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Evaluating the Effects of a Self-Help Mobile Phone App on Worry and Rumination Experienced by Young Adults: Randomized Controlled Trial. 评估自助移动电话应用程序对年轻成年人所经历的忧虑和反刍的影响:随机对照试验
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-13 DOI: 10.2196/51932
Daniel Edge, Edward Watkins, Alexandra Newbold, Thomas Ehring, Mads Frost, Tabea Rosenkranz

Background: Delivery of preventative interventions via mobile phone apps offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT).

Objective: This was a prevention mechanism trial that aimed to investigate whether an RNT-targeting self-help mobile phone app (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being.

Methods: A web-based, single-blind, 2-arm parallel-group randomized controlled trial was conducted with 236 people aged between 16 and 24 years, who self-reported high levels of worry or rumination. Eligible participants were randomized to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after 6 weeks, n=117). The primary outcome was changes in worry and rumination 6 weeks after randomization. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after 6 weeks and changes in all measures after 12 weeks.

Results: Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI -5.57 to -0.28; P=.03; ηp2=0.02) and worry (mean difference -3.97, 95% CI -6.21 to -1.73; P<.001; ηp2=0.06) at 6-week follow-up, relative to the waitlist control. Similar differences were observed for well-being (P<.001), anxiety (P=.03), and depression (P=.04). The waitlist control group also showed improvement when given access to the app after 6 weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point.

Conclusions: The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce RNT. This app, therefore, has potential for the prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated.

Trial registration: ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257.

International registered report identifier (irrid): RR2-10.1186/s12888-021-03536-0.

