Browsing by Author "Klasnja, Predrag"
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- ItemEfficacy of Contextually Tailored Suggestions for Physical Activity: A Micro-randomized Optimization Trial of HeartSteps.(0000-00-00) Klasnja, Predrag; Smith, Shawna; Seewald, Nicholas J; Lee, Andy; Hall, Kelly; Luers, Brook; Hekler, Eric B; Murphy, Susan ABackground HeartSteps is an mHealth intervention that encourages regular walking via activity suggestions tailored to the individuals current context Purpose We conducted a micro randomized trial MRT to evaluate the efficacy of HeartSteps activity suggestions to optimize the intervention Methods We conducted a 6 week MRT with 44 adults Contextually tailored suggestions could be delivered up to five times per day at user selected times At each of these five times for each participant on each day of the study HeartSteps randomized whether to provide an activity suggestion and if so whether to provide a walking or an antisedentary suggestion We used a centered and weighted least squares method to analyze the effect of suggestions on the 30 min step count following suggestion randomization Results Averaging over study days and types of activity suggestions delivering a suggestion versus no suggestion increased the 30 min step count by 14 p 06 35 additional steps over the 253 step average The effect was not evenly distributed in time Providing any type of suggestion versus no suggestion initially increased the step count by 66 167 steps p Under 01 but this effect diminished over time Averaging over study days delivering a walking suggestion versus no suggestion increased the average step count by 24 59 steps p 02 This increase was greater at the start of study 107 or 271 additional steps p Under 01 but decreased over time Antisedentary suggestions had no detectable effect on the 30 min step count Conclusion Contextually tailored walking suggestions are a promising way of initiating bouts of walking throughout the day Clinical Trial information This study was registered on ClinicalTrials gov number NCT03225521
- ItemHealth Weaver Mobile: Designing a Mobile Tool for Managing Personal Health Information during Cancer Care.(2011-02-24) Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Phan, Giovandy; Pratt, WandaCancer patients manage a great deal of information to coordinate their care Critical aspects of this work take place while patients are away from home or have diminished attention due to symptoms or side effects We describe the design of HealthWeaver Mobile a mobile phone application we developed to help patients manage care related information in such situations We discuss findings from two participatory design groups with breast cancer patients and the design decisions made to implement functional requirements uncovered in those groups
- ItemHealthcare in the pocket: mapping the space of mobile-phone health interventions.(2012-02-03) Klasnja, Predrag; Pratt, WandaMobile phones are becoming an increasingly important platform for the delivery of health interventions In recent years researchers have used mobile phones as tools for encouraging physical activity and healthy diets for symptom monitoring in asthma and heart disease for sending patients reminders about upcoming appointments for supporting smoking cessation and for a range of other health problems This paper provides an overview of this rapidly growing body of work We describe the features of mobile phones that make them a particularly promising platform for health interventions and we identify five basic intervention strategies that have been used in mobile phone health applications across different health conditions Finally we outline the directions for future research that could increase our understanding of functional and design requirements for the development of highly effective mobile phone health interventions
- ItemOptimizing Digital Integrated Care via Micro-Randomized Trials.(0000-00-00) Walton, Ashley; Nahum-Shani, Billie; Crosby, Lori; Klasnja, Predrag; Murphy, SusanMobile Health mHealth interventions are a promising tool in providing digitally mediated integrative care They can extend care outside of the clinic by providing reminders to take medications assisting in managing symptoms and supporting healthy behaviors including physical activity healthy eating and stress management mHealth interventions can adapt the delivery of care across time in order to optimize treatment effectiveness Yet there exists limited empirical evidence useful to the development of adaptive mHealth interventions This paper describes a new randomized trial design the Micro Randomized Trial MRT for informing the development of mHealth interventions We provide examples of scientific questions important to the development of a mHealth intervention and describe how these questions can be answered using an MRT This article is protected by copyright All rights reserved
- ItemProbing the benefits of real-time tracking during cancer care.(2013-01-10) Patel, Rupa A; Klasnja, Predrag; Hartzler, Andrea; Unruh, Kenton T; Pratt, WandaPeople with cancer experience many unanticipated symptoms and struggle to communicate them to clinicians Although researchers have developed patient reported outcome PRO tools to address this problem such tools capture retrospective data intended for clinicians to review In contrast real time tracking tools with visible results for patients could improve health outcomes and communication with clinicians while also enhancing patients symptom management To understand potential benefits of such tools we studied the tracking behaviors of 25 women with breast cancer We provided 10 of these participants with a real time tracking tool that served as a technology probe to uncover behaviors and benefits from voluntary use Our findings showed that while patients tracking behaviors without a tool were fragmented and sporadic these behaviors with a tool were more consistent Participants also used tracked data to see patterns among symptoms feel psychosocial comfort and improve symptom communication with clinicians We conclude with design implications for future real time tracking tools
- ItemRethinking Evaluations Of mHealth Systems For Behavior Change.(0000-00-00) Klasnja, Predrag; Hekler, Eric B
- ItemSupporting cancer patients' unanchored health information management with mobile technology.(2011-12-23) Klasnja, Predrag; Hartzler, Andrea; Powell, Christopher; Pratt, WandaCancer patients often need to manage care related information when they are away from home when they are experiencing pain or treatment side effects or when their abilities to deal with information effectively are otherwise impaired In this paper we describe the results from a four week evaluation of HealthWeaver Mobile a mobile phone application that we developed to support such unanchored patient information activities Based on experiences from nine cancer patients our results indicate that HealthWeaver Mobile can help patients to access care related information from anywhere to capture information whenever a need arises and to share information with clinicians during clinic visits The enhanced ability to manage information in turn helps patients to manage their care and to feel more confident in their ability to stay in control of their information and their health
