一项促进心理健康和降低心脏风险的自适应短信干预措施：Text4Health 对照临床试点试验。

An adaptive text message intervention to promote psychological well-being and reduce cardiac risk: The Text4Health controlled clinical pilot trial.

机构信息

Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA.

出版信息

J Psychosom Res. 2024 Feb;177:111583. doi: 10.1016/j.jpsychores.2023.111583. Epub 2023 Dec 30.

DOI:10.1016/j.jpsychores.2023.111583

PMID:38171212

Abstract

OBJECTIVE

In a two-arm pilot trial, we examined the feasibility, acceptability, and preliminary efficacy of a 12-week, adaptive text message intervention (TMI) to promote health behaviors and psychological well-being in 60 individuals with multiple cardiac risk conditions (i.e., hypertension, hyperlipidemia, and/or type 2 diabetes) and suboptimal adherence to exercise or dietary guidance.

METHODS

Participants were allocated to receive the TMI or enhanced usual care (eUC). The TMI included daily adaptive text messages promoting health behaviors, twice-weekly messages to set goals and monitor progress, and monthly phone check-ins. Feasibility (primary outcome) and acceptability were measured by rates of successful text message delivery and daily participant ratings of message utility (0-10 Likert scale). We also assessed impact on health behavior adherence, psychological health, and functional outcomes.

RESULTS

The TMI was feasible (99.3% of messages successfully sent) and well-accepted (mean utility = 7.4/10 [SD 2.6]). At 12 weeks, the TMI led to small-sized greater improvements in moderate to vigorous physical activity (d = 0.37), overall physical activity (d = 0.23), optimism (d = 0.20), anxiety (d = -0.36), self-efficacy (d = 0.22), and physical function (d = 0.20), compared to eUC. It did not impact other outcomes substantially at this time point.

CONCLUSION

This 12-week, adaptive TMI was feasible, well-accepted, and associated with small-sized greater improvements in health behavior and psychological outcomes. Though larger studies are needed, it has the potential to be a scalable, low-intensity program that could be used in clinical practice.

CLINICALTRIALS

govregistration:NCT04382521.

摘要

目的

在一项双臂试验性试验中，我们检查了为期 12 周的适应性短信干预（TMI）促进 60 名具有多种心脏风险条件（即高血压、高血脂和/或 2 型糖尿病）和运动或饮食指导依从性差的个体的健康行为和心理幸福感的可行性、可接受性和初步疗效。

方法

参与者被分配接受 TMI 或增强的常规护理（eUC）。TMI 包括每天促进健康行为的适应性短信，每两周两次的消息设置目标和监测进展，以及每月电话检查。可行性（主要结果）和可接受性通过成功发送短信的比率和每日参与者对消息效用的评分（0-10 分 Likert 量表）来衡量。我们还评估了对健康行为依从性、心理健康和功能结果的影响。

结果

TMI 是可行的（99.3%的消息成功发送），并且易于接受（平均效用=7.4/10 [SD 2.6]）。在 12 周时，与 eUC 相比，TMI 导致中等至剧烈体力活动（d=0.37）、总体体力活动（d=0.23）、乐观（d=0.20）、焦虑（d=-0.36）、自我效能（d=0.22）和身体功能（d=0.20）的小幅改善更大。在这个时间点，它没有对其他结果产生实质性影响。