Modifying Physical Activity and Sedentary Behavior via Mobile Phone Technology

描述（由申请人提供）：本申请解决了广泛的挑战领域（06）使能技术和特定的高优先级主题领域06-OD（OBSSR）-101*“使用新技术来改善或衡量依从性”。构成美国成年人主要杀手的慢性疾病，其中包括心血管疾病、癌症和其他衰老疾病，与关键的健康行为有着千丝万缕的联系。这些包括定期的身体活动，以及最近的久坐行为，如与肥胖，2型糖尿病和其他危险健康状况相关的长时间看电视。不幸的是，大多数美国人对健康行为习惯的定期坚持仍然很差。通信技术的最新进展，如“智能手机”提供了一个潜在的变革性平台，通过提供方便，可持续和上下文有意义的遵守策略，以解决遵守的共同障碍。本研究的主要目标是开发和测试基于理论的行为干预措施，通过最先进的移动的电话技术提供，旨在增加中等强度的体力活动（PA），减少成年人谁可以特别受益于这些节目的电视观看。在01年期间，将在初步工作的基础上应用参与性定性和定量研究方法，在目标人群中开发和形成性测试两个移动的电话程序（即，年龄在25岁及以上的成年人，身体活动水平低，每周看电视超过14小时，超重或肥胖）。2002年，将进行为期四个月的试验性研究，以测试这两个移动的电话计划的可行性和初步成效。最多90名符合资格标准的成人将被随机分配到移动的电话-PA、移动的电话-TV或移动的电话控制程序。鉴于低收入、中年和老年人中不活动、超重和长时间看电视的流行率很高，研究招募活动将特别针对这些群体。日常身体活动和电视观看将通过内置或编程到手机中的自动化方法（例如，加速度测量、位置“感知”方法）沿着用户提供的信息。过程变量（例如，方案满意度）进行评估。中间健康结果的变化（例如，体重、静息血压和心率）和其他相关健康行为（与电视有关的饮食）。本研究产生的效应量、过程和结果信息将为后续更大规模的试验提供信息，该试验评估两个移动的电话项目在促进持续行为依从性方面的长期影响和成本效益。该项目将产生一些项目，一旦在更大规模的试验中进行评估，这些项目就可以很容易地以潜在的低成本在美国人口中传播。因此，潜在的公共卫生影响是巨大的。该项目还将创造新的就业机会，无论是在赠款的范围内，以及在私营部门，如果类型的技术创新，该项目的目标是创造实现。（根据加州生物医学产业的数据，生物技术组织每雇用一名员工，就会有三到五名员工受雇于为该行业服务的公司。）拟议研究的创新之处包括：重点关注最先进的移动的技术平台，该平台代表了一种方便、日益可用和可接受的手段，可以接触到相当大比例的美国成年人;移动的电话技术的干预具体应用，超出了目前研究工作主要针对的评估和监测领域;针对两种不同的、与慢性病风险相关的高度流行的健康行为;以及开发、测试和改进据我们所知将是第一个专门针对减少成年人看电视时间的干预和监测技术。此外，我们将利用与美国一家大型健康保险公司（Humana）的综合消费者体验小组的合作关系，探索潜在的翻译和传播活动以及后续的资助机制，以进一步推进拟议研究中的技术评估和转让活动。尽管增加每周身体活动水平和减少与肥胖和其他健康问题相关的久坐活动对健康有益，但大多数美国成年人发现持续这样做具有挑战性。本研究旨在开发和评估有效的，方便的，易于使用的行为程序，提供最先进的移动的电话技术，增加步行和减少长时间看电视。这种基于移动的电话的程序代表了一种新兴的、潜在的具有成本效益的手段，用于以方便的、上下文有意义的和持续的方式接触相当大比例的美国人。

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (06) Enabling Technologies, and Specific High-Priority Topic Area 06-OD(OBSSR)-101* "Using new technologies to improve or measure adherence". The chronic diseases that constitute the major killers of American adults, among them cardiovascular disease, cancer, and other diseases of aging, are inextricably linked with key health behaviors. These include regular physical activity and, more recently, sedentary behaviors such as prolonged television viewing that are associated with obesity, type-2 diabetes, and other hazardous health conditions. Unfortunately, regular adherence to healthful behavioral regimens remains poor across the majority of Americans. Recent advances in communication technologies such as 'smart phones' offer a potentially transformative platform for addressing common barriers to adherence through delivering convenient, sustainable, and contextually meaningful adherence strategies. The major objectives of this research are to develop and test theoretically based behavioral interventions, delivered via state-of-the-art mobile phone technology and aimed at increasing moderate-intensity physical activity (PA) and decreasing TV viewing among adults who could particularly benefit from such programs. During Year 01, participatory qualitative and quantitative research methods will be applied based on preliminary work to develop and formatively test the two mobile phone programs in the target population (i.e., adults ages 25 years and older who have low physical activity levels, watch greater than 14 hours of TV/week, and are overweight or obese). In Year 02, an experimental 4-month pilot study will be conducted to test the feasibility and preliminary efficacy of the two mobile phone programs. Up to 90 adults meeting eligibility criteria will be randomized to the mobile phone-PA, mobile phone-TV, or a mobile phone Control program. In light of the high prevalence of inactivity, overweight, and prolonged TV viewing among lower-income and midlife and older adults, study recruitment activities will particularly target those groups. Daily physical activity and TV viewing will be assessed through a combination of automated methods built or programmed into the phones (e.g., accelerometry, location 'aware' methods) along with user-provided information. Process variables (e.g., program satisfaction) will be assessed. Change in intermediate health outcomes (e.g., body weight, resting blood pressure and heart rate) and other relevant health behaviors (TV-related eating) will be assessed. The effect size, process, and outcomes information generated by this research will inform a subsequent larger trial evaluating the longer-term impacts and cost-effectiveness of the two mobile phone programs in promoting sustained behavioral adherence. The project will yield programs that, once evaluated in a larger trial, can be readily disseminated across the U.S. population at potentially low cost. The potential public health impacts are thus substantial. The project also will create new jobs, both within the context of the grant as well as in the private sector, if the types of technology innovations the project is aiming to create come to fruition. (According to the California Biomedical Industry, for every one employee of a biotechnology organization, another three to five will be employed in firms that service that industry.) Among the innovations of the proposed research are the focus on a state-of-the-art mobile technology platform that represents a convenient and increasingly available and acceptable means of reaching a substantial proportion of U.S. adults; intervention-specific applications of mobile phone technology that extend beyond the areas of assessment and monitoring where current research efforts have been aimed primarily; targeting of two different, highly prevalent health behaviors linked with chronic disease risk; and development, testing, and refinement of what, to our knowledge, will be the first intervention and monitoring technology aimed specifically at reducing TV viewing time among adults. In addition, we will utilize our collaborative relationship with the integrated consumer experience group at a large U.S. health insurance company (Humana) to explore potential translation and dissemination activities as well as subsequent funding mechanisms in furthering the technology evaluation and transfer activities stemming from the proposed research. Despite the recognized health benefits of increasing weekly levels of physical activity and reducing sedentary activities associated with obesity and other health problems, most American adults find it challenging to do so on an ongoing basis. This research aims to develop and evaluate effective, convenient, and easy to use behavioral programs, delivered by state-of-the-art mobile phone technologies, for increasing walking and decreasing prolonged television viewing. Such mobile phone-based programs represent an emerging, potentially cost-effective means for reaching a substantial proportion of Americans in a convenient, contextually meaningful, and ongoing fashion.