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Principal Investigator: Kavita Radhakrishnan
Organization: UNIVERSITY OF TEXAS AT AUSTIN
Fiscal Year: 2024
Award: $722,583
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY/ABSTRACT
Heart failure (HF) is a growing pandemic; in the U.S., the number of those diagnosed with HF is expected to
rise to 8 million with annual costs at $69 billion by 2030. Despite effective interventions to reduce HF morbidity
and mortality, vulnerable populations with HF suffer disproportionately from hospitalization and mortality
especially in the southern U.S. states. Self-management (SM) behavioral interventions to improve HF
outcomes are therefore imperative. Remote interventions to promote SM behaviors present an important
strategy to address the widening geographical and racial health disparities in HF outcomes. One promising
approach is the use of sensor-controlled digital games (SCDGs), which offer affordable, portable, scalable tools
to facilitate engagement in HF SM behaviors that show the poorest adherence (weight monitoring and physical
activity) while being enjoyable and easy to use. The primary goal of this study is to evaluate the efficacy of a
SCDG intervention that integrates HF participants’ behavioral data from weight scale and activity tracker
sensors to activate game progress, rewards, and feedback. For Aim 1, we will refine an SCDG that we have
already developed for mobile smartphones to be playable for longer durations for sustained behavior
adherence to weight-monitoring and physical activity. For Aim 2, using a randomized controlled clinical trial, we
will compare the SCDG intervention versus a sensor-only intervention for the primary outcome of rate of
engagement in the HF SM behavior of weight-monitoring and the secondary outcomes of physical activity
behavior engagement, HF SM knowledge, self-efficacy, HF functional status, hospitalization, and quality of life
at baseline and at 6, 12, and 24 weeks. For our sample, we will recruit adults aged 45 years or older from 7
southern U.S. states and hospitalized with HF within the past 6 months. We will randomize 200 participants to
either the SCDG intervention group, in which participants will receive sensors that track weight monitoring and
activity and will play the SCDG on a mobile smartphone, or a control group that will receive sensors, an app
that tracks activity and weight monitoring, and standardized written HF educational materials. For Aim 3, we
will conduct a mixed-methods assessment to discern facilitators and barriers impacting participants’
engagement with the sensor-based interventions for HF SM behavior adherence. For Aim 4, based on daily HF
SM weight-monitoring and physical activity behavior data and ecological momentary assessments of
symptoms, mood, satisfaction, and cognitive status, we will conduct digital phenotyping of HF SM weight-
monitoring and physical activity behaviors. This project will generate insight and guidance for scalable and
easy-to-use digital gaming solutions to motivate persistent adherence to HF SM behaviors and improve health
outcomes among individuals with HF.
Terms: <21+ years old><Accelerometer><Active Learning><Address><Adherence><Adult><Adult Human><Age><Behavior><Behavior Conditioning Therapy><Behavior Modification><Behavior Therapy><Behavior Treatment><Behavioral><Behavioral Conditioning Therapy><Behavioral Model><Behavioral Modification><Behavioral Therapy><Behavioral Treatment><Biometrics><Biometry><Biostatistics><Cardiac health><Cell Phone><Cellular Phone><Cellular Telephone><Chronic Disease><Chronic Illness><Clinical Trials><Cognitive><Computer Software Development><Computer Software Engineering><Conditioning Therapy><Control Groups><Cooperative Learning><Data><Death Rate><Diabetes Mellitus><Diagnosis><Disparities><Disparity><Drugs><Ecological momentary assessment><Education><Educational Materials><Educational aspects><Electronics><Equilibrium><Experiential Learning><Face><Feasibility Studies><Feedback><Foundations><Geographic Area><Geographic Locations><Geographic Region><Geographical Location><Geography><Goals><Habits><Health><Health Promotion><Heart><Heart failure><Heart health><Home><Hospital Admission><Hospitalization><Incentives><Individual><Intervention><Intervention Strategies><Knowledge><Knowledge Management><Life Style><Lifestyle><Measures><Medication><Methods><Mobile Phones><Monitor><Moods><Morbidity><Morbidity - disease rate><Motivation><Oklahoma><Outcome><Participant><Patient Compliance><Pattern><Pharmaceutical Preparations><Physical activity><Play><Precision Health><Prevention><Psychology><QOL><Quality of life><Randomized><Randomized Controlled Clinical Trials><Randomized, Controlled Trials><Recommendation><Regimen><Research Resources><Resources><Rewards><Salutogenesis><Sampling><Self Efficacy><Self Management><Software Engineering><Standardization><Symptoms><Technology><Texas><Time><Vulnerable Populations><Weight><Weight maintenance regimen><Writing><accelerometry><activity monitor><activity tracker><adulthood><age group><aged><ages><balance><balance function><behavior adherence><behavior change><behavior intervention><behavior outcome><behavioral adherence><behavioral intervention><behavioral outcome><cardiac failure><chronic disorder><compliance behavior><cost><design><designing><determine efficacy><diabetes><digital><digital phenotyping><disparity in health><drug/agent><effective intervention><efficacy analysis><efficacy assessment><efficacy determination><efficacy evaluation><efficacy examination><electronic><electronic device><evaluate efficacy><evidence base><examine efficacy><faces><facial><feasibility trial><functional status><geographic site><group intervention><health disparity><healthcare burden><homes><hospital re-admission><hospital readmission><hospitalization rates><iPhone><impaired functional status><improved><individual response><individualized response><innovate><innovation><innovative><insight><interventional strategy><mortality><mortality rate><mortality ratio><older adult><older adulthood><pandemic><pandemic disease><participant engagement><patient adherence><patient cooperation><patient engagement><portability><primary outcome><processing speed><promoting health><prospective><racial disparities in health><racial health disparity><randomisation><randomization><randomized control clinical trial><randomized control trial><randomly assigned><re-admission><re-hospitalization><readmission><recruit><rehospitalization><remote intervention><response><satisfaction><scale up><secondary outcome><sensor><skills><smart phone><smartphone><social><technology intervention><technology-based interventions><technology-enabled interventions><technology-focused interventions><tool><vulnerable group><vulnerable individual><vulnerable people><weight control><weight management><weights>