背景:通过手机应用程序提供预防性干预措施,为改善青少年和年轻成年人的心理健康这一全球优先事项提供了一种有效且便捷的方法。焦虑和抑郁的一个已被证实的风险因素是担忧和反刍的增加,也称为重复性消极思维(RNT):这是一项预防机制试验,旨在调查针对 RNT 的自助手机应用程序(MyMoodCoach)是否能减少英国青少年的担忧和反刍。次要目标是测试该应用程序是否能减轻焦虑和抑郁症状并改善幸福感:对 236 名年龄在 16-24 岁之间、自述有高度忧虑或反刍的人进行了基于网络的单盲双臂平行组随机对照试验。符合条件的参与者被随机分配到积极干预组(通常做法,外加使用 RNT 目标移动应用程序长达 6 周,人数为 119 人)或候补对照组(通常做法,6 周后才能使用应用程序,人数为 117 人)。主要结果是随机分组 6 周后担忧和反刍的变化。次要结果包括 6 周后幸福感以及焦虑和抑郁症状的变化,以及 12 周后所有测量指标的变化:结果:随机分配使用以 RNT 为目标的自助应用程序的参与者在 6 周后的随访中显示,相对于候补对照组,他们的反刍(平均差异-2.92,95% CI -5.57至-0.28;P=.03;ηp2=0.02)和担忧(平均差异-3.97,95% CI -6.21至-1.73;Pp2=0.06)水平显著降低。在幸福感方面也观察到了类似的差异(PC结论:相对于等待对照组,MyMoodCoach 应用程序对年轻人的担忧和反刍、幸福感、焦虑和抑郁有显著的积极影响,提供了无指导自助应用程序可以有效减少 RNT 的原理证明。因此,这款应用程序具有预防焦虑症和抑郁症的潜力,但对发病率的长期影响还需要直接评估:ClinicalTrials.gov NCT04950257; https://www.clinicaltrials.gov/ct2/show/NCT04950257.International 注册报告标识符 (irrid):RR2-10.1186/s12888-021-03536-0.
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引用次数: 0
Efficacy of a Web-Based Home Blood Pressure Monitoring Program in Improving Predialysis Blood Pressure Control Among Patients Undergoing Hemodialysis: Randomized Controlled Trial 基于网络的家庭血压监测计划对改善血液透析患者透析前血压控制的效果:随机对照试验
IF 5 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-09 DOI: 10.2196/53355
Tingting Chen, Wenbo Zhao, Qianqian Pei, Yanru Chen, Jinmei Yin, Min Zhang, Cheng Wang, Jing Zheng
Background: Hypertension is highly prevalent among patients undergoing hemodialysis, with a significant proportion experiencing poorly controlled blood pressure (BP). Digital BP management in this population has been underutilized. Objective: This study aimed to explore the efficacy of a Web-based home blood pressure monitoring (HBPM) program in improving pre-dialysis BP control and enhancing knowledge, perception and adherence to HBPM among hypertensive patients undergoing hemodialysis. Methods: A multicenter, open-label, randomized controlled trial was conducted at two hemodialysis units. Patients were randomly allocated in a 1:1 ratio to either the Web-based HBPM program as the intervention group or to usual care as the control group over a 6-month period. The primary outcomes were the pre-dialysis BP control rate, defined as less than 140/90 mmHg, and the pre-dialysis systolic blood pressure (SBP), diastolic blood pressure (DBP), assessed from baseline to the 6-month follow-up. Secondary outcomes included patient knowledge, perception, and adherence to HBPM, evaluated using the home blood pressure monitoring knowledge questionnaire (HBPMKQ), home blood pressure monitoring perception scale (HBPMPS), and home blood pressure monitoring adherence scale (HBPMAS), respectively. The generalized estimating equations analysis was utilized to analyze the primary outcomes in the intention-to-treat analysis. Results: Of the 165 patients enrolled in the program (n=84, Web-based HBPM group; n=81, control group), 145 completed the follow-up assessment. During follow-up period, 11 instances of hypotension occurred in 9 patients in the Web-based HBPM group, compared to 15 events in 14 patients in the control group. The pre-dialysis BP control rate increased from 29.8% to 47.6% in the Web-based HBPM group after the 6-month intervention, while in the control group, it decreased from 37% to 24.7% (x2 =16.82, P <.001; OR = 5.11, 95%CI 2.14–12.23, P <.001). The Web-based HBPM group demonstrated a significant reduction after the 6-month intervention in the pre-dialysis SBP (t =2.46, P =.02; β = −6.09, 95%CI −10.94 – −1.24, P =.01), and the pre-dialysis DBP (t =3.20, P =.002; β = −4.93, 95%CI −7.93 – −1.93, P =.001). Scores on HBPMKQ (t = -9.18, P <.001), HBPMPS (t = −10.65, P <.001), and HBPMAS (t =−8.04, P <.001) were significantly higher after 6-months of intervention. Conclusions: Implementation of a Web-based HBPM program can enhance pre-dialysis BP control, and the knowledge, perception, and adherence to HBPM among patients undergoing hemodialysis. This Web-based HBPM program should be promoted in appropriate clinical settings. Clinical Trial: China Clinical Trial Registration Center ChiCTR2100051535; https://www.chictr.org.cn/showproj.html?proj=133286
背景:高血压在接受血液透析的患者中发病率很高,其中很大一部分患者血压(BP)控制不佳。在这一人群中,数字化血压管理一直未得到充分利用。研究目的本研究旨在探讨基于网络的家庭血压监测(HBPM)项目在改善血液透析患者透析前血压控制以及增强其对 HBPM 的了解、认知和依从性方面的效果。方法:在两家血液透析单位开展了一项多中心、开放标签、随机对照试验。患者按 1:1 的比例随机分配到基于网络的 HBPM 计划作为干预组或常规护理作为对照组,为期 6 个月。主要结果是透析前血压控制率(定义为低于 140/90 mmHg)、透析前收缩压 (SBP) 和舒张压 (DBP),从基线到 6 个月随访期间进行评估。次要结果包括患者对家庭血压监测的知识、感知和依从性,分别使用家庭血压监测知识问卷(HBPMKQ)、家庭血压监测感知量表(HBPMPS)和家庭血压监测依从性量表(HBPMAS)进行评估。采用广义估计方程分析法对意向治疗分析中的主要结果进行分析。结果:165 名患者参加了该项目(网络 HBPM 组 84 人;对照组 81 人),其中 145 人完成了随访评估。在随访期间,网络 HBPM 组有 9 名患者发生了 11 次低血压,而对照组有 14 名患者发生了 15 次低血压。经过 6 个月的干预后,网络 HBPM 组透析前血压控制率从 29.8% 上升到 47.6%,而对照组则从 37% 下降到 24.7%(x2 =16.82,P <.001;OR = 5.11,95%CI 2.14-12.23,P <.001)。基于网络的 HBPM 组在 6 个月的干预后,透析前 SBP(t =2.46,P =.02;β = -6.09,95%CI -10.94--1.24,P =.01)和透析前 DBP(t =3.20,P =.002;β = -4.93,95%CI -7.93--1.93,P =.001)显著下降。干预 6 个月后,HBPMKQ(t = -9.18,P <.001)、HBPMPS(t = -10.65,P <.001)和 HBPMAS(t =-8.04,P <.001)的得分显著提高。结论实施基于网络的 HBPM 计划可以提高血液透析患者透析前的血压控制、对 HBPM 的认识、感知和依从性。这种基于网络的 HBPM 计划应在适当的临床环境中推广。临床试验:中国临床试验注册中心 ChiCTR2100051535; https://www.chictr.org.cn/showproj.html?proj=133286
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引用次数: 0
Data Collection and Management of mHealth, Wearables, and Internet of Things in Digital Behavioral Health Interventions With the Awesome Data Acquisition Method (ADAM): Development of a Novel Informatics Architecture. 在数字行为健康干预中使用真棒数据采集方法 (ADAM),对移动医疗、可穿戴设备和物联网进行数据采集和管理:开发新的信息学架构。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-07 DOI: 10.2196/50043
I Wayan Pulantara, Yuhan Wang, Lora E Burke, Susan M Sereika, Zhadyra Bizhanova, Jacob K Kariuki, Jessica Cheng, Britney Beatrice, India Loar, Maribel Cedillo, Molly B Conroy, Bambang Parmanto

Unlabelled: The integration of health and activity data from various wearable devices into research studies presents technical and operational challenges. The Awesome Data Acquisition Method (ADAM) is a versatile, web-based system that was designed for integrating data from various sources and managing a large-scale multiphase research study. As a data collecting system, ADAM allows real-time data collection from wearable devices through the device's application programmable interface and the mobile app's adaptive real-time questionnaires. As a clinical trial management system, ADAM integrates clinical trial management processes and efficiently supports recruitment, screening, randomization, data tracking, data reporting, and data analysis during the entire research study process. We used a behavioral weight-loss intervention study (SMARTER trial) as a test case to evaluate the ADAM system. SMARTER was a randomized controlled trial that screened 1741 participants and enrolled 502 adults. As a result, the ADAM system was efficiently and successfully deployed to organize and manage the SMARTER trial. Moreover, with its versatile integration capability, the ADAM system made the necessary switch to fully remote assessments and tracking that are performed seamlessly and promptly when the COVID-19 pandemic ceased in-person contact. The remote-native features afforded by the ADAM system minimized the effects of the COVID-19 lockdown on the SMARTER trial. The success of SMARTER proved the comprehensiveness and efficiency of the ADAM system. Moreover, ADAM was designed to be generalizable and scalable to fit other studies with minimal editing, redevelopment, and customization. The ADAM system can benefit various behavioral interventions and different populations.