- ItemToward Increasing Engagement in Substance Use Data Collection: Development of the Substance Abuse Research Assistant App and Protocol for a Microrandomized Trial Using Adolescents and Emerging Adults.(0000-00-00) Rabbi, Mashfiqui; Philyaw Kotov, Meredith; Cunningham, Rebecca; Bonar, Erin E; Nahum-Shani, Inbal; Klasnja, Predrag; Walton, Maureen; Murphy, SusanBACKGROUND Substance use is an alarming public health issue associated with significant morbidity and mortality Adolescents and emerging adults are at particularly high risk because substance use typically initiates and peaks during this developmental period Mobile health apps are a promising data collection and intervention delivery tool for substance using youth as most teens and young adults own a mobile phone However engagement with data collection for most mobile health applications is low and often large fractions of users stop providing data after a week of use OBJECTIVE Substance Abuse Research Assistant SARA is a mobile application to increase or sustain engagement of substance data collection overtime SARA provides a variety of engagement strategies to incentivize data collection a virtual aquarium in the app grows with fish and aquatic resources occasionally funny or inspirational contents eg memes or text messages are provided to generate positive emotions We plan to assess the efficacy of SARA s engagement strategies over time by conducting a micro randomized trial where the engagement strategies will be sequentially manipulated METHODS We aim to recruit participants aged 14 24 years who report any binge drinking or marijuana use in the past month Participants are instructed to use SARA for 1 month During this period participants are asked to complete one survey and two active tasks every day between 6 pm and midnight Through the survey we assess participants daily mood stress levels loneliness and hopefulness while through the active tasks we measure reaction time and spatial memory To incentivize and support the data collection a variety of engagement strategies are used First predata collection strategies include the following 1 at 4 pm a push notification may be issued with an inspirational message from a contemporary celebrity or 2 at 6 pm a push notification may be issued reminding about data collection and incentives Second postdata collection strategies include various rewards such as points which can be used to grow a virtual aquarium with fishes and other treasures and modest monetary rewards up to US 12 US 1 for each 3 day streak also participants may receive funny or inspirational content as memes or gifs or visualizations of prior data During the study the participants will be randomized every day to receive different engagement strategies In the primary analysis we will assess whether issuing 4 pm push notifications or memes or gifs respectively increases self reporting on the current or the following day RESULTS The microrandomized trial started on August 21 2017 and the trial ended on February 28 2018 Seventy three participants were recruited Data analysis is currently underway CONCLUSIONS To the best of our knowledge SARA is the first mobile phone app that systematically manipulates engagement strategies in order to identify the best sequence of strategies that keep participants engaged in data collection Once the optimal strategies to collect data are identified future versions of SARA will use this data to provide just in time adaptive interventions to reduce substance use among youth TRIAL REGISTRATION ClinicalTrials gov NCT03255317 https clinicaltrials gov show NCT03255317 Archived by WebCite at http www webcitation org 70raGWV0e REGISTERED REPORT IDENTIFIER RR1 10 2196 9850
- ItemTutorial for Using Control Systems Engineering to Optimize Adaptive Mobile Health Interventions.(0000-00-00) Hekler, Eric B; Rivera, Daniel E; Martin, Cesar A; Phatak, Sayali S; Freigoun, Mohammad T; Korinek, Elizabeth; Klasnja, Predrag; Adams, Marc A; Buman, Matthew PBACKGROUND Adaptive behavioral interventions are individualized interventions that vary support based on a person s evolving needs Digital technologies enable these adaptive interventions to function at scale Adaptive interventions show great promise for producing better results compared with static interventions related to health outcomes Our central thesis is that adaptive interventions are more likely to succeed at helping individuals meet and maintain behavioral targets if its elements can be iteratively improved via data driven testing ie optimization Control systems engineering is a discipline focused on decision making in systems that change over time and has a wealth of methods that could be useful for optimizing adaptive interventions OBJECTIVE The purpose of this paper was to provide an introductory tutorial on when and what to do when using control systems engineering for designing and optimizing adaptive mobile health mHealth behavioral interventions OVERVIEW We start with a review of the need for optimization building on the multiphase optimization strategy MOST We then provide an overview of control systems engineering followed by attributes of problems that are well matched to control engineering Key steps in the development and optimization of an adaptive intervention from a control engineering perspective are then summarized with a focus on why what and when to do subtasks in each step IMPLICATIONS Control engineering offers exciting opportunities for optimizing individualization and adaptation elements of adaptive interventions Arguably the time is now for control systems engineers and behavioral and health scientists to partner to advance interventions that can be individualized adaptive and scalable This tutorial should aid in creating the bridge between these communities
- ItemUsing mobile And personal sensing technologies to support health behavior change in everyday life: lessons learned.(2010-03-30) Klasnja, Predrag; Consolvo, Sunny; McDonald, David W; Landay, James A; Pratt, WandaLifestyle modification is a key facet of the prevention and management of chronic diseases Mobile devices that people already carry provide a promising platform for facilitating these lifestyle changes This paper describes key lessons learned from the development and evaluation of two mobile systems for encouraging physical activity We argue that by supporting persistent cognitive activation of health goals encouraging an extensive range of relevant healthy behaviors focusing on long term patterns of activity and facilitating social support as an optional but not primary motivator systems can be developed that effectively motivate behavior change and provide support when and where people make decisions that affect their health