RELAX: A mobile application suite targeting obesity and stress

描述（由申请人提供）：肥胖和压力是高度共病的，两者都会增加心血管疾病（CVD）的风险。压力与放纵的饮食、垃圾食品消费以及农产品和全谷物的低消费有关。压力和压力诱发的进食不仅与肥胖有关，而且还预测生活方式干预的最坏结果。除了饮食和体力活动外，压力和压力诱导的饮食都应作为肥胖成年人干预措施的目标，以最大限度地减轻体重和降低心血管疾病风险;然而，这需要进行强化干预。可以利用技术来减少干预负担，同时通过收集和编辑患者数据来告知临床医生决策并直接提供干预，从而解决更复杂的患者问题 战略布局该提案的目的是开发和测试RELAX应用程序套件（AS）的可行性和概念验证，这是一种基于移动的、云和网络的肥胖者生活方式干预的伴侣。RELAX-AS包括RELAX-app和RELAX-web。RELAX-app是一个面向患者的移动的应用程序，将链接到Microsoft Health Vault，这是一个基于云的平台，可以在线安全访问健康数据。RELAX-app将包括自我监测（饮食、运动、压力、压力诱发的进食）;通过易于解释的视觉显示和反馈报告自动反馈，反馈内容包括目标行为之间的数量、时间、背景和关系;以及当压力等级升高时提示的自我指导压力管理功能。RELAX-web是一个基于网络的应用程序，临床医生可以以易于理解的视觉显示形式访问患者的信息， 反馈报告，以提高他们的咨询效率。我们的目标是使用RELAX-AS创建一个干预交付模型，以传统生活方式干预的一半访问量减轻体重和压力。我们提出了一个为期3年的研究，包括3个阶段：需求收集/开发，可用性测试/预试点，和试点。需求收集/开发工作将侧重于用户和临床医生之间的视觉显示、反馈消息和移动交付的减压策略的迭代开发。在可用性测试/预试验阶段，我们将使用简短的4周预试验干预，在目标人群和临床医生中检查RELAX-AS的可用性。在试点阶段，我们将肥胖成年人随机分为3种情况：RELAX-AS，一种通用的饮食/运动应用系统，或没有技术。所有的情况都将接受简短的减肥咨询。可行性结局将包括应用程序功能的使用、可接受性、依从性、临床医生时间、负担、保留、时间和成本。探索性结果包括体重、压力和压力诱导的饮食变化。这项工作将为我们准备一项双臂疗效试验，比较RELAX-AS与简短的生活方式干预，以简单的生活方式干预对体重，压力和压力饮食的影响。

DESCRIPTION (provided by applicant): Obesity and stress are highly comorbid and both increase risk for cardiovascular disease (CVD). Stress is associated with disinhibited eating, junk food consumption and low consumption of produce and whole grains. Both stress and stress-induced eating are not only associated with obesity but also predict worst outcomes in lifestyle interventions. In addition to diet and physical activity, both stress and stress-induced eating should be targeted in interventions obese adults to maximize weight loss and CVD risk reduction; however, this makes for an intensive intervention. Technology could be leveraged to reduce intervention burden while still addressing more complicated patient issues by collecting and compiling patient data to inform clinician decision making and directly delivering intervention strategies. The purpose of this proposal is to develop and test the feasibility and proof-of-concept of RELAX Application Suite (AS), a mobile-, and cloud- and web-based companion to a lifestyle intervention for obese individuals. RELAX-AS includes RELAX-app and RELAX-web. RELAX-app is a patient-facing mobile application that will be linked to Microsoft Health Vault, a cloud-based platform that allows for secure access of health data online. RELAX-app will include self-monitoring (diet, exercise, stress, stress-induced eating); automated feedback via easy-to-interpret visual displays and feedback reports on the amount, timing, context, and relationship between target behaviors; and self-guided stress management features that are prompted when stress ratings are elevated. RELAX-web is a web-based application for clinicians to access the patient's information in the form of easily digestible visual displays and feedback reports to increase the efficiency of their counseling. Our goal is to use RELAX-AS to create an intervention delivery model that reduces both weight and stress with half the visits of traditional lifestyle interventions. We propose a 3-year study that includes 3 phases: Requirements Gathering/Development, Usability Testing/Pre-Pilot, and Pilot. Requirements Gathering/Development work will focus on the iterative development of visual displays, feedback messages, and mobile-delivered stress reduction strategies among users and clinicians. In the Usability Testing/Pre-pilot phase we will examine usability of RELAX-AS in both members of the target population and clinicians using an abbreviated 4-week pre-pilot intervention. In the Pilot phase, we will randomize obese adults to 3 conditions: RELAX-AS, a generic diet/exercise application system, or no technology. All conditions will receive brief weight loss counseling. Feasibility outcomes will be usage of app features, acceptability, adherence, clinician time, burden, retention, time and cost. Exploratory outcomes include changes in weight, stress, and stress-induced eating. This work will prepare us for a 2-arm efficacy trial comparing RELAX-AS with a brief lifestyle intervention to a brief lifestyle intervention alone on weight, stress, and stress eating.