Feasibility, Acceptability, and Influence of mHealth-Supported N-of-1 Trials for Enhanced Cognitive and Emotional Well-Being in US Volunteers

Frontiers in Public Health

article

Richard L. Kravitz¹  Stephen M. Schueller²  Ida Sim³  Jiabei Yang⁴  Christopher H. Schmid⁴  Adrian Aguilera⁵  Elaine J. Chen¹  Yong K. Choi⁶  Eric Hekler⁷  Chris Karr⁸  Katherine K. Kim⁶  Sayali Phatak⁹  Sayantani Sarkar⁶ 

[1] Division of General Medicine, UC Davis Health, United States;Department of Psychological Science, University of California, United States;Department of Medicine, University of California, United States;Department of Biostatistics and Center for Evidence Synthesis in Health, School of Public Health, Brown University, United States;School of Social Welfare, University of California, United States;Betty Irene Moore School of Nursing, University of California, United States;Center for Wireless & Population Health Systems, Qualcomm Institute, Department of Family Medicine & Public Health, Design Lab, University of California, United States;Inc., United States;College of Health Solutions, Arizona State University, United States

关键词: N-of-1 trial;    single patient trial;    mobile health;    digital health;    behavioral health;    psychological well-being;   

DOI  :  10.3389/fpubh.2020.00260

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Although group-level evidence supports the use of behavioral interventions to enhance cognitive and emotional well-being, different interventions may be more acceptable or effective for different people. N-of-1 trials are single-patient crossover trials designed to estimate treatment effectiveness in a single patient. We designed a mobile health (mHealth) supported N-of-1 trial platform permitting US adult volunteers to conduct their own 30-day self-experiments testing a behavioral intervention of their choice (deep breathing/meditation, gratitude journaling, physical activity, or helpful acts) on daily measurements of stress, focus, and happiness. We assessed uptake of the study, perceived usability of the N-of-1 trial system, and influence of results (both reported and perceived) on enthusiasm for the chosen intervention (defined as perceived helpfulness of the chosen intervention and intent to continue performing the intervention in the future). Following a social media and public radio campaign, 447 adults enrolled in the study and 259 completed the post-study survey. Most were highly educated. Perceived system usability was high (mean scale score 4.35/5.0, SD 0.57). Enthusiasm for the chosen intervention was greater among those with higher pre-study expectations that the activity would be beneficial for them ( p < 0.001), those who obtained more positive N-of-1 results (as directly reported to participants) ( p < 0.001), and those who interpreted their N-of-1 study results more positively ( p < 0.001). However, reported results did not significantly influence enthusiasm after controlling for participants' interpretations. The interaction between pre-study expectation of benefit and N-of-1 results interpretation was significant ( p < 0.001), such that those with the lowest starting pre-study expectations reported greater intervention enthusiasm when provided with results they interpreted as positive. We conclude that N-of-1 behavioral trials can be appealing to a broad albeit highly educated and mostly female audience, that usability was acceptable, and that N-of-1 behavioral trials may have the greatest utility among those most skeptical of the intervention to begin with.

【 授权许可】

CC BY