GamerFit: A Digital Intervention to Improve Physical Activity and Sleep Behaviors in Youth with Psychiatric Diagnoses

项目摘要 超过1/4的儿童在17岁之前至少接受过一次精神疾病诊断。 显著增加的慢性病风险，包括肥胖率高，这是由低肥胖推动的 体力活动(PA)水平、睡眠不佳和社交孤立。不健康的PA和睡眠行为不仅 增加可预防的慢性病风险，还会恶化认知和行为功能 挑战这些年轻人的经历。GamerFit的目标是测试基于理论的mHealth的交付 该应用程序利用社交支持、运动游戏和远程健康指导来改善PA水平、睡眠和 帕金森病青年参与者(14-17岁)的精神症状。为了帮助未来的干预 优化，我们将随机选择60名至少有一名PD的参与者，其中30名使用GamerFit应用程序 每周远程健康辅导课程，30次使用商业健康习惯应用程序作为参照组。 GamerFit应用程序将提供一个菜单，其中包括运动游戏、渐进式PA和睡眠计划、集成的自我 监控，预先录制的关于健康PA和睡眠习惯的视频，以及激励短信，以 帮助用户在12周内满足PA和睡眠指南。该项目利用了我们在游戏中的试点数据 和远程健康指导，以改善患有PD的青少年的PA，我们的跨学科团队在以下方面拥有专业知识 发展心理学、PA和睡眠干预设计、基于技术的健康促进和APP 发展。主要的研究问题是：是为期12周的运动游戏和远程健康教练干预， 通过智能手机应用程序提供，这是一种可以接受的、可行的、有效的改善PA和睡眠的方法 青少年帕金森病患者的行为？具体目标如下：具体目标1：审查可行性和 通过移动应用程序对患有帕金森病和他们的青少年进行为期12周的GamerFit干预的可接受性 父母。具体目标2：检验为期12周的GamerFit干预通过 移动应用程序将改善PA水平、睡眠质量和持续时间，与使用 非结构化健康习惯跟踪应用程序。探索性目标：检验12周游戏适合度的假设 通过移动应用提供的干预将改善情绪、行为规范和感知的社交 与对照组相比，隔离和支持；并检验行为影响将 持续到第16周(即干预结束后4周)。我们还将与临床医生合作， 探索将这款应用程序，特别是PA处方纳入精神治疗计划的方法。 该项目通过测试以理论和证据为基础的游戏和 通过一个低成本的应用程序，针对患有帕金森病的青少年的多种健康行为进行远程健康指导干预。

Project Summary More than 1 in 4 children receive at least one psychiatric diagnosis (PD) before age 17. These youth face significantly elevated chronic disease risk including high prevalence of obesity, which is propelled by low physical activity (PA) levels, poor sleep, and social isolation. Unhealthy PA and sleep behaviors not only increase preventable chronic disease risks, they also worsen the cognitive and behavioral functioning challenges these youth experience. The goal of “GamerFit” is to test the delivery of a theory-based mHealth app that utilizes social support, exergaming, and telehealth coaching to improve PA levels, sleep, and psychiatric symptoms among youth participants (ages 14-17 y) with PD. In order to aid future intervention optimization, we will randomize 60 participants with at least one PD, with 30 using the GamerFit app with weekly telehealth coaching sessions and 30 using a commercial healthy habits app as a comparator group. The GamerFit app will provide access to a menu of exergames, progressive PA and sleep plan, integrated self- monitoring, pre-recorded videos addressing healthy PA and sleep habits, and motivational text messages to help users meet PA and sleep guidelines over 12 weeks. The project leverages our pilot data on exergaming and telehealth coaching to improve PA in youth with PD, and our interdisciplinary team has expertise in developmental psychology, PA and sleep intervention design, technology-based health promotion, and app development. The major research question is: Is a 12-week exergaming and telehealth coaching intervention, delivered via a smartphone app, an acceptable, feasible and effective method to improve PA and sleep behaviors in youth with PD? The specific aims are as follows: Specific Aim 1: To examine feasibility and acceptability of the 12-week GamerFit intervention delivered through a mobile app to youth with PD and their parents. Specific Aim 2: To test the hypothesis that the 12-week GamerFit intervention delivered through a mobile app will improve PA levels and sleep quality and duration compared to a comparator group that uses an unstructured healthy habits tracking app. Exploratory Aims: To test the hypothesis that the 12-week GamerFit intervention delivered through a mobile app will improve mood, behavioral regulation, and perceived social isolation and support compared to the comparator group; and to test the hypothesis that behavioral effects will be sustained at week 16 (i.e. 4-weeks after the end of the intervention). We will also work with clinicians to explore approaches to incorporating the app, specifically PA prescriptions, into psychiatric treatment plans. This project impacts the field by testing the delivery of a theory- and evidence-based exergaming and telehealth coaching intervention targeting multiple health behaviors in youth with PD via a low-cost app.