无标签:将来自各种可穿戴设备的健康和活动数据整合到研究中,在技术和操作上都是一个挑战。真棒数据采集方法(ADAM)是一种基于网络的多功能系统,设计用于整合各种来源的数据并管理大规模多阶段研究。作为数据收集系统,ADAM 可通过设备的应用可编程接口和移动应用程序的自适应实时问卷,从可穿戴设备上实时收集数据。作为临床试验管理系统,ADAM 整合了临床试验管理流程,可在整个研究过程中高效支持招募、筛选、随机化、数据跟踪、数据报告和数据分析。我们将一项行为减肥干预研究(SMARTER 试验)作为评估 ADAM 系统的测试案例。SMARTER 是一项随机对照试验,筛选了 1741 名参与者,并招募了 502 名成年人。因此,ADAM 系统被高效、成功地用于组织和管理 SMARTER 试验。此外,ADAM 系统凭借其多功能集成能力,在 COVID-19 大流行病停止人际接触时,实现了完全远程评估和跟踪的必要转换,并及时无缝地执行了评估和跟踪。ADAM 系统提供的远程本地功能将 COVID-19 封锁对 SMARTER 试验的影响降至最低。SMARTER 的成功证明了 ADAM 系统的全面性和高效性。此外,ADAM 的设计具有通用性和可扩展性,只需进行少量编辑、重新开发和定制即可适用于其他研究。ADAM 系统可以使各种行为干预和不同人群受益。
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引用次数: 0
Correction: The Effect of an mHealth Self-Monitoring Intervention (MI-BP) on Blood Pressure Among Black Individuals With Uncontrolled Hypertension: Randomized Controlled Trial. 更正:移动医疗自我监测干预(MI-BP)对高血压未得到控制的黑人血压的影响:随机对照试验。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-06 DOI: 10.2196/64632
Lorraine R Buis, Junhan Kim, Ananda Sen, Dongru Chen, Katee Dawood, Reema Kadri, Rachelle Muladore, Melissa Plegue, Caroline R Richardson, Zora Djuric, Candace McNaughton, David Hutton, Lionel P Robert, Sun Young Park, Phillip Levy

[This corrects the article DOI: 10.2196/57863.].

[此处更正了文章 DOI:10.2196/57863]。
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引用次数: 0
Using Wearables to Study Biopsychosocial Dynamics in Couples Who Cope With a Chronic Health Condition: Ambulatory Assessment Study. 利用可穿戴设备研究慢性病患者夫妇的生物心理社会动态:流动评估研究
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-05 DOI: 10.2196/49576
Theresa Pauly, Janina Lüscher, Lea Olivia Wilhelm, Melanie Alexandra Amrein, George Boateng, Tobias Kowatsch, Elgar Fleisch, Guy Bodenmann, Urte Scholz

Background: Technology has become an integral part of our everyday life, and its use to manage and study health is no exception. Romantic partners play a critical role in managing chronic health conditions as they tend to be a primary source of support.

Objective: This study tests the feasibility of using commercial wearables to monitor couples' unique way of communicating and supporting each other and documents the physiological correlates of interpersonal dynamics (ie, heart rate linkage).

Methods: We analyzed 617 audio recordings of 5-minute duration (384 with concurrent heart rate data) and 527 brief self-reports collected from 11 couples in which 1 partner had type II diabetes during the course of their typical daily lives. Audio data were coded by trained raters for social support. The extent to which heart rate fluctuations were linked among couples was quantified using cross-correlations. Random-intercept multilevel models explored whether cross-correlations might differ by social contexts and exchanges.

Results: Sixty percent of audio recordings captured speech between partners and partners reported personal contact with each other in 75% of self-reports. Based on the coding, social support was found in 6% of recordings, whereas at least 1 partner self-reported social support about half the time (53%). Couples, on average, showed small to moderate interconnections in their heart rate fluctuations (r=0.04-0.22). Couples also varied in the extent to which there was lagged linkage, that is, meaning that changes in one partner's heart rate tended to precede changes in the other partner's heart rate. Exploratory analyses showed that heart rate linkage was stronger (1) in rater-coded partner conversations (vs moments of no rater-coded partner conversations: rdiff=0.13; P=.03), (2) when partners self-reported interpersonal contact (vs moments of no self-reported interpersonal contact: rdiff=0.20; P<.001), and (3) when partners self-reported social support exchanges (vs moments of no self-reported social support exchange: rdiff=0.15; P=.004).

Conclusions: Our study provides initial evidence for the utility of using wearables to collect biopsychosocial data in couples managing a chronic health condition in daily life. Specifically, heart rate linkage might play a role in fostering chronic disease management as a couple. Insights from collecting such data could inform future technology interventions to promote healthy lifestyle engagement and adaptive chronic disease management.

International registered report identifier (irrid): RR2-10.2196/13685.

