MODEL, ARCHITECTURE AND APPLICATION OF CROSS-PLATFORM JUST-IN-TIME ADAPTIVE INTERVENTION (JITAI): AN IMPLEMENTATION IN BEHAVIORAL SLEEP INTERVENTION

Cognitive-behavioral therapies (CBT) are common types of non-pharmacological therapy used in treating mental illnesses and behavioral disorders. Smartphone-based interventions have the potential for improving the delivery of traditional CBT with such novel features as personalization and context awareness. Assessments and interventions are best delivered when they are personalized to fit each individual’s needs and conditions. Just in Time Adaptive Intervention (JITAI) combines this personalized and adaptive intervention with the use of mobile technology. An increasing number of studies have been conducted to assess the effect of JITAI on regulating human health behavior, however there has been no published theoretical model underlying the use of smartphones and mobile devices in relation with JITAI. Therefore, this work aimed to provide 1) a behavioral model and application architecture for JITAI, 2) implementation of the JITAI model and application architecture on behavioral sleep intervention, 3) clinical and usability outcomes of the implementation, and 4) evaluate the model and its clinical feasibility. The JITAI model, architecture and application were designed to accommodate various adaptive health/behavioral interventions. Nevertheless, in this dissertation, sleep intervention was chosen as the case study because 1) sleep is universal recurrent behavior; 2) behavioral sleep treatments are “adaptive” treatment, highly manualized and have well defined outcome measurements. This cross-platform implementation of the JITAI architecture for sleep intervention is named the interactive Resilience Enhancing Sleep Tactics (iREST). The JITAI model, architecture and application were evaluated based on the result of usability and feasibility study of iREST system (n=22). The results suggest that the system were highly usable with a mean SUS (System Usability Scale) score of 85.74. Rate of treatment response (84.21%) and remission (68.42%) were greater than those reported on previous traditional (in-person) behavioral sleep intervention trial. This finding suggests that the JITAI model and architecture are feasible tools for designing and implementing adaptive health behavior intervention through mHealth

The American Academy of Health Behavior 2024 Annual Scientific Meeting: Health Communication, (Mis-)Information, and Behavior: Leveraging Technology for Behavioral Interventions and Health Behavior Research

The American Academy of Health Behavior (AAHB) hosted its 24th Annual Scientific Meeting at The DeSoto Hotel in Savannah, Georgia on April 14-17, 2024. The meeting\u27s theme was “Health Communication, (Mis-)Information, and Behavior: Leveraging Technology for Behavioral Interventions and Health Behavior Research . This publication describes the meeting theme and includes the refereed abstracts presented at the 2024 Annual Scientific Meeting

Exploring perspectives of people with type-1 diabetes on goalsetting strategies within self-management education and care

Background. Collaborative goal-setting strategies are widely recommended for diabetes self-management support within healthcare systems. Creating self-management plans that fit with peoples’ own goals and priorities has been linked with better diabetic control. Consequently, goal-setting has become a core component of many diabetes selfmanagement programmes such as the ‘Dose Adjustment for Normal Eating (DAFNE) programme’. Within DAFNE, people with Type-1 Diabetes (T1D) develop their own goals along with action-plans to stimulate goal-achievement. While widely implemented, limited research has explored how goal-setting strategies are experienced by people with diabetes.Therefore, this study aims to explore the perspectives of people with T1D on theimplementation and value of goal-setting strategies within DAFNE and follow-up diabetes care. Furthermore, views on barriers and facilitators to goal-attainment are explored.Methods. Semi-structured interviews were conducted with 20 people with T1D who attended a DAFNE-programme. Following a longitudinal qualitative research design, interviews took place 1 week, and 6-8 months after completion of DAFNE. A recurrent cross-sectional approach is applied in which themes will be identified at each time-point using thematic analyses.Expected results. Preliminary identified themes surround the difference in value that participants place on goal-setting strategies, and the lack of support for goal-achievement within diabetes care.Current stage. Data collection complete; data-analysis ongoing.Discussion. Goal-setting strategies are increasingly included in guidelines for diabetes support and have become essential parts of many primary care improvement schemes. Therefore, exploring the perspectives of people with T1D on the value and implementation of goal-setting strategies is vital for their optimal application