Accepted for/Published in: JMIR Research Protocols
Date Submitted: Feb 24, 2024
Open Peer Review Period: Feb 25, 2024 - Apr 8, 2024
Date Accepted: May 3, 2024
(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Warning: This is an author submission that is not peer-reviewed or edited.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.
mHealth-based just-in-time adaptive intervention (JITAI) protocol to improve physical activity levels of individuals with spinal cord injury
ABSTRACT
Background:
The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. One of the facilitators that can promote PA is to provide people with an accurate estimate of their everyday PA level in the community. Researchers have validated sensor-based activity monitors in laboratories and free-living conditions to quantify PA and exercise interventions. PA tracking can be combined with mobile health (mHealth) technology to provide a just-in-time adaptive intervention (JITAI) for individuals with SCI in the community.
Objective:
The overarching goal of this study is to investigate the benefits of combining a mHealth-based JITAI with a 14-week web-based PA intervention (WI) program towards increasing and sustaining moderate-intensity (or higher) PA levels among individuals with SCI in the community. This protocol outlines the study design for investigating the impact of integrating a JITAI with the WI program via a randomized controlled trial that integrates a two-arm trial and a micro-randomized trial. The primary aim is to investigate the long-term benefits of adding a JITAI to WI (WI + JITAI). The secondary aim is to investigate the benefit of just-in-time PA feedback on proximal PA. Proximal PA is defined as moderate-intensity PA within 120 min of a PA feedback prompt.
Methods:
Individuals with SCI (N=196; ages 18 to 75) will be randomized to a WI arm or a WI + JITAI arm. Within the WI + JITAI arm, a micro-randomized trial will be used to randomize participants several times a day to various types of tailored feedback and PA recommendations. The study has three phases: 1) baseline (weeks 1 and 2), 2) WI program with or without JITAI (weeks 3 to 16), and 3) PA sustainability (weeks 17 to 24). Participants will be loaned an Android-based smartphone and smartwatch. Participants will provide survey-based information at various time points during the 24-week study and are asked to wear the smartwatch every day for 12 hours or more.
Results:
The study was approved by Temple University’s Institutional Review Board, and recruitment and enrollment began in May of 2023. Data analysis is expected to be completed within six months of ending participant data collection.
Conclusions:
The JITAI has the potential to achieve long-term PA performance by delivering tailored, just-in-time feedback, based on the person's actual PA behavior rather than a generic PA recommendation. New insights from this study may help to design engaging PA interventions for individuals with disability in the community. Clinical Trial: NCT05317832; https://clinicaltrials.gov/study/NCT05317832
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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.