Social Activity Networks and the Mobility of Lower Limb Amputees

描述（由申请人提供）： 医疗保健提供者、保险公司，甚至政治家都在鼓励个人和人群通过自我监测来改善他们的健身和健康。希望是，对一个人的活动，体重，睡眠习惯等的认识可能会激励一个人更活跃，吃得更好，睡得更多。简而言之，意识可能会导致一个更健康，更快乐的人群。智能活动监测器，其中一些小到足以取代夹克上的拉链，戴在手腕上，或夹在鞋带上，可以为佩戴者提供各种反馈。这些设备可以显示和共享各种指标，包括：步数、爬楼梯、行驶距离、活动持续时间和电池状态。有些电池可以更换，可以持续四到五个月;有些电池永远不需要更换，但必须像手机一样每五天充电一次。无线同步到计算机或智能手机的能力使个性化的反馈和同行群体共享。反馈可包括：通过电子邮件进行每周统计摘要;每日、每周、每月人口标准图表;成就奖;以及参加竞赛。对等组共享是一个特别有趣的功能，因为它能够了解社交网络中其他受邀个体的活动水平。通过社交网络了解同伴群体的表现可以成为一种强大的激励因素。虽然提供这些设备可能会改善许多退伍军人下肢截肢者的健康和幸福感，但不知道有多少人会接受这项技术并将其纳入日常生活。拟议研究的主要队列是由于外周血管疾病和糖尿病或在越南遭受的战斗伤害而失去下肢的老年退伍军人。这些退伍军人是623，000名下肢截肢的美国人之一;到2050年，人口预计将增长到140万以上。重要的是，许多年龄较大、活动较少的截肢者通过直接、面对面的接触来优先处理关系，从而寻求安慰、获得信心并保持社会地位。这一发现表明，在我们的队列中，许多人可能与抽象的功能水平（步数）无关，互联网支持的社交网络 可能没什么兴趣。然而，最近有证据表明，这一年龄较大的群体通过互联网联系得越来越多，现在可能是挑战这种刻板印象的时候了。拟议研究的目标是确定是否值得为退伍军人下肢截肢者提供智能活动监视器。我们的两个具体目标是：（1）确定退伍军人下肢截肢者是否愿意使用智能活动监测器作为他们日常生活的一部分，以及（2）发现是否使用或不使用基于互联网的社交网络（同龄人群体社区论坛）的实际和目标活动水平的反馈可以提高活动水平并在很长一段时间内保持它。我们建议为50岁或以上的退伍军人，膝下截肢者（n=90）的样本人群提供智能活动监视器，教他们如何上传活动数据，无论是否有社交网络访问同龄人组，并观察他们的参与和活动水平。结果将回答我们的问题，如果Vetera下肢截肢者愿意习惯性地佩戴智能活动监测器，以及来自设备的反馈，无论是否有参与者同龄人基于互联网的社交网络的影响，都可以在两年的研究期间产生影响。拟议的研究将提供一个彻底的了解是否便宜的设备（<60美元）可以改善退伍军人下肢截肢者的流动性（和健康）。如果成功，我们的长期目标是在全国范围内实施这项技术。

DESCRIPTION (provided by applicant): Project Summary (public abstract) Health care providers, insurance companies, and even politicians are encouraging individuals and populations to improve their fitness and health through self-monitoring. The hope is that awareness of one's activity, weight, sleep habits, etc. might motivate a person to be more active, eat better, and sleep more. In short, awareness might lead to a healthier and happier population. Smart activity monitors, some of which are small enough to replace the zipper on a jacket, be worn on the wrist, or clipped to a shoelace, can provide a variety of feedback to the wearer. The devices can display and share a variety of metrics including: steps taken, stairs climbed, distance travelled, activity duration, and battery status. Some have replaceable batteries that can last four to five months; others have batteries that never need replacing but must be recharged every five days or so like a cell phone. The capacity to wirelessly sync to a computer or smart phone enables personalized feedback and peer group sharing. Feedback can include: weekly summary statics by email; daily, weekly, monthly charts with population norms; achievement awards; and participation in contests. Peer group sharing is a particularly interesting feature as it enables the awareness of the activity levels of other invited individuals within a social network. Knowledge of peer group performance through social networks can be a strong motivator. While the health and happiness of many Veteran lower limb amputees might improve from the provision of these devices, it is unknown how many would embrace the technology and make it part of their everyday life. The major cohort of the proposed research is the aging Veteran who lost a lower limb due to either peripheral vascular disease and diabetes or combat-injuries sustained in Vietnam. These Veterans are among the 623,000 Americans who live with lower limb amputation; a population expected to grow to over 1.4 million by the year 2050. Importantly, many older, less-active amputees seek comfort, gain confidence, and maintain social standing by prioritizing relationships through direct, face-to-face contact. This finding suggests many in our cohort may not relate to an abstract level of function (step counts) and that internet-enabled social networks may be of little interest. However, there is recent evidence to suggest this older cohort are becoming more connected through the internet and now might be the time to challenge this stereotype. The goal of the proposed research is to determine if it is worthwhile to provide Veteran lower limb amputees with smart activity monitors. Our two specific aims are to: (1) Determine if Veteran lower limb amputees are willing to use smart activity monitors as part of their daily life, and (2) Discover if feedback of actual and goal activity levels with or without te use of an internet-based social network (peer group community forum) can elevate activity levels and maintain it over a prolonged period of time. We propose to provide smart activity monitors to a sample population of Veteran, below-knee amputees age 50 or older (n=90), teach them how to upload activity data with or without social network access to a peer group, and observe their participation and activity levels. The results will answer our question if Vetera lower limb amputees are willing to habitually wear smart activity monitors and if feedback from the devices, with and without the influence of an internet-based social network of the participants' peers, can have an influence over duration of the two year study. The proposed research will provide a thorough understanding whether or not an inexpensive device (<$60) can improve the mobility (and health) of Veteran lower limb amputees. If successful, our long-term goal is to pursue a nation-wide implementation of this technology.