背景:科技已成为我们日常生活中不可或缺的一部分,利用科技来管理和研究健康也不例外。浪漫的伴侣在管理慢性健康状况方面发挥着至关重要的作用,因为他们往往是支持的主要来源:本研究测试了使用商用可穿戴设备监测情侣之间独特的沟通和相互支持方式的可行性,并记录了人际动态的生理关联(即心率关联):我们分析了 11 对伴侣中有一方患有 II 型糖尿病的夫妇在典型日常生活过程中采集的 617 份持续 5 分钟的音频记录(其中 384 份同时包含心率数据)和 527 份简短的自我报告。音频数据由训练有素的评分员进行社会支持编码。夫妻间心率波动的关联程度通过交叉相关进行量化。随机截距多层次模型探讨了交叉相关性是否会因社会环境和交流而有所不同:60%的录音记录了伴侣之间的对话,75%的自我报告显示伴侣之间有个人接触。根据编码,在 6% 的录音中发现了社会支持,而在大约一半的时间(53%)里,至少有一名伴侣自我报告了社会支持。平均而言,情侣们的心率波动显示出小幅至中度的相互联系(r=0.04-0.22)。夫妻之间存在滞后联系的程度也各不相同,也就是说,一方的心率变化往往先于另一方的心率变化。探索性分析表明,心率联系在以下情况下更强:(1)有评分者编码的伴侣对话(与无评分者编码的伴侣对话相比:rdiff=0.13;P=.03);(2)伴侣自我报告人际接触(与无自我报告人际接触相比:rdiff=0.20;Pdiff=0.15;P=.004):我们的研究为在日常生活中使用可穿戴设备收集慢性病患者夫妇的生物心理社会数据提供了初步证据。具体来说,心率联系可能会在促进夫妻慢性病管理方面发挥作用。通过收集此类数据得出的见解可为未来的技术干预提供参考,以促进健康生活方式的参与和适应性慢性疾病管理:RR2-10.2196/13685。
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引用次数: 0
Physical Activity, Body Composition, and Fitness Variables in Adolescents After Periods of Mandatory, Promoted or Nonmandatory, Nonpromoted Use of Step Tracker Mobile Apps: Randomized Controlled Trial. 青少年在强制、推广或非强制、非推广使用 Step Tracker 移动应用程序一段时间后的体力活动、身体成分和体能变量:随机对照试验。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-30 DOI: 10.2196/51206
Adrián Mateo-Orcajada, Raquel Vaquero-Cristóbal, Jorge Mota, Lucía Abenza-Cano
<p><strong>Background: </strong>It is not known whether an intervention made mandatory as a physical education (PE) class assignment and aimed at promoting physical activity (PA) in adolescents can create a healthy walking habit, which would allow further improvements to be achieved after the mandatory and promoted intervention has been completed.</p><p><strong>Objective: </strong>The aims of this study were to (1) investigate whether, after a period of using a step tracker mobile app made mandatory and promoted as a PE class assignment, adolescents continue to use it when its use is no longer mandatory and promoted; (2) determine whether there are changes in the PA level, body composition, and fitness of adolescents when the use of the app is mandatory and promoted and when it is neither mandatory nor promoted; and (3) analyze whether the covariates maturity status, gender, and specific app used can have an influence.</p><p><strong>Methods: </strong>A total of 357 students in compulsory secondary education (age: mean 13.92, SD 1.91 y) participated in the study. A randomized controlled trial was conducted consisting of 2 consecutive 10-week interventions. Participants' PA level, body composition, and fitness were measured at baseline (T1), after 10 weeks of mandatory and promoted app use (T2), and after 10 weeks of nonmandatory and nonpromoted app use (T3). Each participant in the experimental group (EG) used 1 of 4 selected step tracker mobile apps after school hours.</p><p><strong>Results: </strong>The results showed that when the use of the apps was neither mandatory nor promoted as a PE class assignment, only a few adolescents (18/216, 8.3%) continued the walking practice. After the mandatory and promoted intervention period (T1 vs T2), a decrease in the sum of 3 skinfolds (mean difference [MD] 1.679; P=.02) as well as improvements in the PA level (MD -0.170; P<.001), maximal oxygen uptake (MD -1.006; P<.001), countermovement jump test (MD -1.337; P=.04), curl-up test (MD -3.791; P<.001), and push-up test (MD -1.920; P<.001) in the EG were recorded. However, the changes between T1 and T2 were significantly greater in the EG than in the control group only in the PA level and curl-up test. Thus, when comparing the measurements taken between T1 and T3, no significant changes in body composition (P=.07) or fitness (P=.84) were observed between the EG and the control group. The covariates maturity status, gender, and specific app used showed a significant effect in most of the analyses performed.</p><p><strong>Conclusions: </strong>A period of mandatory and promoted use of step tracker mobile apps benefited the variables of body composition and fitness in adolescents but did not create a healthy walking habit in this population; therefore, when the use of these apps ceased to be mandatory and promoted, the effects obtained disappeared.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06164041; https://clinicaltrials.gov/study/NCT06
