51. Effect of Adding Telephone-Based Brief Coaching to an mHealth App (Stay Strong) for Promoting Physical Activity Among Veterans: Randomized Controlled Trial
- Author
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Jennifer M Gierisch, Caroline R. Richardson, Laura J. Damschroder, Lorraine R Buis, Felicia McCant, Lori A. Bastian, Eugene Z. Oddone, Hyungjin Myra Kim, Reema Kadri, Gwendolyn Hooks, Courtney White-Clark, and Richard Evans
- Subjects
Adult ,Male ,behavior change ,medicine.medical_specialty ,Active duty ,020205 medical informatics ,Psychological intervention ,Physical activity ,Health Informatics ,02 engineering and technology ,lcsh:Computer applications to medicine. Medical informatics ,Coaching ,wearable ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,mobile app ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Humans ,veterans ,030212 general & internal medicine ,app ,mHealth ,online ,Motivation ,Original Paper ,mobile phone ,exercise ,business.industry ,lcsh:Public aspects of medicine ,Behavior change ,lcsh:RA1-1270 ,Mobile Applications ,Telemedicine ,smartphones ,wearable physical activity tracker ,Physical therapy ,lcsh:R858-859.7 ,Female ,medicine.symptom ,business ,Weight gain - Abstract
Background Though maintaining physical conditioning and a healthy weight are requirements of active military duty, many US veterans lose conditioning and rapidly gain weight after discharge from active duty service. Mobile health (mHealth) interventions using wearable devices are appealing to users and can be effective especially with personalized coaching support. We developed Stay Strong, a mobile app tailored to US veterans, to promote physical activity using a wrist-worn physical activity tracker, a Bluetooth-enabled scale, and an app-based dashboard. We tested whether adding personalized coaching components (Stay Strong+Coaching) would improve physical activity compared to Stay Strong alone. Objective The goal of this study is to compare 12-month outcomes from Stay Strong alone versus Stay Strong+Coaching. Methods Participants (n=357) were recruited from a national random sample of US veterans of recent wars and randomly assigned to the Stay Strong app alone (n=179) or Stay Strong+Coaching (n=178); both programs lasted 12 months. Personalized coaching components for Stay Strong+Coaching comprised of automated in-app motivational messages (3 per week), telephone-based human health coaching (up to 3 calls), and personalized weekly goal setting. All aspects of the enrollment process and program delivery were accomplished virtually for both groups, except for the telephone-based coaching. The primary outcome was change in physical activity at 12 months postbaseline, measured by average weekly Active Minutes, captured by the Fitbit Charge 2 device. Secondary outcomes included changes in step counts, weight, and patient activation. Results The average age of participants was 39.8 (SD 8.7) years, and 25.2% (90/357) were female. Active Minutes decreased from baseline to 12 months for both groups (P Conclusions Adding personalized health coaching comprised of in-app automated messages, up to 3 coaching calls, plus automated weekly personalized goals, did not improve levels of physical activity compared to using a smartphone app alone. Physical activity in both groups decreased over time. Sustaining long-term adherence and engagement in this mHealth intervention proved difficult; approximately two-thirds of the trial’s 357 participants failed to sync their Fitbit device at 12 months and, thus, were lost to follow-up. Trial Registration ClinicalTrials.gov NCT02360293; https://clinicaltrials.gov/ct2/show/NCT02360293 International Registered Report Identifier (IRRID) RR2-10.2196/12526
- Published
- 2020