We included patients aged 18 to 69 years who wereusing a Fitbug-compatible smartphone (ie, iPhone≥4S,Galaxy≥S3). Intending to mainly modify leisure-time activity,we targeted individuals reporting<3 days/week of moderateor vigorous leisure-time activity lasting≥30 min/day by thelong form of the International Physical Activity Questionnaire(IPAQ).9Validation of the questionnaire up to 69 years of ageserved as the rationale for the trial’s upper age limit. We didnot have an eligibility restriction based on smartphone orInternet literacy, although all subjects confirmed havingaccess to e-mail for pertinent trial communication. Werecorded demographic and clinical characteristics, includingdog ownership, because it is thought to have a positive effecton the owner by modifying their cognitive beliefs aboutwalking, providing motivation, and providing social support forwalking.10All patients continued to receive routine care andgave written informed consent. Face-to-face visits were notrequired after enrollment.InterventionsParticipants used their own smartphones. Digital physicalactivity tracking was performed using the Fitbug Orb (Chicago,IL) (Figure S1), a wearable, display-free, triaxial accelerometerthat pairs with low-energy Bluetooth with compatible smartphones. The 3V lithium battery lasts around 6 months and thusdid not require charging or replacement during the trial.Unblinded patients could continuously view their daily stepcount, activity time, and aerobic activity time through smartphone and Web interfaces (Figure S2). The Fitbug app alsoprovided a history tab allowing review of data from previousdays. Activity data were updated every 15 minutes if transmission occurred by beacon mode or were available any time if aparticipant activated a manual data push or streaming mode.To enable real-time activity data to inform smart texts, welinked the application programming interfaces of Fitbug and asmart texting system (Reify, Baltimore, MD). Smart textcontent was written by the physician investigators andreflected behavioral change theories,11particularly of feedback loops and habit formation,12integrated with cardiovascular knowledge and clinical experience. Smart texts took intoaccount the importance of prescription writing and having aspecific, proximal goal; we used a goal of 10 000 steps/day.8,13–15Each participant was a patient of a study physicianwith texts aiming to leverage the physician-patient relationship, using the physician’s name in texts. Messages underwent content iterations to optimize language during pretrialtesting by the study team.Smart texts were grouped as positive reinforcementmessages, sent when a participant was on track to attain orhad already attained his or her daily goal, and boostermessages, to motivate individuals when they were notDOI: 10.1161/JAHA.115.002239 Journal of the American Heart Association 2mActive Trial Martin et alORIGINAL RESEARCHby guest on September 20, 2016 http://jaha.ahajournals.org/ Downl
การแปล กรุณารอสักครู่..