背景:一项作为体育课作业的强制性干预措施旨在促进青少年的体育锻炼(PA),该措施能否培养青少年健康的步行习惯,从而在强制性干预措施结束后取得进一步的改善,目前尚不清楚:本研究的目的是:(1) 调查青少年在使用作为体育课作业强制推广的计步器手机应用一段时间后,在不再强制推广时是否会继续使用该应用;(2) 确定在强制推广和不强制推广时,青少年的体育锻炼水平、身体成分和体能是否会发生变化;(3) 分析成熟状况、性别和使用的具体应用等协变量是否会产生影响:共有 357 名中学义务教育阶段的学生(年龄:平均 13.92 岁,标准差 1.91 岁)参与了研究。研究采用随机对照试验的方式进行,包括 2 次连续 10 周的干预。分别在基线(T1)、强制和推广应用程序使用 10 周后(T2)以及非强制和非推广应用程序使用 10 周后(T3)对参与者的 PA 水平、身体成分和体能进行测量。实验组(EG)的每位参与者都在课余时间使用了 4 款选定的步数跟踪器移动应用程序中的一款:结果表明,在既不强制也不作为体育课作业推广使用应用程序的情况下,只有少数青少年(18/216,8.3%)继续进行步行练习。在强制性和推广性干预期(T1 vs T2)后,3 个皮褶的总和有所下降(平均差 [MD] 1.679;P=.02),PA 水平也有所提高(MD -0.170;P=.02):在一定时期内强制推广使用步数跟踪器手机应用有利于青少年的身体成分和体能变量,但并没有在这一人群中形成健康的步行习惯;因此,当不再强制推广使用这些应用时,所取得的效果就消失了:试验注册:ClinicalTrials.gov NCT06164041;https://clinicaltrials.gov/study/NCT06164041。
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引用次数: 0
Efficacy of a Mobile Health App (eMOTIVA) Regarding Compliance With Cardiac Rehabilitation Guidelines in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial. 移动医疗应用程序 (eMOTIVA) 对冠心病患者遵守心脏康复指南的效果:随机对照临床试验。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-25 DOI: 10.2196/55421
Celia Cruz-Cobo, María Ángeles Bernal-Jiménez, Germán Calle, Livia Luciana Gheorghe, Alejandro Gutiérrez-Barrios, Dolores Cañadas, Josep A Tur, Rafael Vázquez-García, María José Santi-Cano
<p><strong>Background: </strong>Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format.</p><p><strong>Objective: </strong>This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome.</p><p><strong>Methods: </strong>A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability.</p><p><strong>Results: </strong>The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P<.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [<2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P<.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P<.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P<.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P<.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points).</p><p><strong>Conclusions: </strong>With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, kn
背景:心脏康复是冠心病患者康复的基础,而移动医疗技术可能是一种有用的工具,它能以娱乐、有吸引力和用户友好的形式提供基于科学证据的指南:本研究旨在从生活方式、心血管风险因素和急性冠状动脉综合征患者的满意度等方面,比较使用 eMOTIVA 应用程序的移动医疗干预与常规护理在遵守心脏康复指南方面的效果:方法:采用平行分组设计进行随机对照临床试验。试验包括 300 名因急性冠状动脉综合征接受经皮冠状动脉介入治疗的患者(移动医疗组 150 人;对照组 150 人)。两组患者均接受了初始评估(住院期间)以及 3 个月和 6 个月后(面对面咨询)的评估。eMOTIVA 应用程序包含一个虚拟教室,提供有关健康生活方式的音频和视频信息,一个用于自我记录心血管风险因素的部分,以及一个用于反馈信息和游戏化的部分。主要结果变量包括:(1) 是否坚持地中海饮食和进食频率;(2) 体力活动水平、久坐时间和运动能力;(3) 是否戒烟和尼古丁依赖;(4) 对心血管风险因素的了解程度;(5) 应用程序的满意度和可用性:研究分析了 287 名患者(移动保健组 145 人;对照组 142 人)。大多数参与者为男性(207/300,69.0%),平均年龄为 62.53 岁(标准差 8.65)。与对照组相比,移动医疗组在 6 个月后在以下方面有明显改善:(1)坚持地中海饮食(平均 11.92 分,标准差 1.70 分 vs 8.92 分,标准差 2.66 分;PC 结论:使用 eMOTIVA 应用程序后,干预组在坚持地中海饮食、食用某些食物的频率、体力活动、久坐时间、运动能力、知识水平、收缩压、心率和血糖水平等方面都取得了良好的效果。此外,参与者对应用程序的满意度很高,并将其可用性评为 "优秀"。因此,这款创新工具大有可为:试验注册:ClinicalTrials.gov NCT05247606;https://clinicaltrials.gov/study/NCT05247606。
{"title":"Efficacy of a Mobile Health App (eMOTIVA) Regarding Compliance With Cardiac Rehabilitation Guidelines in Patients With Coronary Artery Disease: Randomized Controlled Clinical Trial.","authors":"Celia Cruz-Cobo, María Ángeles Bernal-Jiménez, Germán Calle, Livia Luciana Gheorghe, Alejandro Gutiérrez-Barrios, Dolores Cañadas, Josep A Tur, Rafael Vázquez-García, María José Santi-Cano","doi":"10.2196/55421","DOIUrl":"10.2196/55421","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiac rehabilitation is fundamental among patients recovering from a coronary event, and mHealth technology may constitute a useful tool that provides guidelines based on scientific evidence in an entertaining, attractive, and user-friendly format.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to compare the efficacy of an mHealth intervention involving the eMOTIVA app and that of usual care regarding compliance with cardiac rehabilitation guidelines in terms of lifestyle, cardiovascular risk factors, and satisfaction among patients with acute coronary syndrome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A randomized controlled clinical trial with a parallel group design was conducted. It included 300 patients (mHealth group, 150; control group, 150) who underwent percutaneous coronary intervention for acute coronary syndrome. Both groups underwent evaluations initially (during hospitalization) and after 3 and 6 months (face-to-face consultations). The eMOTIVA app incorporates a virtual classroom providing audio and video information about a healthy lifestyle, a section for self-recording cardiovascular risk factors, and a section for feedback messages and gamification. The primary outcome variables were (1) adherence to the Mediterranean diet and the frequency of consumption of food; (2) physical activity level, sedentary time, and exercise capacity; (3) smoking cessation and nicotine