Departments of Physical Medicine & Rehabilitation (Drs Juengst and Messrs Conley and Luu) and Applied Clinical Research (Dr Juengst), University of Texas Southwestern Medical Center, Dallas; North Texas Traumatic Brain Injury Model System, Dallas, Texas (Drs Juengst and Driver and Ms McShan); and Baylor Scott and White Research Institute, Dallas, and Baylor Scott & White Institute for Rehabilitation, Dallas, Texas (Ms McShan and Dr Driver).
J Head Trauma Rehabil. 2022;37(3):162-170. doi: 10.1097/HTR.0000000000000769. Epub 2022 Mar 15.
To determine the feasibility of mobile health (mHealth) apps for enhancing participation of people with chronic traumatic brain injury (TBI) in the Group Lifestyle Balance (GLB-TBI) weight loss intervention and Brain Health Group (BHG-TBI) active control intervention.
Community.
n = 56 overweight/obese adults with moderate-severe TBI.
The GLB-TBI is a 12-month group- and community-based program to promote healthy eating and physical activity. The BHG-TBI is a 12-month group- and community-based program to promote general brain health, designed as an active control condition matched on time, structure, and perceived benefit to the GLB-TBI. In a randomized controlled trial testing the efficacy of the GLB-TBI for weight loss, participants used a group-specific mHealth app providing daily tips customized according to their intervention allocation.
Compliance (percentage of daily prompts read and completed) and participant-reported satisfaction and usability.
In conjunction with relevant stakeholders, we developed the content and structure of the GLB-TBI and BHG-TBI apps based on core curriculum components. We incorporated cognitive strategies (app notifications) to address potential cognitive impairment common after TBI. Both apps delivered brief daily educational and motivational "tips" derived directly from their respective curricula. Daily use of the apps varied greatly across participants, with most participants who used the apps completing 10% to 50% of daily content. Participants found the apps to be easy to use, but only some found them helpful. App use was substantially different for those who participated in the intervention during (2020) versus before (2019) the COVID-19 pandemic.
Although enhancing an intensive lifestyle intervention with mHealth technology may be helpful, further refinement is needed to optimize the frequency and delivery methods of mHealth content. Although one might expect remote app use to have been higher during the pandemic, we observed the opposite, potentially due to less hands-on training and ongoing support to use the app and/or general technology fatigue with social distancing.
确定移动健康（mHealth）应用程序在增强慢性创伤性脑损伤（TBI）患者参与团体生活方式平衡（GLB-TBI）减肥干预和大脑健康团体（BHG-TBI）主动对照干预中的可行性。
社区。
n = 56 名超重/肥胖的中重度 TBI 成年人。
GLB-TBI 是一项为期 12 个月的团体和社区为基础的计划，旨在促进健康饮食和身体活动。BHG-TBI 是一项为期 12 个月的团体和社区为基础的计划，旨在促进大脑健康，设计为与 GLB-TBI 相匹配的时间、结构和感知效益的主动对照条件。在一项测试 GLB-TBI 减肥效果的随机对照试验中，参与者使用了一个特定于团体的 mHealth 应用程序，该应用程序根据他们的干预分配提供每日个性化提示。
合规性（阅读和完成的每日提示百分比）和参与者报告的满意度和可用性。
我们与相关利益相关者合作，根据核心课程组件开发了 GLB-TBI 和 BHG-TBI 应用程序的内容和结构。我们纳入了认知策略（应用程序通知），以解决 TBI 后常见的潜在认知障碍。这两个应用程序都提供了直接来自其各自课程的简短日常教育和激励性“提示”。参与者对应用程序的使用差异很大，大多数使用应用程序的参与者完成了 10%至 50%的日常内容。参与者发现应用程序易于使用，但只有一些人认为它们有帮助。在 COVID-19 大流行之前（2019 年）和期间（2020 年）参加干预的参与者之间，应用程序的使用情况有很大差异。
虽然使用移动健康技术增强强化生活方式干预可能会有所帮助，但需要进一步改进来优化移动健康内容的频率和交付方式。尽管人们可能期望在大流行期间远程使用应用程序会更高，但我们观察到的情况恰恰相反，这可能是由于对使用应用程序和/或一般技术的培训和支持减少以及对社交距离的技术疲劳。
