Abstract Research shows that skills for improving Psychological Well‐Being (PWB) may belearnedthrough PWB interventions; however, the dynamic mechanisms underlying this learning process are not well understood. Using an Ecological Momentary Intervention (EMI) design, we conducted an 8‐week Randomized Controlled Trial (N = 160; aged 18–22 years), implemented in a mobile Health (mHealth) platform to characterize these dynamical mechanisms. College‐attending early adults were randomized to three groups: an active control group (N = 55); an intervention group (N = 51) with positive practices intervention; and a second intervention group (N = 54) with positive practices and meditation intervention. The mHealth implementation allowed us to introduce the interventions in participants' daily lives while also assessing their PWB (in terms of positive emotions and relationship quality) several times a day. We used a Bayesian process model to analyze changes in PWB in terms of the underlying dynamical characteristics of change. Findings suggested that the mobile assessment tool itself may have longitudinally improved college‐attending early adults' PWB, as evidenced by instances of directional changes in dynamic characteristics (increased within‐person mean levels, decreased intra‐individual variability, and increased regulation) of PWB measures. Moderation analysis also revealed that people who were low on negative affect improved the most in terms of their mean levels of positive emotions and relationship quality.
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Rehabilitation Using Mobile Health for Older Adults With Ischemic Heart Disease in the Home Setting (RESILIENT): Protocol for a Randomized Controlled Trial
Background Participation in ambulatory cardiac rehabilitation remains low, especially among older adults. Although mobile health cardiac rehabilitation (mHealth-CR) provides a novel opportunity to deliver care, age-specific impairments may limit older adults’ uptake, and efficacy data are currently lacking. Objective This study aims to describe the design of the rehabilitation using mobile health for older adults with ischemic heart disease in the home setting (RESILIENT) trial. Methods RESILIENT is a multicenter randomized clinical trial that is enrolling patients aged ≥65 years with ischemic heart disease in a 3:1 ratio to either an intervention (mHealth-CR) or control (usual care) arm, with a target sample size of 400 participants. mHealth-CR consists of a commercially available mobile health software platform coupled with weekly exercise therapist sessions to review progress and set new activity goals. The primary outcome is a change in functional mobility (6-minute walk distance), which is measured at baseline and 3 months. Secondary outcomes are health status, goal attainment, hospital readmission, and mortality. Among intervention participants, engagement with the mHealth-CR platform will be analyzed to understand the characteristics that determine different patterns of use (eg, persistent high engagement and declining engagement). Results As of December 2021, the RESILIENT trial had enrolled 116 participants. Enrollment is projected to continue until October 2023. The trial results are expected to be reported in 2024. Conclusions The RESILIENT trial will generate important evidence about the efficacy of mHealth-CR among older adults in multiple domains and characteristics that determine the sustained use of mHealth-CR. These findings will help design future precision medicine approaches to mobile health implementation in older adults. This knowledge is especially important in light of the COVID-19 pandemic that has shifted much of health care to a remote, internet-based setting. Trial Registration ClinicalTrials.gov NCT03978130; https://clinicaltrials.gov/ct2/show/NCT03978130 International Registered Report Identifier (IRRID) DERR1-10.2196/32163
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- Award ID(s):
- 1700832
- PAR ID:
- 10348233
- Date Published:
- Journal Name:
- JMIR Research Protocols
- Volume:
- 11
- Issue:
- 3
- ISSN:
- 1929-0748
- Page Range / eLocation ID:
- e32163
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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