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

项目概要/摘要： HOPE APP：适合老年人的沉浸式远程医疗解决方案 2型糖尿病（T2 DM）是一种与肥胖、慢性压力、不健康饮食和糖尿病相关的流行病。 不活动。据估计，美国有2900万人患有2型糖尿病，8400万人患有糖尿病前期， 其中65岁以上的成年人，使许多老年人面临更高的不健康老龄化和认知风险， 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困难的， 人们失败，为美国医疗保健成本贡献了3250亿美元。糖尿病组访视（DGV）和糖尿病自我检查 管理教育和支持（DSME/S）帮助T2 DM患者学习和维持健康的生活方式 行为和掌握复杂的疾病管理技能。访问DSME/S是有限的， 参与DSME/S计划的T2 DM成年患者比例低至7%。新技术支持 DSME/S计划正在出现，但大多数未能满足老年人的独特需求， 技术流畅，创造了新的数字鸿沟。See Yourself Health（SYH）团队旨在弥合这一点 数字健康差距的老年人与一个新设计的沉浸式学习计划-希望应用程序- 旨在按需提供糖尿病护理、DGV和DSME/S，为老年糖尿病患者量身定制， 可通过该年龄组常用的移动的设备访问。 幸运的是，新的云游戏技术和用户界面设计的进步将使我们的 团队设计一个新的沉浸式学习环境，专为移动的设备提供DSME/S，以满足 老年人的需求和能力。HOPE应用程序由28个可操作的DSME/S模块组成， 为虚拟世界设计的维护编程，使用强调对等的社交游戏策略， 支持，大脑健康，掌握糖尿病自我管理技能，让用户与他人联系 并模拟新的生活方式行为。第一期工程：我们的目的是评估可行性、可接受性和 新设计的See Yourself Health沉浸式学习DSME/S解决方案的可用性-HOPE APP - 专为患有糖尿病的老年人量身定制，其特征在于通过以下方式提供与移动终端一起使用的适应性人机界面： 技术熟练度低的用户。具体目标一：设计并打造具有教育功能的HOPE APP 内容、模拟体验和专为老年T2 DM患者定制的用户界面。具体 目标2：使用快速迭代测试和评估（RITE）评估HOPE APP的可用性 方法，共有20名参与者，来自65岁以上糖尿病成人目标人群。具体目标3： 测试老年人在移动的设备上使用SYH HOPE APP的可行性。第二阶段计划： 一旦我们证明了使用云交付See Yourself Health DSME/S计划的可行性， 游戏解决方案，我们的目标是评估平台对认知功能，身体健康， 心理健康的结果在一个充分的动力临床试验。

Project Summary/Abstract: The HOPE APP: An Immersive Telehealth Solution Adapted for Older Adults Type 2 diabetes (T2DM) is an epidemic related to obesity, chronic stress, unhealthy eating and inactivity. An estimated 29 million people in the US have T2DM and 84 million have pre-diabetes - nearly half of whom are adults over 65yo, 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 $325 billion in US healthcare costs. Diabetes group visits (DGV) and diabetes self- management education and support (DSME/S) help people with T2DM learn and sustain healthy lifestyle behaviors and master complex disease management skills. Access to DSME/S is limited such that participation in DSME/S programs is as low as 7% of all 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. The See Yourself Health (SYH) team aims to bridge this digital health gap for older adults with a newly designed immersive learning program – the HOPE APP – designed to deliver diabetes care, DGV, and DSME/S on demand, tailored for older adults with diabetes and accessible on mobile devices commonly used by this age group. Fortunately, new cloud gaming technology and advances in user interface design will enable our team to design a new immersive learning environment tailored for mobile devices to offer DSME/S to meet the needs and capabilities of older adults. HOPE App consists of 28 actionable DSME/S modules and maintenance programming designed for a virtual world using social gaming strategies that emphasize peer support, brain health, and mastery of diabetes self-management skills to allow users to connect with others and simulate new lifestyle behaviors. Phase I Project: We aim to assess the feasibility, acceptability and usability of the newly designed See Yourself Health immersive learning DSME/S solution – the HOPE APP - tailored for older adults with diabetes featuring an adapted human interface for use with mobile device by users with low technology fluency. Specific Aim 1: We will design and build the HOPE APP with educational content, simulation experiences, and a user interface tailored for use by older adults with T2DM. Specific Aim 2: To assess the usability of the HOPE APP using the Rapid Iterative Testing and Evaluation (RITE) method with a total of 20 participants from the target population of adults 65+ with diabetes. Specific Aim 3: To test the feasibility of using the HOPE APP by SYH by older adults on mobile devices. Plan for Phase II: Once we demonstrate the feasibility of delivering the See Yourself Health DSME/S program using a cloud gaming solution, we aim to assess the effects of the platform on cognitive function, physical health, and mental health outcomes in a fully powered clinical trial.