An Integrated Closed-loop Feedback System for Pediatric Cardiometabolic Disease

NCT ID: NCT02659163

Last Updated: 2017-09-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

EARLY_PHASE1

Total Enrollment

68 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-31

Study Completion Date

2018-10-31

Brief Summary

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The high prevalence and burden of cardiometabolic disease underlie the urgent need to identify novel approaches to managing and preventing cardiometabolic disease and risk. This project will test an innovative use of mobile health technology to implement a closed-loop feedback system that collects objective patient-generated data and provides clinical recommendations to modify contributing health behaviors. In addition to improving care for cardiometabolic disease, the tools and methods developed by this study for collecting patient data and providing clinical feedback could also easily be adapted and applied to a range of other health conditions, and are thus highly relevant to public health.

Detailed Description

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Cardiometabolic disease - a clustering of medical conditions and risk factors which includes obesity, diabetes, impaired liver function, and an increased risk in children for adult-onset cardiovascular disease - represents a major population-wide health burden in the United States. Management of cardiometabolic disease also imposes a substantial financial burden on the economy and ties up significant healthcare resources. It is well-known that many of the lifestyle and health behaviors that contribute to cardiometabolic disease are difficult to modify once established, and childhood represents an opportune time for promoting healthy behaviors. Patient-centered outcomes research (PCOR) has identified certain health behaviors as important and actionable in modifying cardiometabolic risk, namely weight management, physical activity, screen-time, sleep, and consumption of sugar-sweetened beverages. Mobile health technology (mHealth) could be used to monitor and counsel on common health behaviors associated with cardiometabolic risk, which may facilitate the inclusion of PCOR evidence on cardiometabolic disease into clinical practice. The overall goal of this research is to use mHealth technology to accelerate the uptake of PCOR findings on treatment of cardiometabolic disease. To achieve our goal, this study will develop a novel set of mHealth tools capable of collecting health behavior information and determine to what extent providing clinical feedback on these health behaviors improves obesity and health behaviors among children ages 6-12 year and their families. In this study we will develop, implement, and test the comparative clinical effectiveness of a closed-loop feedback system for collecting patient data and providing recommendations. The specific aims of this study are: 1) to develop an integrated closed-loop feedback system that incorporates longitudinal mHealth data in managing cardiometabolic disease among at-risk families, and 2) to determine the extent to which an integrated closed-loop system that provides feedback on objective patient-generated data improves cardiometabolic risk, as measured by changes in body mass index and health behaviors including, physical activity, screen-time, sleep, and sugar-sweetened beverage consumption. This research will develop novel mHealth tools and approaches that will allow healthcare providers and patients to better understand disease risk and improve disease management by collecting patient data 1) repeatedly over time, 2) simultaneously, and 3) objectively. This study is innovative because it will use mHealth tools to simultaneously collect longitudinal data on multiple health behaviors known to be associated with cardiometabolic risk, and it will offer a new approach to implementing and disseminating PCOR findings via a novel closed-loop feedback system. The high prevalence of cardiometabolic disease makes this innovative closed-loop system very relevant to public health. The mHealth tools and methods developed by this study for collecting patient data and providing clinical feedback could also easily be adapted and applied to a range of other health conditions.

Conditions

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Obesity Health Behavior

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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intervention

Intervention subjects will receive feedback on their health behaviors along with clinical recommendations.

Group Type EXPERIMENTAL

mHealth wristband

Intervention Type BEHAVIORAL

A wristband containing several sensors worn by participants to collect daily objective patient-generated health behavior data on physical activity, sleep, and screen time

mHealth scale

Intervention Type BEHAVIORAL

A wireless scale used by participants to measure and record daily weight.

EMA

Intervention Type BEHAVIORAL

Self-reported information on sugar sweetened beverage consumption collected via mobile messaging

mHealth app

Intervention Type BEHAVIORAL

A mobile application that houses study data and provides two-way messaging between the study team and study participants.

Integrated closed-loop feedback system

Intervention Type BEHAVIORAL

Daily feedback and weekly e-report cards on patient-generated longitudinal health behaviors along with clinical recommendations via mobile messaging

control

Control subjects will receive feedback on their health behaviors for self-guided care.

Group Type ACTIVE_COMPARATOR

mHealth wristband

Intervention Type BEHAVIORAL

A wristband containing several sensors worn by participants to collect daily objective patient-generated health behavior data on physical activity, sleep, and screen time

mHealth scale

Intervention Type BEHAVIORAL

A wireless scale used by participants to measure and record daily weight.

EMA

Intervention Type BEHAVIORAL

Self-reported information on sugar sweetened beverage consumption collected via mobile messaging

mHealth app

Intervention Type BEHAVIORAL

A mobile application that houses study data and provides two-way messaging between the study team and study participants.

Health Behavior Feedback

Intervention Type BEHAVIORAL

Provide feedback on patient-generated health behaviors data, along with standard of care recommendations, for self-guided

Interventions

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mHealth wristband

A wristband containing several sensors worn by participants to collect daily objective patient-generated health behavior data on physical activity, sleep, and screen time

Intervention Type BEHAVIORAL

mHealth scale

A wireless scale used by participants to measure and record daily weight.

Intervention Type BEHAVIORAL

EMA

Self-reported information on sugar sweetened beverage consumption collected via mobile messaging

Intervention Type BEHAVIORAL

mHealth app

A mobile application that houses study data and provides two-way messaging between the study team and study participants.

Intervention Type BEHAVIORAL

Health Behavior Feedback

Provide feedback on patient-generated health behaviors data, along with standard of care recommendations, for self-guided

Intervention Type BEHAVIORAL

Integrated closed-loop feedback system

Daily feedback and weekly e-report cards on patient-generated longitudinal health behaviors along with clinical recommendations via mobile messaging

Intervention Type BEHAVIORAL

Other Intervention Names

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sensors wireless sscale Sugar Sweetened Beverage Assessment

Eligibility Criteria

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Inclusion Criteria

* ages 6-12 years
* body mass index categorized as overweight or obese
* followed for obesity care
* an adult household family member with one or more elevated cardiometabolic risk, as defined by established or documented increased risk of cardiometabolic disease (overweight, obesity, hypertension, coronary artery disease, diabetes or glucose intolerance, dyslipidemia, non-alcoholic fatty liver disease, cerebrovascular disease)
* participating parent must own Android Smartphone
* Wi-Fi access at home
* speak and read English

Exclusion Criteria

* n/a
Minimum Eligible Age

6 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Massachusetts Institute of Technology

OTHER

Sponsor Role collaborator

Massachusetts General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Nicolas M. Oreskovic, MD, MPH

Assistant Professor of Pediatrics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nicolas M Oreskovic, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Central Contacts

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Nicolas M Oreskovic, MD, MPH

Role: CONTACT

617.726.0593

John D Knutsen, PhD

Role: CONTACT

617.726.6721

Other Identifiers

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R21HS024001

Identifier Type: AHRQ

Identifier Source: org_study_id

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