dependence; (4) level of knowledge about cardiovascular risk factors; and (5) app satisfaction and usability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study analyzed 287 patients (mHealth group, 145; control group, 142). Most participants were male (207/300, 69.0%), and the mean age was 62.53 (SD 8.65) years. Significant improvements were observed in the mHealth group compared with the control group at 6 months in terms of (1) adherence to the Mediterranean diet (mean 11.92, SD 1.70 vs 8.92, SD 2.66 points; P&lt;.001) and frequency of eating foods (red meat [≤1/week]: 141/143, 97.9% vs 96/141, 68.1%; industrial pastries [&lt;2/week]: 129/143, 89.6% vs 80/141, 56.8%; oily fish [≥2/week]: 124/143, 86.1% vs 64/141, 41.4%; vegetables [≥2/day]: 130/143, 90.3% vs 78/141, 55.3%; fruit [≥2/day]: 128/143, 88.9% vs 85/141, 60.2%; all P&lt;.001); (2) physical activity (mean 2112.66, SD 1196.67 vs 1372.60, SD 944.62 metabolic equivalents/week; P&lt;.001) and sedentary time (mean 8.38, SD 1.88 vs 9.59, SD 2.09 hours; P&lt;.001); (3) exercise capacity (distance: mean 473.49, SD 102.28 vs 447.25, SD 93.68 meters; P=.04); and (4) level of knowledge (mean 117.85, SD 3.83 vs 111.00, SD 7.11 points; P&lt;.001). App satisfaction was high (mean 42.53, SD 6.38 points), and its usability was excellent (mean 95.60, SD 4.03 points).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;With the eMOTIVA app, favorable results were obtained in the intervention group in terms of adherence to the Mediterranean diet, frequency of eating certain foods, physical activity, sedentary time, exercise capacity, kn","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e55421"},"PeriodicalIF":5.4,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11310647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial. 减少职业学校学生药物使用、赌博和数字媒体使用的手机应用干预:随机对照试验干预组的探索性分析。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-23 DOI: 10.2196/51307
Kristin Grahlher, Matthis Morgenstern, Benjamin Pietsch, Elena Gomes de Matos, Monika Rossa, Kirsten Lochbühler, Anne Daubmann, Rainer Thomasius, Nicolas Arnaud
<p><strong>Background: </strong>During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app ("Meine Zeit ohne") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness.</p><p><strong>Objective: </strong>The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics.</p><p><strong>Methods: </strong>Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection ("congruent use": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models.</p><p><strong>Results: </strong>The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high.</p><p><strong>Conclusions: </strong>The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and use
背景介绍青少年时期通常是使用药物和接触数字媒体的高峰期,并可能成为主要的健康风险。预防活动主要是在正规学校环境中开展的,没有接触到这一系统之外的青少年。我们专门为职业学校学生开发了一款手机应用程序("Meine Zeit ohne"),鼓励参与者在两周内自愿减少或戒除自我选择的成瘾行为,包括使用药物、赌博或与媒体相关的习惯,如游戏或社交媒体使用。一项随机研究的结果表明,使用该应用程序后,对促进健康的行为改变有显著影响。本探索性研究的重点是该研究的干预部分,关注接受度和不同效果:本研究的目的是:(1) 检查使用该应用的参与者的特征;(2) 根据应用的使用方式和参与者的特征,探讨移动干预的有效性;(3) 研究应用使用的变化与参与者基线特征的关系:对干预组研究参与者的日志数据进行了分析,包括应用程序的使用频率(以天为单位)、特定挑战的选择以及挑战选择的个人相关性(即用户超过了某种成瘾行为的预定风险分值)("一致使用":例如,吸烟者选择了与减少或戒烟相关的挑战)。二分结果(有变化与无变化)指的是上个月的药物使用、赌博和媒体相关行为。这些变量之间的关系采用二元、多层次、混合效应逻辑回归模型进行分析:干预组由 2367 名职业学生组成,其中 1458 人(61.6%;平均年龄 19.0 岁,标准差 3.5 岁;830/1458,56.9% 为男性)提供了完整的数据。在这 1458 名学生中,有 894 人(61.3%)开始接受挑战,可以纳入分析(平均年龄为 18.7 岁,标准差为 3.5 岁;363/894,40.6% 为女性)。在这 894 名学生中,有 466 人(52.1%)被认为是应用程序的频繁用户,在两周时间内活跃使用超过 4 天。分析样本中最常选择的挑战领域与社交媒体的使用有关(332/894,37.1%)。在 894 名学生中,共有 407 人(45.5%)选择了与个人相关的行为领域的挑战。当个人选择的挑战领域与行为改变领域相同、选择的挑战与个人相关行为有关以及个人参与不同成瘾行为的风险较高时,应用程序的使用对结果的影响更大:结论:该计划在特定领域的有效性得到了证实,行为领域之间没有溢出效应。有效性似乎取决于应用程序的使用和用户的特征:德国临床试验注册中心 DRKS00023788;https://tinyurl.com/4pzpjkmj.International 注册报告标识符(irrid):RR2-10.1186/s13063-022-06231-x.
{"title":"Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial.","authors":"Kristin Grahlher, Matthis Morgenstern, Benjamin Pietsch, Elena Gomes de Matos, Monika Rossa, Kirsten Lochbühler, Anne Daubmann, Rainer Thomasius, Nicolas Arnaud","doi":"10.2196/51307","DOIUrl":"10.2196/51307","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app (\"Meine Zeit ohne\") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection (\"congruent use\": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and use","PeriodicalId":14756,"journal":{"name":"JMIR mHealth and uHealth","volume":"12 ","pages":"e51307"},"PeriodicalIF":5.4,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conversational Chatbot for Cigarette Smoking Cessation: Results From the 11-Step User-Centered Design Development Process and Randomized Controlled Trial. 戒烟对话聊天机器人:用户中心设计十一步开发流程报告》。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-23 DOI: 10.2196/57318
