Read summaries of the research that won the 2014 targeted grants.
Ecological Momentary Assessment (EMA) of Affect and Health Behavior
By Christopher Cushing, PhD
A number of psychosocial variables have been identified as key predictors of adolescent physical activity. However, current research methodologies are limited to assessing these key predictors on the interval of weeks to months while the power of interventions using mobile technology (mHealth) lies in the ability to assess and intervene on the order of seconds to minutes. Consequently, there is a gap between the available science and the consumer marketplace, which has already begun developing mHealth tools with inadequate research support. The public health potential of the mHealth marketplace cannot be fully realized without basic science to inform consumer-facing interventions. The proposed project will begin to fill this gap in the literature by utilizing a novel methodology for reliably and validly assessing moment-to-moment psychosocial, physiological, and behavioral variables that influence adolescent physical activity. One hundred participants will be recruited to answer ecological momentary assessment (EMA) surveys on a smartphone four times per day, wear a trunk-worn physiological monitoring system 12-hours per day, and a wrist-worn accelerometer 24-hours per day for 14-days. Once the factor structure of the EMA assessment is established, path analysis will be conducted to investigate hypothesized relationships between sleep, physical activity, and psychosocial variables.
Developing a Culturally Tailored Acceptance-Based Behavioral Intervention to Improve Glycemic Control and Quality of Life among Low Income Adolescents with Type-1 Diabetes
By Kris Berlin, PhD
Type-1 Diabetes in childhood is a prevalent and costly disorder associated with substantial morbidity that differentially impacts low-income and minority youth and their families. Given the increased risk for life-threatening consequences of suboptimal glycemic control and evidence of only modest treatment efficacy in general, the development of a comprehensive, innovative and culturally sensitive treatment program is critically needed.
Preliminary data from Dr. Berlin’s Predicting Resiliency in Youth with Type-1 Diabetes (PRYDE) study suggest that diabetes-specific and general processes targeted by Acceptance and Commitment Therapy (ACT; mindfulness, psychological flexibility, values-based living) relate to diabetes-outcomes (HbA1c, quality of life, adherence, family conflict, stress, etc.), and general psychosocial outcomes (family functioning, parenting, youth’s emotional functioning) among a primarily low-income, minority urban sample with T1D and suboptimal glycemic control. As such, the focus of Dr. Berlin’s SPP Targeted Research Grant will be to develop and refine intervention content and procedures based on feedback from qualitative interviews and focus groups with youth with T1D, caregivers, and medical providers. This information will be used to create an initial therapist manual and therapy materials to be used for a later open trial and to support the submission of intervention development grants.
First Steps in Translation of SMARTPHONE JITAI for Obesity Treatment and Prevention
By Elizabeth Kuhl, PhD
Just-In-Time Adaptive Interventions (JITAIs) are an innovative approach to behavioral treatment development where intervention strategies are offered in real-time and adapt based upon a patient’s momentary needs and treatment progress. The Alcohol-Comprehensive Health Enhancement Support System(A-CHESS) is an example of an efficacious SMARTPHONE JITAI whose components(social support, virtual counseling, education and training, location tracking, assessments, and alerts) may facilitate mastery of the food budgeting and time management skills our formative work suggests are necessary for caregivers of obese preschoolers from low-income backgrounds to translate dietary recommendations for treatment of pediatric obesity into practice while simultaneously minimizing logistical barriers to intervention participation. Given 86 percent of preschoolers from low-income backgrounds are of a healthy weight, identifying food-related budgeting skills, purchasing patterns, and routines differentiating their caregivers from those of obese preschoolers is an important first step to developing a SMARTPHONE JITAI targeting these domains. Forty caregivers (20 with non-overweight and 20 with obese preschoolers) will be recruited from Detroit-based WIC clinics for this study. A mixed methods data collection approach (questionnaire, virtual grocery store experiment, food receipt collection, ecological momentary assessment, and focus groups) will be utilized to evaluate our specific aim.