A mobile Enabling Technology to promote adherence to behavioral therapy

描述（由申请人提供）：本申请涉及广泛的挑战领域（06）使能技术，06- da -105：通过ICT/移动技术改善健康。这项研究的最终目标是从根本上改变行为干预的方式。我们提出了一种创新的移动使能技术- ihealth -识别威胁患者康复的压力源，然后在最需要的时刻提供基于证据的干预措施。我们的目标是确定，在受试者中，iHeal检测到的生理和情感变化在多大程度上可以预测受试者的创伤后应激或药物提示。研究小组在技术开发和评估共同发生的疾病的行为干预方面具有相当大的专业知识。我们将研究来自samhsa资助的一项现有调查的25名受试者，该调查利用密集的病例管理来监测退伍军人PTSD和药物滥用的进展。我们提出的调查将与SMAHSA研究共享干预措施，该研究基于对PTSD和药物滥用的动机访谈和认知行为治疗方法的混合。具体目的：1)评估iHeal识别PTSD急性应激反应和环境药物提示等生理和情感现象的准确性；2)评价基于动机访谈的干预措施对PTSD急性应激反应和环境药物提示的影响。这个最初的提议极具创新性。拟议中的iHeal设备将采用尖端无线技术，将可穿戴传感器连接到个人移动计算平台（例如iPhone）。这种联系将使iHeal能够检测共同发生的生物和行为过程，而移动平台中的嵌入式计算使iHeal能够在适当的时候提供基于证据的移情干预。iHeal可以学习以对用户最有效的方式进行干预，包括在简短干预之后建立基于脚本的文本对话模型；使用来自亲人的激励图像或信息；演奏一首意味深长的歌曲；或者在最需要的时候联系咨询师。最终，一种可穿戴无线设备可以预测压力源，并在可能过渡到危险活动时进行干预，在各种社会、行为和生物医学研究企业中具有巨大的潜力。重要的是，iHeal有直接的商业应用，这将促进行为科学、生物医学、计算机科学、电信和电气工程企业的就业增长。iHeal是一款创新设备，它使用可穿戴传感器来检测脉搏、皮肤电导和加速度；传感器阵列无线连接到iPhone上，iPhone上有一个应用程序，可以识别用户的生理变化。与创伤后应激障碍（PTSD）加重或吸毒引起的急性压力相一致的变化，会在iPhone和用户之间产生移情对话，用户输入有关社交/行为/环境背景的实时数据。iPhone（可以跟踪时间和GPS数据）使用预测软件预测即将到来的压力源，并帮助用户避开它们。该提案的公共卫生意义在于：1)iHeal将实时检测同时发生的生物和行为过程；2)识别未被发现的行为状态；3)预测感兴趣的行为；4)在适当的干预时机向用户提供移情干预。因为它是基于现有技术的结合，并有直接的商业应用，iHeal将鼓励行为科学、生物医学、计算机科学、电信和电气工程企业的就业增长。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (06) Enabling Technologies, 06-DA-105: Improving health through ICT/mobile technologies. The ultimate goal of this research is to fundamentally change the ways in which behavioral interventions are delivered. We propose an innovative mobile Enabling Technology-iHeal-that recognizes stressors that threaten a patient's recovery and then delivers evidence-based interventions exactly at the moment of greatest need. Our objective is to determine, within subjects, the extent to which physiologic and affective changes detected by iHeal are predictive, within subjects, of posttraumatic stress or drug cues. The study team has considerable expertise in technology development and in assessment of behavioral interventions in co-occurring disorders. We will study 25 subjects drawn from an existing SAMHSA-funded investigation that utilizes intense case management to monitor progression of PTSD and substance abuse in returning combat veterans. Our proposed investigation will share interventions with the SMAHSA study that are based upon a blending of Motivational Interviewing and Cognitive Behavioral Therapy approaches for PTSD and substance abuse. Specific aims: 1) To evaluate the accuracy with which iHeal characterizes physiological and affective phenomena as acute stress reactions related to PTSD and environmental drug cues; and 2) To evaluate the effect of Motivational Interviewing-based interventions on acute stress reactions related to PTSD and environmental drug cues. This initial proposal is extremely innovative. The proposed iHeal device will employ cutting-edge wireless technology to link wearable sensors to personal mobile computing platforms (e.g., iPhone). This linkage will allow iHeal to detect co-occurring biological and behavioral processes, while embedded computing in the mobile platform permits iHeal to deliver evidence-based empathetic interventions at the opportune moment. iHeal can learn to intervene in ways that are most effective for the user, including scripted text-based dialogues modeled after brief interventions; use of motivating images or messages from loved ones; playing a meaningful song; or contacting a counselor at the moment of greatest need. Ultimately, a wearable wireless device that anticipates stressors and intervenes at a likely transition to risky activities has enormous potential in a variety of social, behavioral, and biomedical research enterprises. Importantly, iHeal has immediate commercial applications that will encourage job growth in behavioral science, biomedical, computer science, telecommunication, and electrical engineering enterprises. iHeal is an innovative device that uses wearable sensors to detect pulse, skin conductance, and acceleration; the sensor array links wirelessly to an iPhone which has an app that identifies changes in the user's physiology. Changes consistent with acute stress from PTSD exacerbations or drug use cues generate an empathetic conversation between the iPhone and the user, who enters real-time data on social/behavioral/environmental contexts. The iPhone (which tracks time and GPS data) uses predictive software to anticipate upcoming stressors and helps the user avoid them. The public health significance of this proposal is 1) iHeal will detect co-occurring biological and behavioral processes in real time; 2) it will discern undiscovered behavioral states; 3) it will predict a behavior of interest; and 4) it will deliver empathetic interventions to the user at the opportune moment for intervention. Because it is based on the union of existing technology and has immediate commercial applications, iHeal will encourage job growth in behavioral science, biomedical, computer science, telecommunication, and electrical engineering enterprises.