Jonathan B Bricker, Brianna Sullivan, Kristin Mull, Margarita Santiago-Torres, Juan M Lavista Ferres
<p><strong>Background: </strong>Conversational chatbots are an emerging digital intervention for smoking cessation. No studies have reported on the entire development process of a cessation chatbot.</p><p><strong>Objective: </strong>We aim to report results of the user-centered design development process and randomized controlled trial for a novel and comprehensive quit smoking conversational chatbot called QuitBot.</p><p><strong>Methods: </strong>The 4 years of formative research for developing QuitBot followed an 11-step process: (1) specifying a conceptual model; (2) conducting content analysis of existing interventions (63 hours of intervention transcripts); (3) assessing user needs; (4) developing the chat's persona ("personality"); (5) prototyping content and persona; (6) developing full functionality; (7) programming the QuitBot; (8) conducting a diary study; (9) conducting a pilot randomized controlled trial (RCT); (10) reviewing results of the RCT; and (11) adding a free-form question and answer (QnA) function, based on user feedback from pilot RCT results. The process of adding a QnA function itself involved a three-step process: (1) generating QnA pairs, (2) fine-tuning large language models (LLMs) on QnA pairs, and (3) evaluating the LLM outputs.</p><p><strong>Results: </strong>We developed a quit smoking program spanning 42 days of 2- to 3-minute conversations covering topics ranging from motivations to quit, setting a quit date, choosing Food and Drug Administration-approved cessation medications, coping with triggers, and recovering from lapses and relapses. In a pilot RCT with 96% three-month outcome data retention, QuitBot demonstrated high user engagement and promising cessation rates compared to the National Cancer Institute's SmokefreeTXT text messaging program, particularly among those who viewed all 42 days of program content: 30-day, complete-case, point prevalence abstinence rates at 3-month follow-up were 63% (39/62) for QuitBot versus 38.5% (45/117) for SmokefreeTXT (odds ratio 2.58, 95% CI 1.34-4.99; P=.005). However, Facebook Messenger intermittently blocked participants' access to QuitBot, so we transitioned from Facebook Messenger to a stand-alone smartphone app as the communication channel. Participants' frustration with QuitBot's inability to answer their open-ended questions led to us develop a core conversational feature, enabling users to ask open-ended questions about quitting cigarette smoking and for the QuitBot to respond with accurate and professional answers. To support this functionality, we developed a library of 11,000 QnA pairs on topics associated with quitting cigarette smoking. Model testing results showed that Microsoft's Azure-based QnA maker effectively handled questions that matched our library of 11,000 QnA pairs. A fine-tuned, contextualized GPT-3.5 (OpenAI) responds to questions that are not within our library of QnA pairs.</p><p><strong>Conclusions: </strong>The development process yielded t
背景对话聊天机器人是一种新兴的戒烟数字干预方法。目前还没有关于戒烟聊天机器人整个开发过程的研究报告:目的:描述一款名为 "戒烟机器人"(QuitBot)的新颖、全面的戒烟对话式聊天机器人以用户为中心的设计开发过程:开发 QuitBot 的四年形成性研究经历了十一个步骤:(1)确定概念模型;(2)对现有干预措施进行内容分析(63 小时的干预记录);(3)评估用户需求;(4)开发聊天角色("个性");(5)内容和角色原型;(6)开发全部功能、(7) 编写戒烟机器人程序,(8) 进行日记研究,(9) 进行试点随机试验,(10) 审查试验结果,(11) 根据试点试验结果中的用户反馈添加自由问答(QnA)功能。添加 QnA 功能的过程本身包括三个步骤:(a) 生成 QnA 对,(b) 微调 QnA 对上的大型语言模型 (LLM),(c) 评估 LLM 模型输出:一项为期 42 天的戒烟计划由 2 到 3 分钟的对话组成,对话主题包括戒烟动机、设定戒烟日期、选择 FDA 批准的戒烟药物、应对诱因以及从失误/复吸中恢复。在一项试点随机试验中,三个月的结果数据保留率为96%,与美国国家癌症研究所的SmokefreeTXT(SFT)短信项目相比,QuitBot的用户参与度很高,戒烟率也很可观--尤其是那些观看了全部42天项目内容的用户:在三个月的随访中,QuitBot的30天完全戒烟率(PPA)为63%(39/62),而SFT为38%(45/117)(OR = 2.58; 95% CI: 1.34, 4.99; P =.005)。然而,Facebook Messenger(FM)间歇性地阻止了参与者访问 QuitBot,因此我们将 FM 转换为独立的智能手机应用程序作为交流渠道。参与者对戒烟机器人无法回答他们的开放式问题感到沮丧,这促使我们开发了一项核心对话功能,使用户能够提出有关戒烟的开放式问题,并让戒烟机器人做出准确、专业的回答。为了支持这一功能,我们开发了一个包含 11,000 对戒烟相关主题的 QnA 库。模型测试结果表明,微软基于 Azure 的 QnA 制造商能够有效处理与我们的 11,000 对 QnA 库相匹配的问题。经过微调、符合上下文的 GPT3.5 可应对不在我们的 QnA 对库中的问题:开发过程产生了第一个基于 LLM 的戒烟程序,该程序以对话聊天机器人的形式提供。迭代测试带来了重大改进,包括交付渠道的改进。一个关键的新增功能是加入了由 LLM 支持的核心对话功能,允许用户提出开放式问题:临床试验:ClinicalTrials.gov Identifier,NCT03585231。
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引用次数: 0
