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Heart Steps: Adaptive mHealth intervention for physical-activity maintenance

a PSC Research Project

Investigators:   Predrag Klasnja, Ambuj Tewari, Susan A. Murphy, Elizabeth Jackson

Many of the risk factors for heart disease are behavioral, such as physical inactivity, smoking, and diets high in saturated and trans-fats. To successfully reduce such risks and adopt a heart-healthy lifestyle, individuals have to make many healthy decisions throughout the day, often when they are not thinking about health but are busy with work, family, and recreational activities. Cardiac rehabilitation and other secondary prevention programs are effective in helping individuals make the initial lifestyle changes needed to reduce their risks, but individuals often fail to maintain those changes after the program ends. In this grant, the investigators propose to develop a novel mHealth application for supporting maintenance of physical activity after cardiac patients finish cardiac rehabilitation. By taking advantage of the frequent interactions that individuals have with their phones throughout the day, the investigators will design and evaluate an adaptive, personalized application that will (1) keep individuals reminded of their health goals, increasing the likelihood that they will notice opportunities to engage in physical activity; (2) provide actionable ideas for how individuals can be active right now, given their current context; and (3) help individuals plan and reflect on their physical activity to enable creation of robust and sustainable physical-activity habits. In addition, the application will adapt its functioning for each user over time in order to minimize user burden while optimizing its ability to encourage physical activity and maintain user engagement. A user-centered design process will be used to investigate design requirements of mHealth technologies for long-term use, and the system will be evaluated in a year-long study with 50 heart-disease patients. Study data will be analyzed to understand how the use of different components affect, over time, individuals? physical activity levels, user burden, and engagement with the system. The project?s innovations lie in grounding the proposed intervention in dual-process models of self-regulation, developing new algorithms to enable adaptation and personalization of how the application works over time, and using a within-subject micro-randomization study design to enable causal accounts of how the application use affects physical activity, user burden, and engagement over the course of a year. The success of the project will provide individuals with continuously available support for staying physically active in the midst of daily life, making it easier for them to develop a robust healthy lifestyle and reduce their cardiac risks.

Funding Period: 12/01/2014 to 11/30/2015

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