一种基于互联网的虚拟教练对超重成年人促进身体活动依从性的随机对照试验。
An internet-based virtual coach to promote physical activity adherence in overweight adults: randomized controlled trial.
作者信息
Watson Alice, Bickmore Timothy, Cange Abby, Kulshreshtha Ambar, Kvedar Joseph
机构信息
Center for Connected Health, Partners HealthCare, Boston, MA 02114, USA.
出版信息
J Med Internet Res. 2012 Jan 26;14(1):e1. doi: 10.2196/jmir.1629.
BACKGROUND
Addressing the obesity epidemic requires the development of effective, scalable interventions. Pedometers and Web-based programs are beneficial in increasing activity levels but might be enhanced by the addition of nonhuman coaching.
OBJECTIVES
We hypothesized that a virtual coach would increase activity levels, via step count, in overweight or obese individuals beyond the effect observed using a pedometer and website alone.
METHODS
We recruited 70 participants with a body mass index (BMI) between 25 and 35 kg/m(2) from the Boston metropolitan area. Participants were assigned to one of two study arms and asked to wear a pedometer and access a website to view step counts. Intervention participants also met with a virtual coach, an automated, animated computer agent that ran on their home computers, set goals, and provided personalized feedback. Data were collected and analyzed in 2008. The primary outcome measure was change in activity level (percentage change in step count) over the 12-week study, split into four 3-week time periods. Major secondary outcomes were change in BMI and participants' satisfaction.
RESULTS
The mean age of participants was 42 years; the majority of participants were female (59/70, 84%), white (53/70, 76%), and college educated (68/70, 97%). Of the initial 70 participants, 62 completed the study. Step counts were maintained in intervention participants but declined in controls. The percentage change in step count between those in the intervention and control arms, from the start to the end, did not reach the threshold for significance (2.9% vs -12.8% respectively, P = .07). However, repeated measures analysis showed a significant difference when comparing percentage changes in step counts between control and intervention participants over all time points (analysis of variance, P = .02). There were no significant changes in secondary outcome measures.
CONCLUSIONS
The virtual coach was beneficial in maintaining activity level. The long-term benefits and additional applications of this technology warrant further study.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00792207; http://clinicaltrials.gov/ct2/show/NCT00792207 (Archived by WebCite at http://www.webcitation.org/63sm9mXUD).
背景
应对肥胖流行需要开发有效且可扩展的干预措施。计步器和基于网络的项目有助于提高活动水平，但增加非人类指导可能会使其效果更佳。
目的
我们假设虚拟教练能使超重或肥胖个体的活动水平（通过步数计算）提高，其效果超过仅使用计步器和网站时所观察到的效果。
方法
我们从波士顿大都市区招募了70名体重指数（BMI）在25至35kg/m²之间的参与者。参与者被分配到两个研究组之一，并被要求佩戴计步器并访问网站以查看步数。干预组的参与者还与虚拟教练见面，虚拟教练是一个在他们家用电脑上运行的自动化动画计算机程序，设定目标并提供个性化反馈。数据于2008年收集和分析。主要结局指标是在为期12周的研究中活动水平的变化（步数变化百分比），该研究分为四个3周时间段。主要次要结局指标是BMI的变化和参与者的满意度。
结果
参与者的平均年龄为42岁；大多数参与者为女性（59/70，84%）、白人（53/70，76%）且受过大学教育（68/70，97%）。最初的70名参与者中，62人完成了研究。干预组参与者的步数保持稳定，而对照组的步数下降。从开始到结束，干预组和对照组之间步数变化的百分比未达到显著差异阈值（分别为2.9%和 -12.8%，P = 0.07）。然而，重复测量分析显示，在比较所有时间点对照组和干预组参与者步数变化百分比时存在显著差异（方差分析，P = 0.02）。次要结局指标无显著变化。
结论
虚拟教练有助于维持活动水平。这项技术的长期益处和其他应用值得进一步研究。
试验注册
ClinicalTrials.gov NCT00792207；http://clinicaltrials.gov/ct2/show/NCT00792207（由WebCite存档于http://www.webcitation.org/63sm9mXUD）
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