Mobile health (mHealth) refers to the application of mobile computing devices (e.g., smartphones and wearables) to healthcare delivery. Although use of such devices for mHealth is growing, evidence supporting their use is currently limited. Most earlier studies failed to leverage rich data streams on user behavior (e.g., recent steps) and context (e.g., weather) leading to mixed results. More innovative approaches that use real-time data to deliver just-in-time-adaptive-interventions (JITAIs) are being developed; however, these are difficult to design, and new methodologies like micro-randomized trials are needed to guide their effective delivery.Hypertension is a leading cause of disability and death in the US, and it remains a high priority for the AHA. Hypertension also disproportionately affects African Americans and is a striking example of health inequity. High dietary sodium intake and inadequate physical activity are both linked to hypertension, but the scientific community has struggled to develop strategies for improving lifestyle choices in these areas. By leveraging modern smartphones that sense users' environments and mine real-time data from calendars, location and other applications, we found JITAIs may successfully deliver highly personalized notifications in early work funded by the NIH. We have designed our University of Michigan (U-M) Center - the Wearables In Reducing risk and Enhancing Daily Life-style (WIRED-L) Program - to test JITAIs to lower blood pressure through lifestyle choices. We will build this program on a digital ecosystem that enrolled over 6100 subjects in mHealth studies last year. Our partner institution - U-M Flint - also will allow us to address existing equity gaps in mHealth. Our aims include:1) adapt two JITAIs to deliver tailored, contextually-rich behavior change messages to hypertension patients; 2) determine the effect of JITAIs on blood pressure over time in a large micro-randomized trial; and 3) expand our Center to develop future mHealth interventions in new conditions and at other SFRN sites.WIRED-L brings together multidisciplinary experts in cardiology, neurology, pharmacy, bioinformatics, biostatistics, computer science, health equity and business to create a reusable platform for studying mHealth.
|Program type||Strategically Focused Research Network|
|Effective start/end date||04/01/2020 → 03/31/2024|