting many older adults at higher risk of unhealthy aging and cognitive decline. A healthy lifestyle can treat and even reverse T2DM. But making lifestyle changes is hard and many people fail, contributing to $327B in US healthcare costs. Diabetes group visits (DGV) and diabetes self- management education and support (DSME/S) help people with T2DM to learn and sustain complex disease management skills. Yet, access to DSME/S is limited such participation in DSME/S programs is reportedly as low as 7% among adults with T2DM. New technologies supporting DSME/S programs are emerging, but most fail to meet the unique needs of older adults with limited technology fluency, creating a new digital divide. See Yourself Health (SYH) aims to bridge this digital health gap for older adults with a newly designed immersive learning and telehealth application – the HOPE App – designed to deliver high-impact, high engagement diabetes care and DSME/S tailored for older adults with diabetes. Advancements in virtual reality software, new cloud gaming technology and user interface design have enabled our team to envision a new telehealth and immersive learning environment to support chronic disease self- management needs of older adults with diabetes. We use virtual reality, telecommunication technology and social gaming strategies to offer real-time peer support, care coaching, and 28 modules of live-action experiential learning programs to help participants master complex diabetes self-management skills. In our Phase I SBIR project, we reached the following milestones: prototyped the HOPE App platform with cloud access and new navigation and communication features; completed usability testing (SUS = 71) with 20 target users and feasibility testing (100% participation) of the HOPE App platform; developed new DSME content for older adults. In Phase II, we will further develop the HOPE App patient engagement and population health management features and capabilities and then assess its efficacy in a fully powered clinical trial. Specific Aim 1: Develop the HOPE App’s state-of-the-art immersive patient engagement experience with automated onboarding, social networking and gamified DSME/S features to support long-term patient retention. Specific Aim 2: Develop the HOPE App’s predictive analytic capabilities for population health management. Specific Aim 3: Clinical validation of the HOPE App intervention on six-month clinical outcomes (A1c), patient reported outcomes (diabetes distress) and engagement (patient retention, adherence to DSME/S). SYH has assembled an expert business team to sell the HOPE APP to our target customer, health care payors. The HOPE APP offers a simple, high- impact, highly engaging, immersive telehealth experience with the potential to become a ubiquitous diabetes management tool to transform diabetes patients into high performing drivers of their own care.

2型糖尿病（T2 DM）是一种流行病。据估计，美国有3400万人患有T2 DM， 患有糖尿病前期-其中近一半是65岁以上的成年人，使许多老年人面临更高的不健康风险 衰老和认知能力下降健康的生活方式可以治疗甚至逆转T2 DM。但是改变生活方式 是很难的，许多人失败了，导致美国医疗保健成本达到3270亿美元。糖尿病组访视（DGV）和 糖尿病自我管理教育和支持（DSME/S）帮助T2 DM患者学习和维持 复杂的疾病管理技能。然而，获得DSME/S的机会有限， 据报道，在T2 DM成人中低至7%。支持DSME/S计划的新技术包括 新兴的，但大多数未能满足老年人的独特需求与有限的技术流畅性，创造了一个新的 数字鸿沟See Yourself Health（SYH）旨在通过一项新的 设计的沉浸式学习和远程医疗应用程序-希望应用程序-旨在提供高影响力，高 参与糖尿病护理和为老年糖尿病患者量身定制的DSME/S。 虚拟现实软件、新的云游戏技术和用户界面设计的进步， 我们的团队设想一个新的远程医疗和沉浸式学习环境，以支持慢性疾病自我， 老年糖尿病患者的管理需求。我们使用虚拟现实，电信技术和 社交游戏策略，提供实时同伴支持，护理指导和28个真人体验模块 学习计划，帮助参与者掌握复杂的糖尿病自我管理技能。在我们的第一阶段SBIR中 项目完成后，我们达到了以下里程碑：建立了具有云访问的HOPE App平台原型， 导航和通信功能;完成了20个目标用户的可用性测试（SUS = 71）， HOPE App平台的可行性测试（100%参与）;为老年人开发了新的DSME内容。 在第二阶段，我们将进一步开发HOPE App患者参与和人群健康管理 功能和能力，然后在完全有效的临床试验中评估其疗效。具体目标1：发展 HOPE App最先进的沉浸式患者参与体验，包括自动化入职、社交 联网和游戏化的DSME/S功能，以支持长期的患者保留。具体目标2：开发 HOPE App的人口健康管理预测分析功能。具体目标3：临床验证 HOPE App干预对6个月临床结局（A1 c）、患者报告结局（糖尿病 痛苦）和参与（患者保留，对DSME/S的依从性）。SYH已经组建了一个专家业务 我们的团队将HOPE APP销售给我们的目标客户，医疗保健支付者。HOPE APP提供了一个简单、高效的 具有影响力、高度参与性、身临其境的远程医疗体验，有可能成为无处不在的糖尿病患者 管理工具，将糖尿病患者转变为自己护理的高绩效驱动者。