Mobile Approaches to Promote Moderate to Vigorous Physical Activity in Type 1 Diabetes
Description: Type 1 Diabetes (T1D) affects ~1 million American adults and increases the risk of mortality attributable to cardiovascular disease by 800%. Interventions for T1D address glycemic control but not overall cardiovascular risk. Moderate-to-vigorous physical activity (MVPA) interventions could provide a novel solution if they could innovatively address the diabetes management and psychosocial challenges around MVPA posed by T1D. Continuous glucose monitoring (CGM) can capture the glycemic impact of exercise on type 1 diabetes (T1D) management, but evidence-based interventions to translate CGM feedback into sustainable adherence to exercise-related behaviors are lacking. Our human-delivered pilot intervention provided adults with T1D access to MVPA videos and monthly client-centered discussions of their CGM and MVPA data with an MVPA coach. Participants said these improved MVPA management behavioral skills and motivation transiently, but stated a need for more frequent and sustained contact, which will require informatics-based automated tools that the present research program will develop. The program represents stages 0-2 of the NIH intervention development model: basic science (informatics analysis of prior-collected data), intervention generation, refinement, modification, adaptation (qualitative evaluation of user perception and receptivity to alpha versions of the tools, modifications according to their feedback), and efficacy testing (clinical trial of beta version of the tool). The informatics-based tools are daily just-in-time adaptive text messages to overcome MVPA barriers at times of vulnerability (using machine learning classification), daily personalized review of short-term MVPA safety hazards with tips to avoid them (using heuristic algorithms), and monthly personalized evaluation of long-term impact of MVPA on blood glucose levels (using Bayesian modeling). This work will inform a Small Business Technology Transfer application to disseminate the application through commercial and healthcare system channels, and an R-Series proposal to test real-world effectiveness by an advanced trial design (e.g., multiphase optimization strategy). The expected outcome is a novel mobile intervention tool that leverages cutting edge informatics to address low MVPA levels and cardiovascular-related sequalae in adults with T1D.
Funder: American Heart Association
Amount: $230,500
Funding type: fellowship
Funder scheme: Career Development Award
Start date: 2021-07-01
End date: 2024-06-30
Investigators: Garrett Ash, Garrett Ash
Institution: Yale University
Funded outputs count: 13
Funder award ID: 852679
OpenAlex ID: G687547249