Modifying Physical Activity and Sedentary Behavior via Mobile Phone Technology

描述(由申请人提供)：本申请涉及广泛的挑战领域(06)使能技术，以及特定的高优先级主题领域06-OD(OBSSR)-101*“使用新技术改善或衡量遵从性”。构成美国成年人主要杀手的慢性病，包括心血管疾病、癌症和其他老年病，与关键的健康行为密不可分。这些包括有规律的体育活动，以及最近久坐不动的行为，如长时间看电视，这与肥胖、2型糖尿病和其他有害的健康状况有关。不幸的是，在大多数美国人中，经常遵守健康行为养生法的情况仍然很差。通信技术的最新进展，如“智能手机”，通过提供方便、可持续和有背景意义的遵守战略，为解决遵守方面的常见障碍提供了一个潜在的变革性平台。这项研究的主要目标是开发和测试基于理论的行为干预措施，通过最先进的手机技术提供，旨在增加中等强度的体力活动(PA)，减少成年人看电视，他们可能特别受益于这类节目。在2001年，将在前期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(即体力活动水平较低、每周看电视时间超过14小时、超重或肥胖的25岁及以上成年人)中开发和形式化测试这两个移动电话项目。在二零零二年，我们会进行为期四个月的试验性试验研究，以测试这两项流动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年人将被随机分配到手机-PA、手机-电视或手机控制计划。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比例很高，研究招募活动将特别针对这些群体。日常体力活动和看电视将通过内置或编程到手机中的自动化方法(例如，加速度法、位置感知方法)以及用户提供的信息的组合来评估。将评估过程变量(例如，计划满意度)。将评估中等健康结果(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)的变化。这项研究产生的效果大小、过程和结果信息将为后续的更大规模的试验提供信息，评估这两个移动电话项目在促进持续行为遵守方面的长期影响和成本效益。该项目将产生一些项目，一旦在更大的试验中进行评估，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。如果该项目旨在创造的各种技术创新取得成果，该项目还将在赠款范围内以及私营部门创造新的就业机会。(根据加州生物医疗行业的数据，生物技术组织每有一名员工，就会有另外三到五名员工受雇于为该行业服务的公司。)拟议研究的创新包括关注最先进的移动技术平台，它代表着一种方便、日益可用和可接受的方式，可以接触到相当大比例的美国成年人；移动电话技术的特定干预应用，超出了当前研究努力主要针对的评估和监测领域；针对两种与慢性病风险有关的不同、高度普遍的健康行为；以及开发、测试和完善据我们所知，将是第一项专门旨在减少成年人看电视时间的干预和监测技术。此外，我们将利用我们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，以及后续的资金机制，以进一步推动拟议研究产生的技术评估和转让活动。尽管每周增加体力活动和减少与肥胖和其他健康问题相关的久坐活动对健康有好处，但大多数美国成年人发现，持续这样做是有挑战性的。这项研究旨在开发和评估由最先进的移动电话技术提供的有效、方便和易于使用的行为程序，以增加步行和减少长时间观看电视。这类基于手机的计划代表着一种新兴的、潜在的成本效益高的手段，可以方便、有背景意义和持续的方式接触到相当大一部分美国人。

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.