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针对残疾人的电子健康/移动健康远程健康试点项目的回顾性评估:正念、运动与营养以增强复原力(MENTOR)

Retrospective evaluation of a pilot eHealth/mHealth telewellness program for people with disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR).

作者信息

Rimmer James H, Wilroy Jereme, Galea Pierre, Jeter Amanda, Lai Byron W

机构信息

Dean's Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.

Lakeshore Foundation, Homewood, AL, USA.

出版信息

Mhealth. 2022 Apr 20;8:15. doi: 10.21037/mhealth-21-34. eCollection 2022.

Abstract

BACKGROUND

People with disabilities have few options to participate in wellness programs that are tailored to their health, functional level, specific interests/needs, and available in the comfort of their home. To address this need, we evaluated a mobile health wellness program for people with physical disabilities.

METHODS

Retrospective pilot evaluation of MENTOR (Mindfulness, Exercise, and Nutrition To Optimize Resilience), an 8-week, 40-hour online telewellness program adapted from the peer reviewed literature on wellness. The three core wellness domains-mindfulness, exercise, and nutrition-were delivered via Zoom to groups of participants with a disability. Each group met weekly with an assigned health coach who responded to Q&A about the program and presented new material on several additional wellness domains that could impact their health (e.g., relationships, contribution to society/community, spending outdoor time in nature). Pre/post measures included the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the UAB/Lakeshore Wellness Assessment (LWA). Participants were also interviewed and provided feedback after the program, which was thematically analyzed.

RESULTS

A total of 154 people from 15 states enrolled in the MENTOR program and 135 completed it (87.7% completers). Data were analyzed from a subset of participants (n=53) who were asked to complete a pre/post assessment and had complete data. Participants who were physically inactive at baseline improved their GLTEQ total activity (P=0.002; effect size =0.56) and moderate-to-vigorous activity scores (P=0.005; effect size =0.53). LWA results demonstrated that participants increased their exercise behavior (P=0.006; effect sizes =0.39) and contribution to society/community (P=0.013; effect size =0.37). Participants with low overall wellness (mental, physical & emotional health) at baseline had statistically significant improvements in exercise, nutrition, sleep, core values, self-care, hobbies, contribution to society/community, relationships, and overall wellness (all P<0.05 with effect sizes ranging from 0.43 to 1.07). Resultant qualitative themes were: (I) lifestyle transformation occurred through new positive experiences, physical and mental health benefits, and adoption of healthy behaviors; and (II) engagement through accessible online bonding through enjoyable and professional experiences.

CONCLUSIONS

A pilot telewellness program for people with disabilities is feasible and potentially effective in improving several domains of wellness. There is a need for precision-based mobile health (mHealth) programs that are tailored for people with disabilities and that can be accessed from various portable devices including their phone and/or tablet.

摘要

背景

残疾人士几乎没有机会参与针对其健康状况、功能水平、特定兴趣/需求且能让他们在舒适的家中参与的健康计划。为满足这一需求,我们对一项针对身体残疾人士的移动健康计划进行了评估。

方法

对MENTOR(正念、运动与营养以优化恢复力)进行回顾性试点评估,这是一项为期8周、共40小时的在线远程健康计划,改编自关于健康的同行评审文献。通过Zoom向残疾参与者群体提供正念、运动和营养这三个核心健康领域的内容。每个小组每周与指定的健康教练会面,教练会解答关于该计划的问答,并介绍一些可能影响他们健康的其他健康领域的新材料(例如人际关系、对社会/社区的贡献、在大自然中户外活动的时间)。前后测量包括戈丁休闲时间运动问卷(GLTEQ)和UAB/湖滨健康评估(LWA)。参与者在计划结束后还接受了访谈并提供反馈,对这些反馈进行了主题分析。

结果

来自15个州的154人报名参加了MENTOR计划,135人完成了该计划(完成率87.7%)。对一部分被要求完成前后评估且数据完整的参与者(n = 53)进行了数据分析。基线时身体不活跃的参与者提高了他们的GLTEQ总活动量(P = 0.002;效应量 = 0.56)和中度至剧烈活动得分(P = 0.005;效应量 = 0.53)。LWA结果表明,参与者增加了他们的运动行为(P = 0.006;效应量 = 0.39)以及对社会/社区的贡献(P = 0.013;效应量 = 0.37)。基线时整体健康水平(心理、身体和情绪健康)较低的参与者在运动、营养、睡眠、核心价值观、自我护理、爱好、对社会/社区的贡献、人际关系和整体健康方面有统计学上的显著改善(所有P < 0.05,效应量范围为0.43至1.07)。产生的定性主题为:(I)通过新的积极体验、身心健康益处以及采用健康行为实现了生活方式的转变;(II)通过愉快且专业的体验进行无障碍在线互动实现了参与度提升。

结论

一项针对残疾人士的试点远程健康计划在改善多个健康领域方面是可行的且可能有效。需要有基于精准度的移动健康(mHealth)计划,这些计划要为残疾人士量身定制,并且可以从包括手机和/或平板电脑在内的各种便携式设备访问。

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