Dance4Healing: a feasibility study to reduce health disparity and increase engagement of an intergenerational telehealth program for minority diabetes patients and their care partners.

项目摘要/摘要 2018年1-2年，3420万美国糖尿病(DM)患者花费了327亿美元。其中68%将死于心血管疾病3。美国疾病控制与预防中心报告称，糖尿病对少数民族的影响不成比例。与Palaniappan博士合作，这项创新将扩大研究领域，并对少数族裔健康产生更广泛的影响。Palaniappan博士开创了对糖尿病患者的健康差距和运动/舞蹈干预的研究。目前，对体重正常的糖尿病患者(NWD)有效的生活方式建议缺乏数据，占II型糖尿病患者的五分之一。NWD在亚洲人群和老年人中尤其普遍，面临着比肥胖糖尿病患者更高的死亡率4。研究表明，跳舞可以改善糖尿病，并将心血管疾病死亡率降低46%。5.然而，这些干预措施只能当面提供。有许多锻炼计划和现场视频工具，但它们很少能满足个人的移动性和无障碍需求。因此，有一个尚未得到满足的需求，即一个易于采用的远程医疗平台，吸引患者在家中跳舞。在NIMHD少数民族健康和健康差距研究框架的指导下，该项目将研究多种种族/民族因素对健康行为的影响，并开发一种使用创新艺术疗法(CAT：音乐、舞蹈、艺术)的文化敏感的新型习惯建立算法，用于远程活动参与系统，具有多级跟踪和有效的行为提示。Dance4Healing(D4H)的专有个性化将根据用户的需求/愿望进行定制，并找到兼容的伙伴，通过预先录制的和现场直播的视频课程建立持久的习惯(想想YouTube+Zoom+eHarmony for Health伙伴)。这项可行性研究将与斯坦福大学教授和老龄研究所合作，开发一个突破性的智能平台，集成生物传感器和远程健康直播视频平台(TLVP)。我们在糖尿病和心血管健康、生物追踪、行为科学、舞蹈疗法和数据/人工智能科学方面的多学科专家团队将追求以下目标：目标1：针对不同的移动性、可访问性需求、潜在语言障碍、整合文化意识和识别有效行为提示的用户研究。里程碑：12次1小时的定性用户访谈，以获得对当前程序和用户界面设计的反馈。目的2：通过为期8周的正念运动远程保健计划，建立并测试生物传感器集成(Garmin Vivosmart®4，Omron Scale)的可行性。里程碑：至少80%的参与者成功使用了平台生物传感器。目的3：开发一种与NIMHD研究框架相结合的多级跟踪人工智能算法，并测试其在个性化推荐和根据偏好、能力和需求定制的伙伴匹配中的可行性。里程碑：1)开发偏好数据、自我报告数据与EHR数据的数据收集和集成方法。2)开发了基于这些数据的人工智能算法。该项目的成功将为与美国心脏协会进行的多中心试验的第二阶段奠定基础，并改善3420万美国糖尿病患者的生活质量，进一步推动D4H成为连接艺术和健康的体验领导者的愿景。

PROJECT SUMMARY/ABSTRACT 34.2 M Americans with Diabetes Mellitus (DM) cost $327 B in 2018 1-2 . 68% of them will die from cardiovascular disease 3 . CDC reported that DM disproportionately affects minorities. Partnering with Dr. Palaniappan, who has pioneered research on health disparities and exercise/dance intervention for DM patients, this innovation will expand the research field and have a broader impact on minority health. Currently, there is a lack of data on effective lifestyle recommendations for normal-weight diabetics (NWD), accounting for 1 in 5 Type II DM patients. NWD is especially prevalent in Asian populations and the elderly, facing higher mortality rates than obese diabetics 4 . Research shows dance improves DM and reduces cardiovascular deaths by 46%. 5 . These interventions, however, are only available in person. There are many exercise programs and live video tools, but they rarely cater to an individual’s mobility and accessibility needs. Hence, there is an unmet need for an easy-to-adopt telehealth platform enticing patients to dance from home. Guided by The NIMHD Minority Health and Health Disparities Research Framework, this project will study the effects of multiple races/ethnicities factors on health behaviors, and develop a culturally sensitive novel habit-building algorithm using Creative Arts Therapy (CAT: Music, Dance, Arts) for remote activity engagement systems with multilevel tracking and effective behavior prompts. Dance4Healing’s (D4H) proprietary personalization will tailor to users’ needs/desires, and find compatible buddies to build lasting habits with pre-recorded and live video classes (think YouTube + Zoom + eHarmony for health buddies). This feasibility study will partner with Stanford professors and the Institute on Aging to develop a groundbreaking smart platform integrating biosensors and a Telehealth Live Video Platform (TLVP). Our multidisciplinary team of experts in diabetes and cardiovascular health, biotracking, behavioral sciences, dance therapy, and data/AI science will pursue the following aims: AIM 1: User research on tailoring D4H TLVP to varied mobility, accessibility needs, potential language barriers, integrating cultural awareness, and identifying effective behavior prompts. Milestones: 12 qualitative 1-hour user interviews for feedback on the current program and UI design. AIM 2: Build and test the feasibility of biosensor integration (Garmin vivosmart® 4, Omron Scale) through an 8-week Mindful Movement telehealth program. Milestones: Successful use of platform biosensors by at least 80% of participants. AIM 3: Develop a novel AI algorithm aligned with NIMHD Research Framework with multilevel tracking and test its feasibility in personalized recommendations and buddy matching tailored to preferences, abilities, and needs. Milestones: 1) Develop data collection and integration methods for preference data, self-reported data with EHR data. 2) Develop an AI algorithm based on this data. Success of this project will lay the groundwork for Phase II for a multicenter trial with American Heart Association, and improve QoL for 34.2 M diabetic Americans, furthering D4H’s vision to become an experience leader bridging art and health.