This project aims to fill the urgent need for a safe and engaging intervention that promotes physical activityin a population of patients with chronic diseases (e.g., diabetes, asthma, osteoarthritis, and chronic heartfailure). Compelling evidence suggests that physical activity is an effective therapeutic intervention fornumerous chronic diseases. However, in spite of the wide consensus that physical activity should be anintegral treatment component for many chronic diseases, most patients remain inactive1 due to a variety ofbarriers and obstacles they regularly encounter. We therefore propose to innovatively adapt an efficacious exercise-promoting intervention that targetssedentary employees2 to a population with specific needs and constraints that result from chronic disease anddeliver this intervention as a mobile application that can be accessed via smartphone, tablet, or computer. We propose a program design that follows recommendations derived from a recent NIH-funded meta-analytic review of interventions to promote physical activity in patients with chronic diseases, whichemphasizes the importance of behavioral activation as opposed to cognitive-behavioral intervention features.3Our comprehensive mobile application is therefore composed of (a) an initial screening; (b) baseline physicalactivity (PA) levels recorded via wireless accelerometer device; (c) an assessment that elicits informationregarding preferences for and barriers to PA; (d) goal setting; (e) daily e-mail or text messages stating the goalfor the day, the type of exercise, and a link to a video demonstrating the exercise; (f) a brief check-in todetermine whether the user is currently encountering a barrier (pain, fatigue, etc.) and tailored remediation forthe barrier through social media functionality and expert advice; (g) prompts to execute the daily exercise; (h)integration of a wireless accelerometer device (e.g., Fitbit(R)) to supplement self-reported exercise data andto drive tailored feedback and goal setting; (i) check-in regarding activity completion (e.g., 'have youcompleted the exercise?,' 'did you enjoy this exercise?,' 'do you feel better after this exercise?'); (j)immediate, personalized feedback on how executed physical activities contribute to goal progress; and (k)feedback reports for the primary care physician. Together these design features will promote and support asustainable habit of regular PA in this vulnerable population. In a 30-day pre-post study, we will test preliminary efficacy and feasibility of this prototype intervention in apopulation of 38 adult patients with chronic osteoarthritis. The Phase I prototype program will be limited todemonstrating feasibility with individuals with osteoarthritis to control the overall scope of the Phase Iproject. We hypothesize that this intervention will engage this population and increase subjects' PA level frompre- to post-assessment. If this pilot efficacy trial yields satisfactory results, the Phase 2 project will expandthe scope of the program to include all patients with additional chronic diseases (e.g., osteoarthritis,hypertension, diabetes, pulmonary disease).
Thesaurus Terms: Address;Adult;American;American Medical Association;Asthma;Behavioral;Chronic;Chronic Disease;Chronically Ill;Clinical Trials;Cognitive Therapy;College;Computers;Consensus;Data;Degenerative Polyarthritis;Design;Devices;Diabetes Mellitus;Disease;Disease Management;Disorder Prevention;Effectiveness;Efficacy Trial;Employee;Evaluation;Evidence Base;Exercise;Fatigue;Feedback;Focus Groups;Funding;Goals;Habits;Health;Health Planning;Heart Failure;Hypertension;Improved;Individual;Internet;Intervention;Link;Lung;Lung Diseases;Mails;Medical;Medicine;Meta-Analysis;Mobile Application;Monitor;Neglect;Online Systems;Outcome;Pain;Patient Population;Patient Self-Report;Patients;Phase;Physical Activity;Physicians;Population;Preference;Prevalence;Primary Care Physician;Programs;Prototype;Provider;Public Health Medicine (Field);Public Health Relevance;Recommendation;Remediation;Reporting;Screening;Sedentary;Social;Sports Medicine;Tablets;Testing;Text;Therapeutic Intervention;Time;Timeline;Underserved Population;United States;United States National Institutes Of Health;Update;Usability;Visit;Vulnerable Populations;Wireless Technology;