Feasibility and Preliminary Effects of a Social Media-Based Peer-Group Mobile Messaging Smoking Cessation Intervention Among Chinese Immigrants who Smoke: Pilot Randomized Controlled Trial. 在吸烟的中国移民中开展基于社交媒体的同伴小组移动信息戒烟干预的可行性和初步效果:试点随机对照试验》。
IF 5.4 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-22 DOI: 10.2196/59496
Nan Jiang, Ariel Zhao, Erin S Rogers, Ana Paula Cupertino, Xiaoquan Zhao, Francisco Cartujano-Barrera, Katherine Siu, Scott E Sherman
<p><strong>Background: </strong>Chinese immigrants experience significant disparities in tobacco use. Culturally adapted tobacco treatments targeting this population are sparse and the use is low. The low use of these treatment programs is attributed to their exclusive focus on individuals who are ready to quit and the wide range of barriers that Chinese immigrants face to access these programs. To support Chinese immigrant smokers at all levels of readiness to quit and address their access barriers, we developed the WeChat Quit Coach, a culturally and linguistically appropriate WeChat (Tencent Holdings Limited)-based peer group mobile messaging smoking cessation intervention.</p><p><strong>Objective: </strong>This study aims to assess the feasibility, acceptability, and preliminary effects of WeChat Quit Coach.</p><p><strong>Methods: </strong>We enrolled a total of 60 Chinese immigrant smokers in 2022 in New York City for a pilot randomized controlled trial (RCT) and a single-arm pilot test. The first 40 participants were randomized to either the intervention arm (WeChat Quit Coach) or the control arm (self-help print material) using 1:1 block randomization stratified by sex. WeChat Quit Coach lasted 6 weeks, featuring small peer groups moderated by a coach, daily text messages with text questions, and chat-based instant messaging support from the coach in response to peer questions. The next 20 participants were enrolled in the single-arm pilot test to further assess intervention feasibility and acceptability. All 60 participants were offered a 4-week supply of complimentary nicotine replacement therapy. Surveys were administered at baseline and 6 weeks, with participants in the pilot RCT completing an additional survey at 6 months and biochemical verification of abstinence at both follow-ups.</p><p><strong>Results: </strong>Of 74 individuals screened, 68 (92%) were eligible and 60 (88%) were enrolled. The majority of participants, with a mean age of 42.5 (SD 13.8) years, were male (49/60, 82%) and not ready to quit, with 70% (42/60) in the precontemplation or contemplation stage at the time of enrollment. The pilot RCT had follow-up rates of 98% (39/40) at 6 weeks and 93% (37/40) at 6 months, while the single-arm test achieved 100% follow-up at 6 weeks. On average, participants responded to daily text questions for 25.1 days over the 42-day intervention period and 23% (9/40) used the chat-based instant messaging support. Most participants were satisfied with WeChat Quit Coach (36/39, 92%) and would recommend it to others (32/39, 82%). At 6 months, self-reported 7-day point prevalence abstinence rates were 25% (5/20) in the intervention arm and 15% (3/20) in the control arm, with biochemically verified abstinence rates of 25% (5/20) and 5% (1/20), respectively.</p><p><strong>Conclusions: </strong>WeChat Quit Coach was feasible and well-received by Chinese immigrants who smoke and produced promising effects on abstinence. Large trials are warran
背景:中国移民在烟草使用方面存在很大差异。针对这一人群的适应文化的烟草治疗项目很少,使用率也很低。这些治疗项目之所以使用率低,是因为它们只针对准备戒烟的人,而且华裔移民在使用这些项目时面临各种障碍。为了支持处于不同戒烟准备水平的中国移民吸烟者,并解决他们的戒烟障碍,我们开发了 "微信戒烟教练",这是一种基于微信(腾讯控股有限公司)的同侪群移动信息戒烟干预措施,适合不同的文化和语言:本研究旨在评估微信戒烟教练的可行性、可接受性和初步效果:2022 年,我们在纽约市共招募了 60 名中国移民吸烟者,进行随机对照试验(RCT)和单臂试点测试。首批40名参与者按性别分层,以1:1整群随机方式被随机分配到干预组(微信戒烟教练)或对照组(自助印刷材料)。微信戒烟教练 "为期 6 周,主要内容包括由教练主持的小型同伴小组、包含文字问题的每日短信,以及教练针对同伴提出的问题提供的即时聊天支持。接下来的 20 名参与者参加了单臂试点测试,以进一步评估干预的可行性和可接受性。所有 60 名参与者都获得了为期 4 周的免费尼古丁替代疗法。在基线和 6 周时进行调查,试点 RCT 的参与者在 6 个月时完成额外的调查,并在两次随访时完成戒烟的生化验证:在筛选出的 74 人中,68 人(92%)符合条件,60 人(88%)被录取。大多数参与者的平均年龄为 42.5 岁(标准差为 13.8 岁),男性(49/60,82%),尚未做好戒烟准备,70%(42/60)的参与者在报名时处于前考虑或考虑阶段。试点 RCT 的 6 周随访率为 98%(39/40),6 个月随访率为 93%(37/40),而单臂试验的 6 周随访率为 100%。在为期 42 天的干预期间,参与者平均每天回复文字问题 25.1 天,23%(9/40)的参与者使用了基于聊天的即时信息支持。大多数参与者对微信戒烟教练感到满意(36/39,92%),并愿意向他人推荐(32/39,82%)。6个月后,干预组的自我报告7天点戒断率为25%(5/20),对照组为15%(3/20),经生化验证的戒断率分别为25%(5/20)和5%(1/20):结论:微信戒烟教练是可行的,深受中国吸烟移民的欢迎,对戒烟产生了良好的效果。有必要进行大规模试验,以评估其在这一服务不足人群中促进戒烟的效果:试验注册:ClinicalTrials.gov NCT05130788;https://clinicaltrials.gov/study/NCT05130788。
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JMIR mHealth and uHealth
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