Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.
Background/aims: The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young...
| Publicado en: | Clinical Trials Vol. 12; no. 6; pp. 634 - 646 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | pictorial research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Sage Publications, Ltd.
Dec2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110940634&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110940634 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17407745 AB6 jtl: Clinical Trials issn: 17407745 maglogo: N pubinfo: dt: Dec2015 vid: 12 iid: 6 pid: 33180 pub: Sage Publications, Ltd. place: <Blank> artinfo: ui: 110940634 110940634 110940634 10.1177/1740774515597222 110940634 ppf: 634 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial. aug: au: Lin, Pao-Hwa Intille, Stephen Bennett, Gary Bosworth, Hayden B. Corsino, Leonor Voils, Corrine Grambow, Steven Lazenka, Tony Batch, Bryan C. Tyson, Crystal Svetkey, Laura P. affil: Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC, USA sug: subj: Obesity Prevention and Control Health Promotion Mobile Applications Human Adult Adolescence Body Mass Index Randomized Controlled Trials Models, Theoretical Focus Groups Smartphone Funding Source Adult: 19-44 years Adolescent: 13-18 years ab: Background/aims: The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this article is to describe the design and development of the intervention tested in the Cell Phone Intervention for You study and to highlight the importance of adaptive intervention design that made it possible. The Cell Phone Intervention for You study was a National Heart, Lung, and Blood Institute–sponsored, controlled, 24-month randomized clinical trial comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (body mass index ≥ 25 kg/m2) young adults. Methods: Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, adaptive intervention design, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The adaptive intervention design strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. Adaptive intervention design was made possible by exploiting the mobile phone’s remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. Results: The cell phone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive—providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over 2 years to promote and sustain engagement. The personal coaching intervention, alternatively, was primarily personal coaching with trained coaches based on a proven intervention, enhanced with a mobile application, but where all interactions with the technology were participant-initiated. Conclusion: The complexity and length of the technology-based randomized clinical trial created challenges in engagement and technology adaptation, which were generally discovered using novel remote monitoring technology and addressed using the adaptive intervention design. Investigators should plan to develop tools and procedures that explicitly support continuous remote monitoring of interventions to support adaptive intervention design in long-term, technology-based studies, as well as developing the interventions themselves. pubtype: Academic Journal doctype: pictorial research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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