R01HD103904

Mhealth-Based Just-in-Time Adaptive Intervention to Improve Physical Activity Levels of Individuals with Spinal Cord Injury - Project Summary

The lack of regular physical activity (PA) in over 290,000 individuals with spinal cord injury (SCI) in the United States (US) is an ongoing health crisis. This lack of activity has potentially devastating consequences because low levels of PA in people with SCI elevate the risk of mortality due to cardiovascular diseases, diabetes, and lung disease. Furthermore, low levels of PA in individuals with SCI have been associated with secondary conditions such as pain, fatigue, weight gain, and deconditioning.

Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. Sensor-based activity monitors can assess PA and exercise interventions by quantifying wheelchair movement, movement of the individual, and physiological changes. However, these monitors do not provide real-time, tailored feedback and recommendations that might help individuals with SCI increase their PA levels in the community.

The overarching goal of this proposal is to evaluate a sensor-enabled, just-in-time adaptive intervention (JITAI) strategy to increase and sustain PA levels among individuals with SCI in their communities. The long-term goal of this research is to effectively integrate a mobile health JITAI with existing PA intervention programs to motivate health-related behavior change in individuals with SCI.

A primary objective of this proposal is to extend our pilot work to evaluate the integration of a JITAI with a web-based 14-week PA intervention program from the National Center on Health, Physical Activity and Disability (Aim 1). We hypothesize that the integration of web-based PA intervention program with JITAI will result in significantly higher PA levels over 14 weeks compared to the standard web-based PA intervention program alone.

A secondary objective of this study is to extend existing algorithms that use commercial wearable technology to robustly detect PA behaviors to facilitate the delivery of tailored just-in-time actionable feedback and PA recommendations for individuals with SCI (Aims 3 and 4). The integration of the JITAI, which provides feedback and PA recommendations due to sensor-based assessments of PA, with the standard web-based PA intervention program will be tested via a clinical trial that combines a randomized controlled trial and a micro-randomized trial.

Our team includes investigators with expertise in SCI research, mobile health, PA tracking, and behavioral change interventions. The proposed study will yield novel insights about JITAI and JITAI combined with more traditional, web-based PA intervention programs, which will help researchers design engaging PA interventions for individuals with disability in the community that may improve their health and quality of life.

Temple University-Of The Commonwealth System Of Higher Education

THE EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENTS MISSION IS TO LEAD RESEARCH AND TRAINING TO UNDERSTAND HUMAN DEVELOPMENT, IMPROVE REPRODUCTIVE HEALTH, ENHANCE THE LIVES OF CHILDREN AND ADOLESCENTS, AND OPTIMIZE ABILITIES FOR ALL.

93.865 - Child Health and Human Development Extramural Research

National Institute of Child Health and Human Development (NICHD) [HHS - NIH]

Philadelphia, Pennsylvania 191226005 United States

Single Zip Code

NICHD Research Project Grant (R01 - Clinical Trial Required) (PA-18-480)

Amendment Since initial award the End Date has been extended from 06/30/26 to 12/31/26 and the total obligations have increased 361% from $654,531 to $3,014,118.