An mHealth Intervention to Increase Activity Among Patients at Risk for Type 2 Diabetes

 描述(申请人提供)：2型糖尿病(T2D)患者经常久坐不动的生活方式，这不仅是糖尿病的危险因素，而且可能会加剧疾病。因此，建议增加体力活动是T2D预防和管理的基石。从历史上看，增加活动量是锻炼的同义词；然而，我们现在知道，即使是更适度的活动量(例如，简单地散步)或仅仅减少久坐时间的比例，也可能足以改善健康状况。一些旨在增加活动的干预措施显示出了希望；另一些干预措施则不那么成功。廉价计步器的出现，以及最近出现的低成本三轴加速度计，现在使监测活动水平和向用户提供反馈变得容易得多。这些设备是捕捉与步行相关的活动的理想设备，步行是T2D患者最受欢迎和可接受的运动形式，但只有当患者真的佩戴它们时才能使用。因此，有必要开发实用的方法，鼓励患者不仅佩戴这些监测设备，而且鼓励他们增加活动。这项建议的总体目标是开发新的实用、负担得起和易于使用的方法，以增加有T2D风险的患者和那些已被诊断为T2D的患者的活动。为了实现这一目标，我们将测试MapTrek，一款移动健康游戏或我们自己的设计，使用低成本的三轴加速计来鼓励患者更多地步行，我们将测试这种仅使用加速计的对照组的移动健康干预。我们生成的数据将有助于为更大规模的务实试验提供信息，以调查长期临床结果和成本。

 DESCRIPTION (provided by applicant): Patients with type two diabetes (T2D) frequently lead sedentary life styles which are not only a risk factor for diabetes, but can also exacerbate the disease. Recommending increased physical activity is therefore a cornerstone of T2D prevention and management. Historically, increasing activity was synonymous with exercise; however, we now know that even much more modest activity levels (e.g., simply walking) or merely decreasing the proportion of sedentary time may be sufficient to improve health outcomes. Some interventions designed to increase activity have shown promise; others have been less successful. The availability of inexpensive pedometers, and, more recently, low cost triaxial accelerometers, has now made it much easier to monitor activity levels and provide feedback to users. These devices are ideal for capturing activity associated with walking, the most popular and acceptable form of exercise for patients with T2D, but only if patients actually wear them. Thus, there is a need to develop pragmatic approaches that encourage patients to not only wear these monitoring devices, but also to motivate them to increase their activity. The overarching goal is of this proposal is to develop new practical, affordable, and easy-to-use approaches to increase activity among patients at risk for developing T2D and those already diagnosed with T2D. To achieve this goal we will test MapTrek, an m-health game or our own design that uses low cost triaxial accelerometers to encourage patients to walk more, and we will test this m-health intervention against a control group using the accelerometers alone. The data we generate will help inform a larger pragmatic trial to investigate long-term clinical outcomes and costs.