Browsing by Subject "lifestyle"

Now showing 1 - 4 of 4
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    Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.
    (Clin Trials, 2015-12) 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
    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.
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    Potential consequences of adverse lifestyle factors on decision-making as modeled by the Drosophila melanogaster egg-laying process
    (2023-04-14) Camacho, Sabrina
    Studies have shown that lifestyle factors including impaired gut microbiome health, advanced maternal age, and a diet high in sugar may negatively impact cognitive functioning, but their effects on decision-making have not been thoroughly examined. This study aimed to describe the effects of these three factors on decision-making as well as to determine whether the mechanism behind these effects is metabolic or sensory. This was assessed using Drosophila melanogaster egg-laying chamber assays in which Drosophila were given two choices of substrate on which to lay their eggs: sucrose vs. plain or sucrose vs. sucrose. It was found that neither a reduced gut microbiome nor advanced maternal age influenced decision-making. A high-sugar diet resulted in increased sucrose preference. Neither a metabolic nor a peripheral sensory mechanism explained this phenotype, for ingesting just the nutritious element of sucrose nor just peripheral sensing of the sweet element of sucrose was sufficient to increase sucrose preference. An internal sensory mechanism using Gr43A neurons partially accounted for this phenotype, for the lack of internal sensor activity prevented the unfavorable assessment of sweetness, increasing the perceived value of sucrose. It can be concluded that a diet surpassing healthy sugar levels caused adverse changes in decision-making through a combination of metabolic and sensory mechanisms. This study fills the gap in research about whether lifestyle factors affect decision-making in humans and in Drosophila. The results of this study can be a motivator for people to adopt healthier diets and monitor their sugar intake.
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    The importance of cholesterol medication adherence: the need for behavioral change intervention programs.
    (Patient preference and adherence, 2018-01) Bosworth, Hayden B; Ngouyombo, Barbara; Liska, Jan; Zullig, Leah L; Atlani, Caroline; Beal, Anne C
    Lipid-lowering medications have been shown to be efficacious, but adherence is suboptimal. This is a narrative, perspective review of recently published literature in the field of medication adherence research for lipid-lowering medications. We provide an overview of the impact of suboptimal adherence and use a World Health Organization framework (patient, condition, therapy, socioeconomic, and health system-related systems) to discuss factors that influence hyperlipidemia treatment adherence. Further, the review involves an evaluation of intervention strategies to increase hyperlipidemia treatment adherence with a special focus on mHealth interventions, patient reminders on packaging labels, nurse- and pharmacist-led interventions, and health teams. It also highlights opportunities for pharmaceutical companies to support and scale such behavioral interventions. Medication adherence remains a challenge for the long-term management of chronic conditions, especially those involving asymptomatic disease such as hyperlipidemia. To engage patients and enhance motivation over time, hyperlipidemia interventions must be targeted to individual patients' needs, with sequencing and frequency of contact tailored to the various stages of behavioral change.
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    The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD.
    (Translational journal of the American College of Sports Medicine, 2018-03) Hall, Katherine S; Morey, Miriam C; Beckham, Jean C; Bosworth, Hayden B; Pebole, Michelle M; Pieper, Carl F; Sloane, Richard
    Posttraumatic stress disorder (PTSD) affects up to 30% of military veterans. Older veterans, many of whom have lived with PTSD symptoms for several decades, report a number of negative health outcomes. Despite the demonstrated benefits of regular exercise on physical and psychological health, no studies have explored the impact of exercise in older veterans with PTSD. This paper describes the development, design, and implementation of the Warrior Wellness exercise pilot study for older veterans with PTSD. Veterans aged ≥60 with a Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnosis of PTSD will be recruited and randomized to (a) Warrior Wellness, a 12-week supervised, facility-based exercise intervention, or (b) usual care for 12 weeks. Warrior Wellness is a theory- and evidence-based behavioral intervention that involves 3 sessions per week of multi-component exercise training that targets strength, endurance, balance, and flexibility. Warrior Wellness focuses on satisfaction with outcomes, self-efficacy, self-monitoring, and autonomy. Factors associated with program adherence, defined as the number of sessions attended during the 12 weeks, will be explored. Primary outcomes include PTSD symptoms and cardiovascular endurance, assessed at baseline and 12 weeks. Compared to those in usual care, it is hypothesized that those in the Warrior Wellness condition will improve on these efficacy outcomes. The Warrior Wellness study will provide evidence on whether a short-term exercise intervention is feasible, acceptable, and effective among older veterans with PTSD, and explore factors associated with program adherence. ClinicalTrials.gov Identifier: NCT02295995.