Accepted for/Published in: JMIR Serious Games
Date Submitted: Mar 30, 2021
Open Peer Review Period: Apr 12, 2021 - Jun 12, 2021
Date Accepted: Jun 28, 2021
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Sensor-controlled digital game and heart failure self-management behaviors: A feasibility randomized controlled trial study
ABSTRACT
Background:
Poor self-management of heart failure (HF) contributes to devastating health consequences. Our innovative sensor-controlled digital game (SCDG) integrates data from sensors to trigger game rewards, progress, and feedback based on HF individuals’ real-time behaviors.
Objective:
To compare daily weight-monitoring and physical activity behavior adherence by older adults using a SCDG intervention versus a sensor-only intervention, in a feasibility randomized controlled trial.
Methods:
English-speaking HF adults aged ≥55 years who owned a smartphone and could walk unassisted were recruited from Texas and Oklahoma from November 2019 to August 2020. Both groups were given activity tracker and smart weight scale sensors to track behaviors for 12 weeks. Feasibility outcomes of recruitment, retention, intervention engagement, and satisfaction were assessed. Besides daily weight-monitoring and physical activity adherence, participants’ knowledge, functional status, quality of life (QoL), self-reported HF behaviors, motivation to engage in behaviors, and HF-related hospitalization were also compared between the groups at baseline, 6, 12, and 24 weeks.
Results:
Participants (N=38; intervention n=19; control n=19) with HF were enrolled (47% female, 47% ≥65 years, 55% HF hospitalization in past 6 months, 76% White); 82% of patients (n=31; intervention, 15/19, 79%; control, 16/19, 84%) had both weight monitoring and physical activity data at the end of 12 weeks and 71% (n =27; intervention, 14/19, 74%; control, 13/19, 68%) participated in follow-up assessments at 24 weeks. For the intervention group participants who installed the SCDG app (n=15), the number of days each player opened the game app was strongly associated with the number of days the player engaged in weight-monitoring (r=0.72, P=0.04) and with the number of days with physical activity step data (r=0.9, P < 0.001). Participants who completed the satisfaction survey (intervention, n=13) reported that the SCDG was easy to use. Trends of improvement in daily weight-monitoring and physical activity in the intervention group and within-group improvements in HF functional status, QoL, knowledge, self-efficacy, and HF hospitalization in both groups were observed in this feasibility trial.
Conclusions:
Playing an SCDG on smartphones was feasible and acceptable for older adults with HF for motivating daily weight monitoring and physical activity. A larger efficacy trial of the SCDG intervention will be needed to validate trends of improvement in daily weight monitoring and physical activity behaviors. Clinical Trial: Clinicaltrials.gov NCT03947983; https://clinicaltrials.gov/ct2/show/NCT03947983
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.