基于移动健康的即时自适应干预措施提高脊髓损伤患者的身体活动水平：一项随机对照试验的方案。

mHealth-Based Just-in-Time Adaptive Intervention to Improve the Physical Activity Levels of Individuals With Spinal Cord Injury: Protocol for a Randomized Controlled Trial.

机构信息

Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, PA, United States.

Khoury College of Computer Sciences, Northeastern University, Boston, MA, United States.

出版信息

JMIR Res Protoc. 2024 Jun 28;13:e57699. doi: 10.2196/57699.

DOI:10.2196/57699

PMID:38941145

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11245659/

Abstract

BACKGROUND

The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. Providing people with an accurate estimate of their everyday PA level can promote PA. Furthermore, PA tracking can be combined with mobile health technology such as smartphones and smartwatches to provide a just-in-time adaptive intervention (JITAI) for individuals with SCI as they go about everyday life. A JITAI can prompt an individual to set a PA goal or provide feedback about their PA levels.

OBJECTIVE

The primary aim of this study is to investigate whether minutes of moderate-intensity PA among individuals with SCI can be increased by integrating a JITAI with a web-based PA intervention (WI) program. The WI program is a 14-week web-based PA program widely recommended for individuals with disabilities. A secondary aim is to investigate the benefit of a JITAI on proximal PA, defined as minutes of moderate-intensity PA within 120 minutes of a PA feedback prompt.

METHODS

Individuals with SCI (N=196) will be randomized to a WI arm or a WI+JITAI arm. Within the WI+JITAI arm, a microrandomized trial will be used to randomize participants several times a day to different tailored feedback and PA recommendations. Participants will take part in the 24-week study from their home environment in the community. The study has three phases: (1) baseline, (2) WI program with or without JITAI, and (3) PA sustainability. Participants will provide survey-based information at the initial meeting and at the end of weeks 2, 8, 16, and 24. Participants will be asked to wear a smartwatch every day for ≥12 hours for the duration of the study.

RESULTS

Recruitment and enrollment began in May 2023. Data analysis is expected to be completed within 6 months of finishing participant data collection.

CONCLUSIONS

The JITAI has the potential to achieve long-term PA performance by delivering tailored, just-in-time feedback based on the person's actual PA behavior rather than a generic PA recommendation. New insights from this study may guide intervention designers to develop engaging PA interventions for individuals with disability.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05317832; https://clinicaltrials.gov/study/NCT05317832.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57699.

摘要

背景

美国脊髓损伤患者缺乏规律的身体活动，这是一个持续存在的健康危机。有规律的身体活动和基于锻炼的干预措施与改善脊髓损伤患者的预后和更健康的生活方式有关。为人们提供对其日常身体活动水平的准确估计可以促进身体活动。此外，身体活动追踪可以与智能手机和智能手表等移动健康技术相结合，为脊髓损伤患者提供即时自适应干预（JITAI），因为他们在日常生活中。JITAI 可以提示个人设定身体活动目标或提供有关其身体活动水平的反馈。

目的

本研究的主要目的是调查通过将 JITAI 与基于网络的身体活动干预（WI）程序相结合，是否可以增加脊髓损伤患者的中等强度身体活动分钟数。WI 程序是一种广泛推荐给残疾人士的 14 周基于网络的身体活动程序。次要目的是调查 JITAI 对近端身体活动的益处，近端身体活动定义为在收到身体活动反馈提示后 120 分钟内的中等强度身体活动分钟数。

方法

将 196 名脊髓损伤患者随机分配到 WI 组或 WI+JITAI 组。在 WI+JITAI 组中，将每天多次使用微随机试验随机分配参与者接受不同的定制反馈和身体活动建议。参与者将在社区的家庭环境中参加 24 周的研究。该研究有三个阶段：（1）基线，（2）WI 程序，无论是否有 JITAI，（3）身体活动可持续性。参与者将在初次会议和第 2、8、16 和 24 周结束时提供基于调查的信息。参与者将被要求在研究期间每天佩戴智能手表至少 12 小时。